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The fiscal challenges facing the people
of Newfoundland and Labrador are formidable. Indeed, many residents
of this province have already had to swallow some of the bitter
medicine associated with spending restraint measures which the
government has imposed over the last year. Even if Premier Danny
Williams’ campaign to secure the full and rightful entitlements of
the province’s offshore resources is entirely successful, the road
to economic security will not be without its trials and
tribulations, both for the government and the people.
Unfortunately, both the problem and the
solution are more complicated than merely harnessing more resource
revenue and tightening public expenditures. The road to economic
recovery requires the conquering of a different kind of liability,
one that I would refer to as the “demographic deficit”. There is an
urgent need to reverse the long-standing population hemorrhage that
has been plaguing this province. Current trends indicate a growth of
public services consumption reflected by an aging population and a
corresponding decline in young people who would normally be fuelling
the public system. This province must attract a critical mass of
working age people over the next decade if we are to achieve
economic stability and prosperity.
As a relative newcomer to Newfoundland
and Labrador (having moved to St. John’s three years ago from
Ontario), I can bear witness to the many advantages of living in
this great province. But most prospective residents, as I did, want
to be sure that certain fundamental needs will be met. Highest on
the list is timely, quality medical care. In this context, the
preservation of a medical system that is and is seen to be on par
with the rest of Canada will be an essential prerequisite to
achieving the province's economic aspirations. Although the current
situation is good, the future prospects in this sector are
uncertain.
Approximately 25 per cent of the
current 1,008 practicing physicians in the province are over 55 and
will need to be replaced over the next decade. This comes at a time
when the global doctor shortage is severe and the replacement
capacity of the system is limited. Because the market forces that
emerge from a low-supply high-demand dynamic do not distinguish
between “have” and “have not” provinces, we will need to remain in
step with the world around us to ensure a relatively stable medical
care system. This means that compensation must remain competitive
and that the working environment and quality of life for doctors in
this province are comparable to those in other parts of the country.
Premier Williams’ efforts to achieve
economic stability and security for Newfoundland and Labrador must
succeed because the very viability of the province is at stake. All
residents of the province have an inherent obligation to contribute
to the effort and physicians are not exempt from this
responsibility. The NLMA and all its members intend to assist
government in meaningful ways that will make a difference. Indeed,
we have already launched a number of important initiatives.
Over the last year, the NLMA has been
vigorously involved in developing an electronic medical records
system under the brand name “Nell”. Our business arm “SmoothWater”
is working in partnership with Unisys Canada in developing the only
open source ASP system in the country. Our strategy is based on a
consolidated provincial system that will not be subject to multiple
vendors or proprietary licensing. This is the only initiative of its
kind in Canada (estimated to cost in excess of $12 million), that is
not being heavily underwritten by provincial government funding. The
system being designed will facilitate better operational control and
enhance cost-effectiveness of services. This undertaking is being
coordinated with the Newfoundland and Labrador Centre for Health
Information (NLCHI) and, if successful, will create many new jobs in
the IT sector.
Our Association is collaborating
closely with the government’s provincial drug program to explore new
ways and means of containing spiralling drug costs. This partnership
effort will be successful if there is continued meaningful
consultation between the government and physicians, and as long as
quality of patient care is not compromised. Similarly, the NLMA is
open to further exploring innovations in health care delivery
arrangements as long as the process continues to be transparent and
progressive.
In the coming months, the NLMA and the
Government of Newfoundland and Labrador will once again be engaged
in negotiations to renew the agreement that expires on September 30,
2005. As we approach these discussions, we will remain mindful of
the many competing priorities which the government must contend with
and the need to be flexible and creative in finding the best
solutions for our common problems. We are hopeful that the
government will approach us with the same spirit and that the people
of the province will be the beneficiaries of this goodwill. |
