Road scholars.

Skilled personnel are, or are expected to be, in short supply in Canada especially in the health care system. We are aware of immigrants to Canada who have high levels of education and training but are unable to use their skills in this country. A Toronto Sun article on highly educated taxi drivers called these people "Road Scholars." A CBC television report last year described an experienced physician who was working as a cleaner in a Calgary hospital. (As a result of the publicity, this man is now a medical resident on his way to full professional status). Canada's health minister, Ujjal Dosanjh, calls for efforts to get doctors out of the taxis and into the health care system. One report says that Canada has about 1,000 physicians trained in other countries who are not able to practice in this country.

The common problem for all immigrants is that they lack "Canadian experience" or cannot surmount the hurdles that prevent them from obtaining Canadian qualification.

Evaluating foreign education and training can be a very difficult process because the professional bodies and the educational and training institutions in this country do not have sufficient knowledge of similar institutions in other parts of the World, especially Africa, Asia, Latin America and the former Soviet Union. Yes it is difficult, but we see little evidence of any efforts being made in this direction.

One of the ways to qualify foreign-trained health workers is to provide residencies and training positions in our hospitals. However, in the 1990s the provinces cut the number of residencies for foreign-trained physicians at the same time as they cut medical training. The reason: studies in the 1980s showed that Canada was heading for a surplus of physicians. However, little was done to update these projections in the past two decades. Now we are faced with the need to restore these positions.

Cost cutting measures in the 1990s also reduced the number of nursing positions and younger nurses were eliminated in wholesale numbers. Other health-care related positions such as psychologists and social workers were also reduced drastically. This was called "common sense" and seen as being "more business-like." Today we are complaining of shortages everywhere in the health care field. Facing large-scale retirement of health care professionals in the next decade, we certainly need to look at the potential of bringing our hidden assets into the mainstream of health care. The federal government should be leading and offering financial aid to the provinces for the purpose of qualifying the skilled people who are already in our midst.

We could go overseas to find the skills we need. Other affluent countries are actively recruiting in the poorer countries. Raiding poorer countries for health care staff is a serious ethical and moral issue and we should follow the lead of the United Kingdom which restricts National Health Service institutions from recruiting in the poor countries unless the U.K. government has a mutually beneficial agreement with the supplying country. It is now planning similar restrictions on the recruitment of social workers and other community service personnel because overseas recruiting is not a preferred solution.

We Canadians have to look to our own resources to solve our problems. (As we believe in freedom of movement, we do not suggest restrictions on individuals who wish to migrate, but aggressive large scale recruiting should certainly be restricted or at the very least, discouraged.).

According to the projections we have seen, it is unlikely that expanded training opportunities will be sufficient or come fast enough to meet the need. This brings us to another question: are we using our existing personnel in the most efficient and efficacious way? This question has arisen many times over the past four decades and persists today because we have made little effort to evaluate the human resources situation in our health system. We assume that we have the best of all possible health care and that all we need is more people and more money to do more of the same.

If we are to deal with the real health needs of our population, we need to take a hard look at the ways we train personnel; we need to utilize all the skills available, and we need to make the necessary adjustments to do better. This is the only way we have of assuring that we have enough people doing the work that needs to be done.

--L.K.