Mr. Speaker, I am pleased to rise today to speak to Motion No. 226. which seeks to give instructions to the Standing Committee on Health regarding health care delivery in rural Canada.

There is an extremely concerning shortage of family doctors and nurses in Canada, particularly in rural areas. The lack of broadband Internet also prevents rural communities from accessing online health services. The committee should also consider the worrisome deterioration of rural hospitals in its study.

I want to thank the member for Kenora for bringing the motion before the House. My daughter was a nurse in his lovely riding, so she is well acquainted with its hospital and the health care services that are available there.

As the member for Sarnia—Lambton, I note that Sarnia is a mixture of urban and rural, so there are also quite a number of parts of my riding where services and transportation are not available.

I would like to start by talking about the current situation in health care in general in Canada.

We know there is already a shortage of doctors and nurses across the country. I have travelled from coast to coast to coast and spoken with people in various ridings. I would like to give members a few examples of the shortage, starting with what I think is one of the worst cases I have heard, which is Cape Breton.

Cape Breton was missing 52 emergency room physicians and a vascular surgeon. People who cut an artery in Cape Breton would lose a limb or die because they would not be able to get to Halifax in time to get the services.

Let us look across the country. Given the wait times in Ottawa, it takes six years to get a family doctor. The former member for Nanaimo—Ladysmith ran provincially, and one of the priority issues she brought up was the shortage of doctors in B.C. Truly, there is a shortage of health care workers.

This is particularly disturbing, as we have an aging population. Right now, one in six people is a senior, and that will be one in four in the next six to 10 years. With that comes a need for a number of different services.

First of all, we are seeing a movement toward more chronic disease, in part due to rising obesity rates, smoking issues and so on. Also, as people are living longer, we are seeing an increase in dementia, and there is a need for palliative care. Of course, I have been a strong advocate for palliative care during my time in the House. About 70% of Canadians do not have any access to palliative care, and this is especially true in rural and remote places. It is a pressing problem.

As I look to the government that has been in power for four years, I see absolutely no plan to address the gaps that exist regarding the resources for health care workers and all the infrastructure needed in places like Petrolia, which is one of the hamlets within my riding. Right now, the electrical and mechanical systems in place at the Charlotte Eleanor Englehart Hospital are so obsolete and so likely to fail that Petrolia is planning how it will shut down the hospital when the systems fail. All of the patients will have to be moved to the nearby high school. Petrolia needs $5 million to repair that infrastructure.

I could tell members similar stories, from across the nation, of hospitals that have not received any funding for infrastructure. Clearly the provinces do not have money for that. One solution the government could bring forward in that light is a program that would specify rural hospitals and their infrastructure needs, which would address some of the outstanding issues there.

Another need in many rural and remote places is broadband Internet. As we move increasingly to using virtual services, such as virtual palliative care and virtual consultations, communities need broadband Internet to receive them. There is a huge need for this in the north. My riding has several places without good access to the Internet. I think it will be incredibly important to address this need.

One of the other problems with the rural and remote health care system is just accessing the services. Transportation can be very costly and, as the member for Kenora has mentioned, it can take a really long time. In Kenora, people transit by airplane. In my riding, even though there are many services, a lot of people have to go to nearby London, which is an hour away. For low-income people and those who do not have transportation, there is no service to take them for weekly cancer treatments or other procedures. Transportation is a big barrier, and we need to find solutions to address that.

There have been some really innovative solutions that I discovered when I was working on the palliative care private member's bill. One of them was the use of paramedics to deliver palliative care. Trained paramedics, during the hours they are not taking care of emergencies, would distribute pain medications and perform procedures that patients need. This is really cost-efficient, because they are already on the payroll, and it is a great service for people who have trouble accessing services and cannot get the transportation they need. It is those kinds of innovations that will be really important as we move forward.

Another issue in my riding—and I heard it is also an issue in Kenora—has to do with how to attract doctors, nurses and health care workers to go to rural places. There has to be some kind of incentive. One of the great innovations, also in Petrolia, was a clinic that was put together with multiple family physicians and nurse practitioners providing various services. Because the doctors did not have to be sole family physicians working umpteen hours in practice and then being on call for emergencies, the balance of life and work was much better. There was a real effort made to attract doctors to that practice. They are doing a fine job and making services very accessible to people who live nearby. In fact, because of the quality, in some cases people are even coming from Sarnia to Petrolia to access services.

We need to come up with solutions on how to provide health care and work with the provinces and territories. Every region is different. We talked about some of the barriers, such as travel during bad weather, for accessing services, but in some places, the problems are different. Some places have an aging population. In my riding, 50% of people are over the age of 57, so care for seniors is a key issue, and I know that is true as well in Nova Scotia and a number of places across the country.

At the end of the day, I would be happy to have the health committee study this issue. I wish we had time in this parliamentary session, but, as has already been pointed out, it is unlikely that a study could be taken up at this point in time. Perhaps it will happen in a future Parliament.

This is an urgent need and something we need to consider. We need to put together a plan that will identify the health care workers required and how to get them. In some cases, there are enough workers in Canada; in some cases, we will have to change how we train doctors, for example. There was a very innovative example in New Brunswick, where, although there is no teaching hospital or university for residencies, the province partnered with Dalhousie University and Sherbrooke for a residency program that would provide medical services in New Brunswick and allow doctors to be certified. That kind of innovation is needed to address the health care worker issue.

In addition, there is a need for an infrastructure plan, as I have mentioned, for broadband Internet and hospital care and other services. For example, we see an increasing need for home care. Home care in rural and remote situations is increasingly difficult because of the amount of travel time and, in some cases, the weather, etc.

When we get this plan together with the resources and infrastructure and decide which services we will need as we move toward more chronic disease and an aging population with more dementia, thus requiring more palliative care, then we can start to execute that plan. It could not happen soon enough because, as I have said, one person in six being a senior now will be one in four within six to 10 years.

It is an urgent issue, and I am happy to support this motion.

Marilyn Gladu

$533,532.00