Once more into the breach as Reform MPMDs prepare for a federal election
Patrick Sullivan
CMAJ 1997;156:1315-6
[ en bref ]
Patrick Sullivan is news and features editor at CMAJ.
© 1997 Canadian Medical Association (text and abstract/résumé)
In brief
Six physicians sit in the House of Commons' 295 seats -- 4 Liberals and 2 Reformers. The latter came to Parliament with a party that hoped to tranform Canada's political system but has had little luck doing it. Instead, the party has faced internal and external criticism. Despite the somewhat rocky term, both Grant Hill and Keith Martin hope for election to a second and final term in Parliament.
En bref
Parmi les 295 députés fédéraux, six médecins siègent à la Chambre des communes, soit 4 Libéraux et 2 Réformistes. Ces derniers ont joint les rangs des parlementaires au sein d'un parti qui avait espéré transformer le système politique canadien mais qui n'y est guère arrivé. Le parti a eu plutôt à affronter les critiques, autant internes qu'externes. Malgré la période assez mouvementée qu'a connue leur parti, Grant Hill et Keith Martin espèrent tous deux être réélus pour un deuxième et dernier mandat au Parlement.
The Reform Party has faced some vicious criticism internally and externally in the past year, during which 1 of its 53 MPs was kicked out of caucus and another resigned to take a new job. However, this hasn't fazed 2 physicians who left their practices in 1993 and won seats as Reform MPs. Both say they will be back to contest the federal election expected later this year, and both have stronger views than ever on the need for more physicians to participate in politics.
"I'm not a career politician," says Dr. Grant Hill, a 53-year-old GP-surgeon, "but I said at the start that I wanted 2 terms and I will run again."
Hill, whose Alberta riding of Macleod begins near Calgary and takes in the southwest corner of Alberta, says he will leave his first term "impressed that you can have an impact -- I thought I'd be more frustrated than I have been."
He sounds more positive than Dr. Keith Martin, Reform MP for the British Columbia riding of Esquimalt-Juan de Fuca. "I may have lost my marbles, but I will run again," says Martin, a 37-year-old emergency physician. His 3 years in Parliament have convinced him that Canada has become "a fiefdom controlled by a few," and he remains unimpressed by a parliamentary structure that forces MPs "to fall in like trained seals." Still, he says, Parliament needs physicians willing to speak out because "Canadians are not getting the health care they need."
Both MPs came to Ottawa hoping to improve the health care system and both are frustrated as their first term comes to an end. Hill, for instance, runs into a brick wall whenever he argues that a parallel private system would take some user pressure off the public system. "All you hear is that I'm trying to Americanize medicare," he says, "when I'm trying to 'Europeanize' it."
Hill says all European countries allow private systems to operate parallel to public ones -- other than Canada, the only countries that don't allow it are Cuba and North Korea. He also says the country must define what "medically necessary" means and the federal government must provide stable funding.
His riding has 30 small towns, allowing him to touch base with many rural physicians. Hill says they consider him their conduit into the system but sometimes overestimate the impact an MP can have. Many doctors have contacted him about the GST, and some think he'll "grab a minister by the collar" to explain the tax's impact on physicians.
Hill tried to stay in medicine after the 1993 election by performing surgery once a month, but time constraints and travel considerations meant he had to give up and sell his practice. "But in a lot of ways [politics] is similar to medicine," says Hill. "Instead of seeing a patient, you see a constituent. They come to me with problems like immigration or the GST and I become an ombudsman for them."
Martin has continued to practise emergency and family medicine in BC during parliamentary breaks and in the summer. "I have to do that," he explains, "because it provides a big reality check. You're incredibly isolated from the real world on Parliament Hill -- it's hard to imagine how isolated. You become cut off from the hardship and suffering that people endure."
His knowledge about what is happening within the health care system, which grows every time he sees patients during return visits to BC, leaves him frustrated and angry. The February broadcast of the final report from the National Forum on Health left him so angry he was ready to "get out of my chair and punch the TV."
Martin talked to a colleague a few days before the report's release and at the time 8 of the 13 emergency beds in that physician's hospital were filled by patients awaiting a bed on a ward. He says situations like that left him seething after the National Forum reported that no crisis exists in Canadian health care. "Shame on you for saying there is a crisis," forum member Dr. Tom Noseworthy said when the report was released.
"I say shame on them," says Martin of the National Forum. He complained that few forum members have had to face the day-to-day realities that confront physicians involved in clinical care. "I could show them the silent sick," he says.
His reaction to the forum may be another sign of his cynicism about federal politics. When he spoke at the CMA's 1996 Leadership Conference he said he sometimes wondered why physicians, members of one of the most respected groups in society, would ever seek to become politicians and members of one of society's most "reviled" groups. However, he has mellowed a little since then. "Any physician interested in running definitely should go for it -- by all means run."
Hill agrees that physician activism is essential. "I see really good signs that physicians finally realize this, and the activism over the GST is one example -- I've had lots of letters about this because of what the CMA has been doing."
He says doctors should keep active during the upcoming election campaign by raising health care issues at public forums. "And if you're considering running, do it! This [House of Commons] would be a better place with more doctors, with more nurses, with more people with practical life experiences."
For Martin, political life has been an education. Most people do not know he is an MP, or even what an MP is. "They have more urgent concerns than politics," he says with a shrug. With an election looming, he won't guess which way the political winds will blow. Redistribution has affected his riding and he has also had to deal with "a huge amount of anti-Reform sentiment."
He predicts his party will face vehement attacks over the health care issue. He isn't worried, saying he looks forward to "getting in the pit" with his opponents.
Martin is convinced that medicine has to join forces with other groups if it is to affect the direction of the health care system. "What I'm telling colleagues is that we need a strong, conscientious and compassionate voice," he says. "If our profession and other groups like nurses joined hands, we'd have that strong voice."
Hill, who has 7 children, including 3 still at home, says he faced no family pressure to leave politics. He returns to Alberta every weekend that he is in Ottawa and intends to return to practice as soon as his political career ends, but only after completing a 1-year refresher course. "Medicine is way more difficult than politics, but when I go back to it I'll be so happy that the worst complaint will seem like nothing."
Martin, who is single, intends to return to emergency medicine after completing a refresher course; he will probably seek certification in the field. However, even though he misses medicine he has no regrets about deciding to seek public office. "I wouldn't be here if I didn't think I could do something."
Neither Hill nor Martin will leave Ottawa with an MP's pension. Hill said he would have been guaranteed a total of $840 000 if he completed 2 terms in Parliament and lived until age 75. All but 1 Reform MP refused the pension.
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