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William R.J. Rennie, M.D., FRCSC
President, The Canadian Orthopaedic Association Since my last message in the August/Sep-tember edition of the COA Bulletin, a number of things have happened which lend further credence to the statement that "Our Voice is Being Heard". I will try to detail some of these for you as well as try to bring some perspective to other issues facing some of our membership.
 | | Dr. William & Mrs. Norma Rennie |
In mid-September, I attended the British Orthopaedic Association Annual Meeting in Cardiff, Wales. While there, I was invited to speak at a symposium on total hip arthroplasty concerning patient and surgeon access to the health care system from a Canadian perspective. I highlighted the Canadian demographic issues showing an aging but more active population, the prevalence of osteoarthritis in that population, and the drastically increasing need for access to the system for procedures such as joint arthroplasty. Also highlighted were the need for more orthopaedic surgeons and more resources to allow them to do their job. Nursing shortages are clearly a global problem which may require some innovative solutions, at least, in the short term. Clearly, we are not coping with the increasing demand for orthopaedic services, not only in Canada, but in many other parts of the world as well. These are issues which we are continuing to try to solve. I have already outlined the efforts being carried out through the 'Canada in Motion' programme. Since then, additional meetings have been held with the Minister of Health of Nova Scotia and with the Ministry of Health in Ontario.
In Nova Scotia, Dr. Ross K. Leighton (representing the COA), along with a representative from the Arthritis Society, met with the Nova Scotia Minister of Health, Jamie Muir. The main focus of the meeting was waiting lists in Nova Scotia where wait times in Halifax at the QEII have more than doubled in the past year. The Health Minister has promised to discuss this at the federal level and is supportive of the establishment of standards for orthopaedic waiting times. In Ontario, Dr. Robin R. Richards, COA Secretary, and a representative from the Arthritis Society met with the Ontario Ministry of Health in early October. The results of this meeting are unavailable at the time of writing this article.
At the federal government level, we are delighted to announce that Minister of Health, Anne McLellan, has finally made Canada a signatory to the Bone and Joint Decade. The signed endorsement states: "the Department endorses the declaration of 2000-2010 as the Bone and Joint Decade and hopes that by working in partnership nationally and internationally, more progress can be made toward the reduction of bone and joint disorders in Canada and the rest of the world." The COA, together with its partners in musculoskeletal diseases, have been working towards this endorsement since 1999 and we are delighted that Minister McLellan has finally seen fit to bring Canada in step with the majority of the rest of the world.
There are, however, storm clouds gathering in the province of Quebec. The introduction of Bill 114 by Health Minister François Legault contains draconian measures to control Quebec doctors. These measures include:
- The necessity to sign a contract with a regional health board which will tell doctors where and in what type of practice they can work. Without a contract, a billing number will not be issued;
- Specialists will be directed to outlying, underserviced regions, with essentially no exceptions;
- Specialists will be obliged to increase workloads to fill gaps in service, even if they already have a full schedule. Failure to do so will result in pay reductions to 70%.
In addition to the Canadian Medical Association, the Royal College and many physician groups in Quebec, I have written to the Quebec Health Minister on behalf of, and in support of our Quebec colleagues, decrying the introduction of this oppressive legislation. It will surely lead to further losses of orthopaedic surgeons and worsening access to orthopaedic care for the people of Quebec. In addition, the loss of professional integrity, choice and independence must be opposed at any cost. At the recent Quebec Orthopaedic Association Annual Meeting, it was clear that the orthopaedic surgeons of Quebec are prepared and determined to fight this legislation. We must stand with them.
There are also suggestions that the government of British Columbia is contemplating similar legislation. Having already lost one court battle, they appear to be ready to try again. We must stand together in opposition to any legislation that would destroy our professional freedoms.
Since my last message, the world has passed the first anniversary of what is now called "9/11". Who will ever forget the horrifying scenes of that day and the infinite changes that the world has since undergone. No one is immune to tragedy. We have suffered our own with the sudden loss of Dr. Sandy Kirkley on September 8, 2002. She, her huband Michael and their two sons were in a private plane crash that killed both Sandy and Michael. The sudden loss of a vibrant, intelligent, caring physician, wife and mother seems as incomprehensible as the fall of the World Trade Center. Nothing will ever be quite the same again. Lasting tributes to Sandy's memory are being considered. We will inform you of them in the very near future.
Despite these dark events, there still remains room for some optimism. The recent federal throne speech would indicate that the federal government is willing to spend more money on health care. We must be ready to offer them concrete believable programmes to which those dollars can flow. The Romanow Commission Report was due in November of this year and it hopefully has some constructive and positive things to say about health care delivery. The Canadian Orthopaedic Foundation, after a reasonably successful Hip Hip Hooray Walk this year, and thanks to the stewardship of Dr. Hubert Labelle and Mr. Doug Thomson, is now back on firmer ground. Your Association Executive is continuing to work hard to improve the lot of all orthopaedic surgeons and hopefully as the storm clouds pass, we may even see a ray or two of sunshine.
As we approach the end of another year, take pride in your accomplishments. You are important to those who place their faith and trust in you including your patients, families and loved ones. Let us all hope that the New Year will bring renewed hope and peace.
Norma and I wish you and your loved ones all the best during the Holiday Season. |
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