CMAJ 2011 election survey: health human resources.

proposal for health human resources advanced over the past decade was a comprehensive “pan-Canadian” strategy for educating, recruiting, licensing and equipping doctors that was recommended by a blue-ribbon panel called Task Force Two in 2006. The comprehensive plan, A Physician Human Resource Strategy for Canada: Final Report, urged wholesale reforms in five areas related to physician supply — education and training; interprofessionalism; recruitment and retention; licensure, regulatory issues and liability; and, infrastructure and technology — while proposing that responsibility for overhauling the current system be vested with some manner of national agency (www.cmaj.ca /cgi/doi/10.1503/cmaj.060598). The proposal, though, was eventually consigned to gather dust on library shelves after it became mired in quintessential Canadian squabbles over jurisdiction. Various medical associations argued that they shouldn’t have to relinquish their licensing authority, while several provinces objected to a national approach to health human resources on the grounds that it would limit their ability to recruit doctors to underserviced areas. Small wonder, then, that no political party boldly stepped out during CMAJ’s 2011 election survey by advocating policies that favour some sort of pan-Canadian approach to educating, recruiting and licensing doctors and other health professionals. The New Democrats come closest to such a notion, with a series of promises including one to “establish a Health Human Resources Centre, often referred to as an Observatory, to identify the need for health human resources across the country and help plan for the future.” The party would also forgive all student loans to all medical students who agree to family practice for a 10-year period and spend $80 million to train an additional 1200 physicians over 10 years, 6000 nurses over 6 years and an unspecified number of other health professionals. As well, they would “establish programs aimed at recruiting and supporting low-income, rural and aboriginal medical students,” create a fund to repatriate 300 Canadian physicians within four years, and revise the foreign credential recognition system to make it easier for physicians educated abroad to work in Canada. The prescriptions of the remaining political parties were largely confined to relatively modest measures aimed at recruiting young doctors to underserviced areas. The Liberals propose to do so by forgiving Canada Student Loans for doctors, nurses and nurse practitioners if they agree to toil in a “designated underserved small-town or rural community.” Family doctors would be eligible for loan forgiveness of up to $8000 per year to a maximum $40 000, while nurses and nurse practitioners will be eligible for forgiveness up to $4000 per year to a maximum $20 000. Some form of equivalent would be negotiated for Quebec students, who do not participate in the federal loans program. As well, the Liberals say they would spend $40 million on unspecified measures to “improve rural health services” after discussing the matter with the provinces and territories. The Conservative Party, meanwhile, declined to participate in the CMAJ survey. But it did indicate in the recent federal budget, which was not approved by Parliament (www.budget .gc.ca/2011 /plan/Budget2011-eng.pdf), that they plan to attract doctors, nurses and nurse practitioners to “under-served” rural and remote communities by forgiving students a portion of their Canada Student Loans if they agree to work in isolated environments, commencing in fiscal 2012–13. The Conservatives did not define what constitutes such communities while proposing that graduating medical students be eligible to have $8000 per year written off their loans, to a maximum $40 000, and that nurses and nurse practitioners be eligible for a News CMAJ