MONTREAL - The incoming leader of the association representing Canada's doctors says private health care will play a key role in helping the country's ailing public system.
In his inaugural address, Dr. Robert Ouellet told the Canadian Medical Association on Wednesday that he envisions a mixed public and private health-care system.
"The fact is that the private system exists, and like it or not, it is here to stay," Ouellet told hundreds of doctors gathered in Montreal for the CMA's annual meeting.
"We need to accommodate it in order for the public system to prosper."
Ouellet, who runs several private radiology clinics in Quebec, said Canadians must "pull their heads out of the sand" and realize that private health care exists almost everywhere in the world.
He said private care can "intervene in a complementary way" where the public system is overburdened.
He cited a host of statistics to back his case: Canadian health-care costs have quadrupled in the last 20 years; the country's doctor-to-patient ratio has plummeted; by 2011, the number of Canadians over 80 will have jumped by 43 per cent.
Ouellet called the overall state of Canadian health care "alarming."
"We have one of the most costly and least efficient health systems of any industrialized country," he said.
But he also stressed that he was not advocating the privatization of the Canadian health-care system.
"It's not for everyone... it's not all doctors who will go to the private side, that's for sure, and it's not feasible everywhere," Ouellet, 62, said.
The native of Longueuil, Que. works in both sectors, like many radiologists in Quebec.
"Does it make sense, in the face of a shortage of operating rooms, to ban surgeons who provide 90 per cent of their services in a hospital from performing five to 10 per cent of their surgeries in a private clinic?" he asked.
Ouellet was to be sworn in Wednesday evening by the CMA's outgoing president, Dr. Brian Day.
Day, an orthopedic surgeon who founded a private surgical facility in Vancouver, was dubbed the "Darth Vader" of medicare by opponents of the private system.
Ouellet's nomination signals the CMA - which represents 67,000 doctors across Canada - will continue to push for private solutions to public health-care problems.
Opponents to increased privatization counter that more private care would only stretch waiting lists.
"I totally agree with Dr. Ouellet that we need to do better. . . but most of my patients can't afford to go to Dr. Ouellet's clinics," said Dr. Danielle Martin, a family physician and chair of Canadian Doctors for Medicare.
She said projects like running two operating rooms side-by-side, so one can be cleaned while medical teams move to the other, are already improving efficiency in hospitals around the country.
"We're going to have to find solutions that benefit everyone and not just people who can afford to pay," said Martin, who works in Toronto and rural Ontario.
"There's just no market outside of major cities for this kind of thing."
But Ouellet claims most Canadian doctors support a shift to a more public-private mix.
"They knew what Brian (Day) was doing, they knew what I'm doing, and they voted for us," said Ouellet, who noted nobody ran against him for the leadership.
Newfoundland and Labrador Medical Association president Dr. Elizabeth Callahan said she is open to exploring new avenues to improve patient care.
Callahan said there are currently no private clinics in the province, but more people are considering them as a viable alternative.
"We've always been highly in favour of a publicly-funded system, but I think we, as an organization, certainly have reached the stage where we realize there have to be alternatives because the system is not working," Callahan said Wednesday.
"The wait times are totally unacceptable and there are shortages across the country, especially in Newfoundland. The cracks are starting to show."
Day believes one of the main challenges his successor will face is bringing national attention back to the health-care debate.
"The CMA remains concerned that federal politicians are not addressing some of the key issues affecting health and health care," he said.
On Monday, federal Health Minister Tony Clement angered doctors by questioning the ethics of physicians who support safe-injection sites for drug addicts.
Ouellet received a long round of applause Wednesday when he took Clement to task for the remarks.
"We have been trained and are dedicated to providing excellent care to our patients," Ouellet said.
"We don't need lectures on ethics from politicians. I think Mr. Minister, the message is clear."
