Public-health activists are organizing a forum to remind Canada that it is not living up to its commitment under the Declaration of Alma-Ata, a major international agreement on health care that will mark its 30th anniversary in September this year.
Adopted at an international conference organized by the World Health Organization and UNICEF in the city of Alma-Ata (now Almaty) in the then–Soviet republic of Kazakhstan, the declaration set the goal of providing all citizens of the world “a level of health that will permit them to lead a socially and economically productive life”.
But according to Vancouver-based health activist Yuly Chan, Statistics Canada findings released in 2008 indicate that about 1.7 million Canadians cannot find a family doctor.
“The declaration set the goal of health for all by year 2000 mainly by providing primary health care, and we all know that the first point of contact for health care is the family physician,” Chan, spokesperson of the Alliance of People’s Health, told the Georgia Straight. (The alliance will host the forum on the last weekend of September at the SFU Harbour Centre campus.)
Vancouver resident Cathy Woods is among the one out of 15 Canadians found by the StatsCan study (released in June 2008) to be having difficulties in getting accepted as a regular patient by a family doctor.
Woods, a 66-year-old former school teacher, describes as “bizarre” her experience for the past two-and-a-half years in trying to find a family physician.
“Eight of them have turned me down,” Woods told the Straight. “In each case, they say something different. All of a sudden [they claimed], ”˜I’ve got more patients and I’m busier than I thought I would be.’ ”
A mother of three grown children, Woods related that she used to have a family doctor who looked after her overall health and prescribed morphine to ease the pain caused by a chronic illness. When the doctor decided to relocate to Toronto, Woods said she couldn’t get a replacement doctor from any of the physicians in the same clinic where she used to see her physician.
Woods later found a doctor to prescribe her morphine, and this practitioner referred her to three MDs who turned her down.
In August, Woods said, she went to the clinic of Dr. Peter Marr on Robson Street. “He never really looked at me,” Woods recalled. “He went on his computer; he said: ”˜Is it all right if I see your medications?’ I didn’t know he was just gonna search on-line and find my medications. And so he sees morphine, he said: ”˜Oh I don’t deal with that.’ I said, ”˜No, you won’t have to; I have a doctor that I get that from.’ And then a little while later, he said: ”˜I don’t do narcotics addictions.’ I said, ”˜I don’t have an addiction.’ He said, ”˜I don’t treat chronic pain.’ ”
Marr has bought a newspaper ad stating that he is accepting new patients, and these include families, children, men and women, seniors, and prenatal.
The Straight sought Marr for comment, and an e-mail from the clinic in response read: “The nature of her medical problem is not appropriate for my family practice.”
According to the 2008 StatsCan report, there are actually about 4.1 million people who don’t have a regular medical doctor, because they were either unable to find one or they hadn’t looked.
Of those 4.1 million Canadians without a regular doctor, StatsCan reported that 3.3 million people sought treatment through various ways. They did so through walk-in clinics, hospital emergency rooms, community health centres, hospital outpatient clinics, and telephone health lines.
Vancouver Centre Liberal MP Hedy Fry was a family physician for two decades before entering politics. She recalled that in 1987, she chaired a committee of the Canadian Medical Association that issued a report noting that many family physicians and specialists were 55 or older and that there was a need to replace them over the next 15 years.
“The reality of delivering health care depends on a solid core of good family physicians,” Fry told the Straight. “It’s one thing to have a walk-in clinic and they fill a gap. But if you have chronic diseases, you need somebody who is dedicated to taking care of you. A family physician is still the most cost-effective way to deliver health care in Canada.”
Fry, a former president of the B.C. Medical Association, also recalled that the Liberal government of then–prime minister Paul Martin took note of the problem and, in 2005, tried to institute a program to annually bring in 1,000 new family doctors. She said that these physicians were supposed to be internationally trained immigrant doctors.
But according to Fry, this and other programs of the Martin government were overtaken by the federal election that was won by the Conservatives. “[Conservative Prime Minister] Stephen Harper has never once mentioned this issue,” she claimed.
Encouraging new medical graduates to go into family practice is also another challenge. Fry explained that a medical graduate usually comes out of school with a $75,000 student loan. According to her, it takes about $150,000 to start a family practice.
Shamim Jetha, president of the B.C. College of Family Physicians, cited results of a 2007 survey of 20,000 doctors nationwide that suggested access to a family doctor isn’t about to become easier.
According to Jetha, 31 percent of family physicians in B.C. reported that they intend to reduce their working hours. She explained that doctors normally put in 52 hours per week and an extra 130 hours a month for on-call duty.
“Like other professions, family physicians need a balance in their professional and personal lives,” Jetha told the Straight.
Jetha likewise recognized the need to improve the process of evaluating the credentials of foreign-trained doctors, as well as producing the proper mix of family physicians and specialists from medical schools.
“No one level of government is going to solve this problem,” Jetha said. “You need a pan-Canadian solution to recruit and train doctors.”