Exporting our doctors

By Esther E. Steeves

Just when it seemed the debate on private vs. public health care had been shelved…


The controversy was back on the agenda last week when it became known the Calgary Health Region put in a bid to offer consulting services for private British health clinics due to recent trouble in the British public health system.


Too few British doctors there, charged with the care of too many patients, are leaving busy centres like London in droves for the country where they hope to practice without the demands of highly populated regions. This has worsened the problem by leaving fewer medical professionals in urban areas than ever before, leading the British government to resort to unprecedented levels of privatized health care.


As a result, Canadian doctors may soon find themselves practicing without the constraints of our domestic national health system, working instead under British laws granting them a level of control not available in Canada since the 1940s.


This bid raises numerous questions and concerns, ranging from Liberal health critics worried about the CHR’s financial priorities, to the precedent involvement in privatization abroad will set for future discussions on similar changes to Canadian health programs.


How will doctors respond to continuing refusal by Canadian officials to allow private practices at home if they are increasingly able to work privately in another country?


If privatization abroad is a great success will physicians not import their experiences and attempt to make similar reforms in their own provinces?


Can free universal health care be maintained if the lure of other countries is strong enough to displace a large number of Canadian doctors?


On the other hand, experimenting with private health care outside Canada is an innovative alternative to allowing two-tiered medical care domestically. Since the dawn of Canadian medicare, doctors have held grievances regarding their lack of ability to control their own profession at levels they enjoyed in pre-public health days. Funding is constantly fought over and resources have become objects of fierce jealousy as the cost of technology increases the demand for the latest method of diagnostic testing.


After years of struggling with public health boards composed of communications specialists, economists and other non-medical personnel, the opportunity to sidestep these committees is a great chance for Canadian doctors to test their ability to advance medical knowledge and technology uninhibited by the burden of politics.


The CHR’s truly worthwhile endeavour has the potential to substantially improve the quality of Canadian health care providers by offering them an outlet for medical consultation without governmental barriers.


However, the accessibility of our health programs must be preserved at all costs. While physicians will certainly benefit from flirting with privatized health care abroad, aspects of their experiences brought home must be beneficial not only to the medical profession but to the health of the Canadian public. It is on this point that the value of the entire experiment hinges.


Doctors must take full advantage of their educational opportunities, but the freedom which may be given to doctors through privatization must be used to improve the existing health care systems in Canada without compromising its availability to all Canadians.


If such a compromise is the necessary cost of this attempt to provide doctors an opportunity to expand their expertise, we are better off with doctors who practise under restrictions and feed off the innovation of others for the sake of maintaining a minimum health standard for all.

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