Tom Mulcair: Why Pierre Poilievre's plan to work with provinces to reduce barriers is a good idea
As part of its efforts to deal with the serious shortage of nurses and doctors in the province, the Ontario government has directed the colleges of nurses and physicians to streamline entrance requirements for foreign-trained professionals.
That’s the right call.
The professional licensing bodies are creatures of the provincial legislatures. Self-regulation by the professions is the backbone of our system, but the public interest commands that the ultimate authority reside with democratically-elected officials.
Never waste a crisis, the saying goes, and as we slowly exit the seventh wave of the pandemic, serious shortages of medical personnel have turned a spotlight on an overdue reform.
Many of the rules governing credentialing and equivalences between Canadian and foreign graduates are archaic, based on preconceived notions and in serious need of an objective overhaul.
Prior to the French language leadership debate, professional licensing bodies were high on the list of gatekeepers that Pierre Polievre was planning to reel in.
Of course, professional regulation is first and foremost provincial jurisdiction. If Poilievre didn’t know that prior to the Quebec debate his own handlers (dare I say: gatekeepers?) clearly did and he backed away from his more strident posture.
Now, he said, he was going to work with the provinces to help reduce barriers. That, too, is a good idea.
Poilievre was right to make that concession to constitutional reality, but the validity of his core point was made obvious when the government of Ontario issued its recent directives.
THIS IS ABOUT PUBLIC PROTECTION
There’s nothing new in this debate. There’s a joke in Quebec (where over one million people don’t have a family doctor) that the best way to see a physician is to take a taxi. There’s a good chance the driver is a foreign-trained medical doctor.
I was president of the regulatory agency that oversees all of the professions in Quebec. The same debates took place then and, in the meantime, a lot of solid effort has gone into developing objective ways to evaluate training and determine equivalence of diplomas.
The bottom line is that this is about public protection so no shortcuts that could compromise safety should be allowed, even when there’s a shortage.
At the same time, training standards are more and more harmonized and while safety is the top concern, there’s still a lot of institutional bias in assessing foreign-trained medical professionals.
DON’T PENALIZE FOREIGN GRADUATES
We tend to forget that professional regulation isn’t only about entering a profession. It’s also about inspecting and supervising professionals once admitted. An entire disciplinary process caps the system to ensure respect of patients, standards of practice and rules of ethics.
Yes, we should supervise all professionals. No, we shouldn’t penalize foreign grads by suggesting that letting them in exposes the public to greater harm. They’ll be subject to the same rigorous supervision as all other members of the profession.
I recall a heated discussion between one of the officers of our regulatory agency and a senior player from the college of physicians. It turned on the quality of foreign grads and their training.
My colleague asked a simple question: if you’re travelling in Europe and have a heart attack will you refuse treatment in a local hospital? The answer, of course, was no. Why then all the barriers to integrating those same doctors who choose to move here?
There are arguments that have to do with credentialing: could letting in foreign practitioners dilute the overall evaluation of Canadian graduates and hurt their chances to get licensed in the United States, for example?
These issues are easily dealt with and shouldn’t be used as a shield to prevent foreign graduates from helping to provide the health care Canadians need and deserve.
Similar to Canada, in the U.S., professional regulation is considered a jurisdiction of the individual states: a subset of their policing and lincensing powers. They continue to have many barriers to interstate credentialing and the recognition of professionals.
Here in Canada, we’ve done a decent job of facilitating interprovincial recognition of professionals, though some needless hurdles remain here as well.
I was the first Canadian elected to the Board of the Council on Licensure, Enforcement and Regulation in the U.S.
It was soon after the signing of the original NAFTA. That treaty had the effect of reducing barriers to professional mobility between Canada and the U.S. The only restrictions allowed from now on would have to be competency based. Clearly and transparently.
WHAT WE NEED IN CANADA
Many states still had rules that required you to have taken your licensing exam in the state where you wanted to practise. For example, back then, a New York pharmacist had to be physically seated in Florida when they wrote the licensing exam, if they hoped to practise there. That had everything to do with protecting Florida’s pharmacists from competition and nothing to do with public protection.
Many of those unjustifiable interstate rules were swept away by an international agreement that required an objective look at the motive for restrictions. If a requirement wasn’t about competency and public protection, how could it be maintained?
It’s that type of objective analysis of restrictions and prerequisites that we need here in Canada now.
A second set of professional barriers should be under that objective microscope right now: the scope of practice rules between various health professions. The border line between what one professional can do and what requires membership in a different profession is often fraught and can compromise the ability to do the only thing that matters -- helping the patient.
My brother and I spent a good part of the weekend with our mother in a small regional hospital emergency ward. The care was top-notch but at one point the physician said he’d have to wait another hour before being able to stitch up the leg my mom had injured in her nursing home.
The LPN who was assisting explained that she was allowed to install one type of line and inject this substance but not that medication. That required an RN and none was available. The clock was ticking because stitches had to go in within a certain time after the accident.
All went well in the final result but the question that came to me was: is this barrier between professions really, objectively necessary? Or is it a relic from past arbitrations between professional bodies?
We should take advantage of the current context to insist that governments and professional bodies undertake a concerted effort to:
- Reduce barriers to recognition of foreign professionals;
- Develop objective ways to evaluate diplomas and experience.
- Review restrictions between professions, to improve care.
Tom Mulcair was the leader of the federal New Democratic Party of Canada between 2012 and 2017
IN DEPTH
Budget 2024 prioritizes housing while taxing highest earners, deficit projected at $39.8B
In an effort to level the playing field for young people, in the 2024 federal budget, the government is targeting Canada's highest earners with new taxes in order to help offset billions in new spending to enhance the country's housing supply and social supports.
'One of the greatest': Former prime minister Brian Mulroney commemorated at state funeral
Prominent Canadians, political leaders, and family members remembered former prime minister and Progressive Conservative titan Brian Mulroney as an ambitious and compassionate nation-builder at his state funeral on Saturday.
'Democracy requires constant vigilance' Trudeau testifies at inquiry into foreign election interference in Canada
Prime Minister Justin Trudeau testified Wednesday before the national public inquiry into foreign interference in Canada's electoral processes, following a day of testimony from top cabinet ministers about allegations of meddling in the 2019 and 2021 federal elections. Recap all the prime minister had to say.
As Poilievre sides with Smith on trans restrictions, former Conservative candidate says he's 'playing with fire'
Siding with Alberta Premier Danielle Smith on her proposed restrictions on transgender youth, Conservative Leader Pierre Poilievre confirmed Wednesday that he is against trans and non-binary minors using puberty blockers.
Supports for passengers, farmers, artists: 7 bills from MPs and Senators to watch in 2024
When parliamentarians return to Ottawa in a few weeks to kick off the 2024 sitting, there are a few bills from MPs and senators that will be worth keeping an eye on, from a 'gutted' proposal to offer a carbon tax break to farmers, to an initiative aimed at improving Canada's DNA data bank.
Opinion
opinion Don Martin: Gusher of Liberal spending won't put out the fire in this dumpster
A Hail Mary rehash of the greatest hits from the Trudeau government’s three-week travelling pony-show, the 2024 federal budget takes aim at reversing the party’s popularity plunge in the under-40 set, writes political columnist Don Martin. But will it work before the next election?
opinion Don Martin: The doctor Trudeau dumped has a prescription for better health care
Political columnist Don Martin sat down with former federal health minister Jane Philpott, who's on a crusade to help fix Canada's broken health care system, and who declined to take any shots at the prime minister who dumped her from caucus.
opinion Don Martin: Trudeau's seeking shelter from the housing storm he helped create
While Justin Trudeau's recent housing announcements are generally drawing praise from experts, political columnist Don Martin argues there shouldn’t be any standing ovations for a prime minister who helped caused the problem in the first place.
opinion Don Martin: Poilievre has the field to himself as he races across the country to big crowds
It came to pass on Thursday evening that the confidentially predictable failure of the Official Opposition non-confidence motion went down with 204 Liberal, BQ and NDP nays to 116 Conservative yeas. But forcing Canada into a federal election campaign was never the point.
opinion Don Martin: How a beer break may have doomed the carbon tax hike
When the Liberal government chopped a planned beer excise tax hike to two per cent from 4.5 per cent and froze future increases until after the next election, says political columnist Don Martin, it almost guaranteed a similar carbon tax move in the offing.
CTVNews.ca Top Stories
Spectacular aurora light show to be seen across Canada Friday night
A rare and severe solar storm is expected to bring spectacular displays of the northern lights, also known as aurora borealis, across much of Canada and parts of the United States on Friday night.
Town of Fort Nelson, B.C., ordered to evacuate due to wildfire
The entire town of Fort Nelson, B.C., as well as the nearby Fort Nelson First Nation, has been ordered to evacuate due to an out-of-control wildfire.
Bouchard lifts Edmonton Oilers to 4-3 overtime win over Canucks in Game 2
Evan Bouchard scored 5:38 into overtime and the Edmonton Oilers bounced back for a 4-3 win over the Vancouver Canucks in the second round of the Stanley Cup playoffs on Friday.
McGill University seeks emergency injunction to dismantle pro-Palestinian encampment
McGill University has filed a request for an injunction to have the pro-Palestinian encampment removed from its campus.
Which Canadian cities have the highest and lowest grocery prices?
Where you live plays a big factor in what you pay at the grocery store. And while it's no secret the same item may have a different price depending on the store, city or province, we wanted to see just how big the differences are, and why.
Swarm of 20,000 bees gather around woman’s car west of Toronto
A swarm of roughly 20,000 bees gathered around a woman’s car in the parking lot of Burlington Centre.
Video shows naked raccoon catching B.C. family by surprise
When Marvin Henschel spotted a strange and hairless creature wandering through a front lawn in B.C.'s Lower Mainland, he could barely believe his eyes.
Barron Trump declines to serve as an RNC delegate
Former U.S. President Donald Trump's youngest son, Barron Trump, has declined to serve as a delegate at this summer’s Republican National Convention, according to a senior Trump campaign adviser and a statement from Melania Trump's office.
Out-of-control wildfire prompts evacuation alert for Fort McMurray, Saprae Creek Estates Friday night
An evacuation alert was issued for two Wood Buffalo communities Friday night, as crews battled an out-of-control wildfire near Fort McMurray.
Local Spotlight
From outer space? Sask. farmers baffled after discovering strange wreckage in field
A family of fifth generation farmers from Ituna, Sask. are trying to find answers after discovering several strange objects lying on their land.
Wilfrid Laurier football player drafted despite only playing 27 games in his entire life
A Listowel, Ont. man, drafted by the Hamilton Tigercats last week, is also getting looks from the NFL, despite only playing 27 games of football in his life.
Toronto-area dessert shop featured by Keith Lee forced to move after zoning complaint
A small Ajax dessert shop that recently received a glowing review from celebrity food critic Keith Lee is being forced to move after a zoning complaint was made following the social media influencer’s visit last month.
'Oh Crap!' New exhibit at Canada Science and Technology Museum explores human waste
The Canada Science and Technology Museum is inviting visitors to explore their poop. A new exhibition opens at the Ottawa museum on Friday called, 'Oh Crap! Rethinking human waste.'
Regina police hope new biometric monitoring system will save lives in detention facility
The Regina Police Service says it is the first in Saskatchewan and possibly Canada to implement new technology in its detention facility that will offer real-time monitoring of detainees’ vital health metrics.
Vancouver and Edmonton's mayors bet on who will win Round 2 of the playoffs. Here's what's at stake
The stakes have been set for a bet between Vancouver and Edmonton's mayors on who will win Round 2 of the Stanley Cup playoffs.
'No other life taken': Mother leads ATV helmet drive to honour daughter's legacy
A grieving mother is hosting a helmet drive in the hopes of protecting children on Manitoba First Nations from a similar tragedy that killed her daughter.
Northern Ont. woman makes 'eggstraordinary' find
A chicken farmer near Mattawa made an 'eggstraordinary' find Friday morning when she discovered one of her hens laid an egg close to three times the size of an average large chicken egg.
P.E.I. lighthouse, N.B. river spotlighted in Canada Post series
A P.E.I. lighthouse and a New Brunswick river are being honoured in a Canada Post series.