Dr. Ruth Collins-Nakai President Canadian Medical Association TORONTO, Oct. 6 /CNW Telbec/ - Honourable Minister, Dr. Flynn, my colleague and president of the OntarioMedical Association, head table guests, ladies and gentlemen. Merci de votreprésence aujourd'hui. Mr. President (turn to Empire Club President Whittaker). Thank you for your kind introduction. Listening to the number of positions I have held, it occurred to me thatsome of you might wonder whether I am capable of holding down a job! The onejob that I have had - the one job I still love more than any other - is theone called cardiologist. It was what I was trained to do. It is what I lovethe best. For me, there is no greater reward than to hear the steady, strongheartbeat of a tiny infant. That strong heartbeat says to me, to the world: "Iam alive. I am a fighter. I am with you." Thinking about that and thinking about what I wanted to share with youtoday, I thought of a story that paints a picture of our health care system,the system that means so much to Canadians and to me. The story begins with a blue baby, only four days old. It was urgent this tiny bundle received immediate medical care and he did- initially. ... But as he grew other problems arose and at one point, he hadto leave his home province and travel to Ontario because they didn't have theequipment he needed in Alberta. Later on, he even needed care outside Canada -at the Mayo Clinic. To arrange this care I started making phone calls - many phone calls - myanxiety climbing with each message left, with each "you will have to obtainapproval from ..." In the end, we were able to move him, his heart wasrepaired and he had a chance at a normal life. I was very relieved and veryhappy. But I can tell you that I was not happy - and I remain unhappy - thatsomething like that could happen in a nation as bountiful and blessed asCanada. Our health care system - like the nation itself - depends on cooperationacross jurisdictions, across borders and across professions. There is a child like the one I described in every city and town, inevery province, in every region of Canada. But it is not just heart problems.You probably have a loved one or friend who needs some kind of health caretoday. Every child, and every parent, every patient - deserves better. Theydeserve a country that gives back certain important things to them, just asthey give to their country. They deserve the best education we can provide asa society. They deserve to be safe in the community where they live. Theydeserve the chance to earn a living, and to contribute to the greater good.They deserve to be healthy, and they deserve our help when their health is notas good as it could be, or should be. Those essential things are entitlements of citizenship in this, what allof us know to be the greatest nation on Earth. But - and you knew there would be a "but," didn't you? There often is. Canada, which at one time was the most attractive place on Earth to live,is falling behind. I cannot say it more simply than that. As a Canadian, as a parent, as the president of an associationrepresenting 62,000 Canadian doctors I believe we are falling behind in thethings that count the most. We are no longer what we once were. We arecertainly no longer what we could be, and should be. As Canadians we are knownfor both our courage and our commitment to community. We have gotten where weare today by confronting difficult truths, head-on, and working collectivelyto change them. When I look around me now I see many troubling things. Perhapsyou do, too. For example, we have all heard a lot about the "social deficit"lately, because we have one and because it is growing. Canadians who deservemore are getting less and less. Did you know our infant mortality rates are rising, not falling, inrelative and absolute terms? We have tumbled from our top-five ranking in the 1980s - to where we aretoday. In the twenty-second spot out of twenty-seven OECD countries. Did you know one million Canadian children live in poverty - enough tofill the 50,000 seats in the SkyDome Rogers Centre, just down the street,twenty times over? Did you know we have the second highest pre-school obesity rate in theworld? That, as the Ontario Medical Association warned in its new report justthis week, we are facing an "obesity epidemic" among our children? Did you know that an Aboriginal teenager has a greater chance ofcommitting suicide than going to university? Simply put, we are failing to care adequately for those who need our helpthe most. It is shocking. It is appalling. It is simply unacceptable. In these circumstances, what do the overwhelming majority of Canadiansrank as their number one priority? I am sure you know: health care. NotGomery, not federal-provincial rows, not the environment, not even security.Health care, health care, health care. And, out of that group who sees healthcare as number one, what is the number one issue? Access to doctors andnurses. Canadians want and need more doctors and nurses. It is just thatsimple. Values into action We have a widespread shortage of doctors and nurses in this country. Ifyou look at physician-to-patient ratios around the industrialized world, werank way back - a dismal number twenty-sixth out of thirty countries. What does this mean? I'll tell you. It means that nearly four millionCanadians - just about the population of the Greater Toronto Area - cannotfind a G.P. or family physician, no matter how hard they try. If a first minister were right here, right now, listening to this litanyof shortcomings, they might tell you: "Well, we signed a health care deal ayear ago! Governments are working together better! We are spending more moneyon health than ever before!" Those things might all be true, and all of uscould certainly imagine a politician saying them, couldn't we? Canadians - the Canadians doctors talk to, every day in waiting rooms andhospital wards - don't want more words from politicians. They want action -and they want it now. Right now. Last week the CMA polled Canadians, and I am releasing the results today.I don't want to talk statistics, but I can tell you that eight in tenCanadians agree with us that national performance goals need to beestablished. The same number agree that a new federal fund should be createdto cover the cost of patients and their families who have to travel to gettimely access to needed health care services. The numbers don't lie. They tell me - they tell all of us - that ourpolitical leaders need to be doing better. Here, then, is my message to you asindividual Canadians and through you, to our political leaders: join Canada'sdoctors in our call to action. To the politicians, I say: the clock is ticking, and it is tickingominously, on the Supreme Court of Canada's historic decision in the Chaoullicase. But some politicians haven't heard the wake-up call. They prefer to hitthe snooze button - yet again - until the next election. Meanwhile, Canadiansare getting tired of waiting for the health services they pay for. Some ofthem are getting sicker as they wait. They - all of us - want, no demand,action. To the politicians, I say: you talk about Canadian values all the time.Well, I say - we say - it is time to ensure that those values mean something.Canadians need to pull together. That means helping one another when we needhelp. Governments, both federal and provincial have said that they take waittimes seriously. They are not taking them seriously enough. I am appealing to each and every one of you in this room as individualCanadians and as leaders in your community. We must all ensure that the timelines for doing so are met. Our patientsexpect and deserve no less. The Supreme Court of Canada has said politicians must take wait timesseriously, by taking meaningful and lasting action. The first deadline -December 2005 looms large. It cannot be missed. The Prime Minister of Canadahas appointed Dr. Brian Postl as Senior Advisor on Wait Times. We see this asa very positive move, and the doctors of Canada will continue to support hisefforts by bringing all parties together to reduce wait times. We must allstrive to put the Canadian back into Canadian health care. A universal systemwhere no one gets left behind means just that. We cannot and must not acceptthat people living in different provinces will have quite different accesswhen it comes to medically-required care. In the coming weeks we will be sharing more details about how you can getinvolved. Right now, today, I ask you to choose to make a difference. Write toyour MP or your MPP or MLA. Write a letter to the editor. Talk to yourcolleagues and neighbours or find a political candidate who wants to make adifference too. We must pull together, or we will simply be pulled apart. Canadians must oar in together Good government - like good business, as everyone along Bay Street knows -needs vision. Vision must also be values-based since values drive behaviour.Behaviour, in turn, drives performance. So it is with health and socialpolicy. Health is the ultimate accountant for a country's social andeducational policies. Our performance is clearly lagging behind othercountries. In order to improve our performance we must change our behaviour tofit our core values as a country. These changes are needed now. Canada's physicians work with - and serve - you, our patients, every dayin examining rooms, hospital wards and in homes, right across this land. Wenow want to work with you to lift up this nation's health care system - and,in so doing, help lift up the nation itself. Each of us here today must cometogether to ensure that all Canadians have access to the quality health carethey need, at the time and to the extent that they need it. We must ensurethat access to medical care is based upon medical need, and not upon the sizeof a pocketbook. There are things that give CMA, and all of us, cause for optimism. Thereis a consensus on national benchmarks -- performance goals -- benchmarks puttogether by the Wait Time Alliance, members of which I am proud to say havejoined us today. The WTA is a group of national organizations representing specialistdoctors. With the CMA, they have worked hard to develop maximum, medically-acceptable wait times. Doctors, nurses and other health care providers havealso worked together to address the critical shortages of health carepersonnel, right now. Health care providers and Canadians, have united around the need todevelop national health goals to encourage health-improvement programs, and tohelp us make informed decisions about funding - when, where, how. But there are also things that worry me greatly. The Wait Time Alliance Final Report was released in August and greeted bysilence even though it gave all governments a set of tools on a silver platterto reduce wait times in their own priority areas. Right now, right away. TheWait Time Alliance has sought meetings with the Council of the Federation tomove ahead on wait times, only to be frozen out. Canada's health careprofessionals remain frozen out of the upcoming meeting of federal, provincialleaders in ten days because our leaders want to change the channel and move onfrom health. Provinces each want to establish their own wait times for health careservices. That is not good enough. Canadian citizenship means getting the careyou need, when you need it, wherever you live. Provinces need to come togetherto make this so. Politicians talked a good game about solving personnel shortages with theten-year plan on health last September, but one year later they haven't evenreleased their preliminary work plan. Governments can do more, should do more,must do more. Let me give you an example. Many of today's medical students graduate with mortgage-sized debt loadsof about $120,000. The 2004 National Physician Survey showed us that huge debtloads have a big impact on the type of practice pursued by young doctors -and, significantly, where they practice medicine. As a consequence, rural andfamily doctors are on the endangered species list even as many Canadians whowant to study medicine have to leave their country to do it. Governments needto make medical education more accessible to more young people. Repayment ofCanada Student Loans even while still pursuing residency training is simplyunjust. I call on Prime Minister Paul Martin to change this now! Before I close, you may wonder why I haven't addressed the issue ofprivate insurance for health care in Canada, given the media coverage of thissummer's Supreme Court decision. I decided NOT to talk about it because CMA's position has not changed.Our policy is to do everything we can to support and improve publicly-fundedmedicare in Canada. Private health care is not a panacea for the ills of our system. However, if the public system fails, we must determine how best toprotect patients. The CMA is looking at these issues right now as it works to develop aresearch paper on the relationship between the public and private health caresystems in Canada. Our focus is on improving the system we have by meeting thetimelines for pan-Canadian wait-time benchmarks and by increasing the numbersof doctors and nurses and other personnel. Health care providers are doing their part. We want to work with anyoneand everyone willing to fix the system. And we want to work with you! Conclusion When I started this speech, I may have left you with the impression thatthe youngster I mentioned was a combination of many of children I have seenover the years. Actually, his name is Ryan and he is very real. I am also proud to say that Ryan is here with us today. Recently, I had the great, great pleasure of seeing him again. He told me that he is now a medical student at McMaster University - afuture colleague in training! Ryan - the future face of Medicare - persevered through his ordeal as aninfant, as a child and as a teenager and is now seeking to give back. Ryan knows about not taking your eyes off your goals. I ask you to join me acknowledging Ryan - for his commitment to medicine,for his commitment to making a great country even greater. For simply beingwith us. I asked Ryan to come here today because I wanted you to see what I andother doctors see. There are real people behind the statistics, with real-life problems. Real people who are owed real solutions, and not more words. We owe that to the many thousands of Canadians sitting in hospital andwaiting rooms right now, this afternoon, in every corner of Canada. They'rewondering if they will get the timely care they need. We have to be able toget patients to the right place for the right care, when they need it. We owethat to ourselves, as a nation. Canada should not be falling behind in thethings that count. If we are to be a great nation once again, we all have a responsibilityto one another. We urge you to join with us - so that Canada may once againclaim greatness for Ryan, and for all like Ryan, who need our help - they haveno more time to wait. Merci. Thank you.

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