Patrick Sullivan is CMAJ's news and features editor.
Canadian Medical Association Journal 1995; 153: 1154
Dr. Hedy Fry, parliamentary secretary to the federal health minister, told 40 physicians attending the annual meeting of the Federation of Medical Women of Canada (FMWC) that Ottawa has no plans to alter the basis of Canada's health care system. Fry, a past president of the British Columbia Medical Association (BCMA) who has years of experience on BCMA and CMA committees, said her party's Red Book states that Ottawa will protect medicare and the Canada Health Act and it does not intend to deviate from that policy. "Canadians don't want their system to change," she said. "Health-system renewal doesn't mean shifting principles."
However attempts to improve the system are possible, she added, and doctors have to be involved in these discussions.
Fry made a strong pitch for Prime Minister Jean Chrétien's National Forum on Health, arguing that it will give health care increased visibility that will allow Canadians to discuss major issues: "The process is being led by 24 men and women, and they want to spark a frank and open dialogue." Ultimately, she added, "how the system should work will be up to the public."
How "frank and open" the dialogue will be is open to debate, for Fry made clear that the national forum's starting premise is that the fundamentals of the existing health care system do not need to be altered and there will be no room for modifications such as increased privatization. (At the CMA annual meeting, General Council called on the association to conduct a national debate on the need for a parallel private health care system.)
The CMA's scepticism about the national forum and federal health policies was made clear by Dr. Jack Armstrong, the new CMA president, in his inaugural speech. Although Fry said the forum "will create a vision for health care change," Armstrong is worried that it will become "merely an expedient mouthpiece for the federal government." If that happens, he warned, "we must not be silent."
Armstrong fired several shots across the federal bow. "If the federal minister of health says that less federal financing really means more clout, we must speak out," he said. "And if the federal government pledges to do all it can to curb the use of tobacco, a habit that kills 40 000 Canadians a year, and then reduces tobacco taxes, permitting countless more young Canadians to start smoking, then we must speak out and point out the hypocrisy."
Fry said she realizes that many physicians feel frustrated and ignored in debates about the future of medicare "but it is not OK to throw up your hands, because changes will take place regardless of whether physicians are involved. And you can't afford to be uninvolved."
During a question-and-answer session, Fry said female physicians have to take much of the blame for the male dominance of organized medicine. "Those of you in this room have taken a leadership role," she said, "but look at how [few] of you there are. Are the women in medicine standing up and running for office? When you say the provincial organizations are run by men, are you involved in trying to change that?"
Fry maintained that the involvement of female physicians is crucial to organized medicine because "you have a different perspective to bring to the debate. What you need to do as a federation is be vocal, be loud and say what you think."
She added that she would pay close attention to the number of women participating in the CMA's annual meeting. "If 10% of the participants are women," she said in an interview, "I'll be surprised."
The FMWC's new president is Dr. Rozmin Kamani, a Vancouver family physician, who said the federation can play a leadership role in issues affecting women's health. "There is history in the making," she said, "and we want to be part of it."