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Challenges for a as an Independent. (Recounts are • Liberal Dr. Robert Vaughan, in pending for some results.) Ontario’s Prince Edward–Hastings Conservative minority The majority government requires riding; 155 seats, meaning that Harper will • Dr. Gordon Guyatt, an NDP candidate he new federal Conservative have to forge coalitions with other in the Ontario riding of Ancaster– government’s minority posi- parties in the Commons, likely on Dundas–Flamborough–Westdale; T tion means it will not be able to an issue-by-issue basis, to remain in • Dr. Martin Plaisance, an NDP candi- do anything too drastic, says a profes- power. date in Quebec’s Sherbrooke riding; sor of political science at the Univer- In the early weeks of campaigning, • Dr. Richard Mathias, who ran for sity of Windsor. Harper promised that any changes the Green Party in BC’s Richmond “To the extent that [Prime Minister- he made to medicare would comply riding; elect ] wants to undo with the principles of the • Dr. Chris Milburn, a Green candidate any of the federal/provincial deals, Health Act. “Anything less is the viola- in Nova Scotia’s Sydney–Victoria; and that is going to be very hard to do,” tion of a sacrosanct commitment that • Dr. Ron Matsusaki, trying for the says Heather MacIvor. Although the all governments have made to Canadi- Greens in PEI’s Egmont riding. Health Accord that the Liberals nego- ans,” he said. — Laura Eggertson and Barbara tiated with the provinces in 2004 is “We must treat all patients equally Sibbald, CMAJ not legally binding, for example, for essential health care services, re- “there is a certain amount of political gardless of ability to pay — anything DOI:10.1503/cmaj.060109 capital invested, especially on the less is un-Canadian.” provincial side,” says MacIvor, a re- Only 4 of the 11 doctors who ran for searcher on the rebuilding of the Con- federal office were elected — all 4 were servative Party. sitting MPs. Dr. Carolyn Bennett News @ a glance Any tampering would throw funding (’s St. Paul’s riding), Dr. promises — some of which were guar- (Quebec’s Pierrefonds- Closed book: Health Canada plans to anteed over 10 years — out the window. Dollard), Dr. (Vancouver Cen- halve its budget at 6 Ottawa health sci- “It would be an incredible hornet’s test tre) and Dr. Keith Martin (BC’s Es- ence libraries and reduce staff from 26 for Harper to stir up,” she said. quimalt–Juan de Fuca) were all to 10 over the next 3 years. At the same The Conservatives won 124 seats in re-elected for the Liberals. time the department will create an elec- the Jan. 23 election. The Liberals were The 7 defeated physicians were: tronic library in collaboration with the reduced to 103, the Bloc Québécois • Conservative candidate Dr. Bob Mul- National Research Council at a cost of dropped to 51, the NDP moved up to lan, who lost to Liberal Scott Brison $41.8 million over 5 years. The move is 29, and 1 MP, André Arthur, won a seat in Nova Scotia’s Kings–Hants; part of a federal effort to trim $269 mil- lion from the department’s budget. The Canadian Health Library Association says federal scientists can’t do their jobs Promises, promises without timely access to scientific publi- During the 56-day election campaign, Stephen Harper vowed “there will be no private, cations. “It’s a big loss for scientists parallel system” of health care under the Conservatives’ stewardship. There will, and researchers,” says CHLA President however, be “real reform and real change.” The Tories promised to: Tamsin Addams-Webber. Without li- •comply with the principles of the Canada Health Act brary access, many individuals and de- •work with the provinces to “allow for a mix of public and private health care partments may have to purchase re- delivery, as long as health care remains publicly funded and universally sources directly. The cuts “could be a accessible” false economy,” says Addams-Webber. •create a Patient Wait-Times Guarantee to ensure essential medical treatment within clinically acceptable times — or allow treatment in another jurisdiction The Lottery: A Quebec coroner wants •establish wait-time reduction targets by the end of 2006 (instead of 2007 as scheduled) lottery ticket vendors to be trained to help combat compulsive gambling. The •expand educational programs for health care professionals recommendations stem from an investi- •improve access to natural and complementary health products and supplements gation into the Aug. 21, 2005, suicide of •finance a $260-million, 5-year Canadian Strategy for Cancer Control 62-year-old André Baril. The Carignan •immediately compensate people who contracted hepatitis C from tainted blood man killed himself after spending his •introduce a National Disability Act life savings of $50 000 primarily on a •spend 1% of all federal health funding annually promoting physical activity lottery game called Banco. Like vendors •provide tax credits of up to $500 annually for parents of children enrolled in of alcohol, people who sell lottery tick- programs promoting physical activity ets “are responsible for the welfare of •abandon Kyoto Protocol targets in favour of a new Clean Air Act their customers,” wrote coroner Jean- François Dorval. He says lotto retailers

CMAJ • February 14, 2006 • 174(4) | 446 News

1995. In a letter dated Dec. 7, 2005, YMC gent referrals and the greatest number chair Dr. Bruce Beaton apologized for of specialists per 100 000 population, the loss the files in March 2000 and ac- there was no clear pattern between wait knowledged the “personal and profes- times and the number of specialists per sional distress” this caused Reddoch. capita. For example, Ontario and BC The Yukon Court of Appeal eventually respectively had the third and fourth dismissed the charge of unprofessional largest number of specialists per n o i

s conduct in late 2001. Reddoch says he’s 100 000 population, yet they had longer o l p x “pleased” with the apology. — Com- than average wait times. Multiple re- E t r

A piled by Barbara Sibbald, CMAJ gression analysis showed a statistically significant negative relation between should be licensed and trained to recog- DOI:10.1503/cmaj.060042 the percentage of wait times from re- nize gambling addicts and refuse to sell ferral to consultation that were 1 week scratch-and-win and online tickets to or less and the provincial GDP (p = customers they think should not buy 0.04) and a nonsignificant relation be- them. Loto-Quebec said this would be Pulse tween such wait times and the number difficult, given that there are 10 000 ven- of specialists (p = 0.43). dors across the province, many with Do richer provinces Although PEI had the shortest wait more than one person selling tickets. times for urgent referrals, these results Loto-Quebec already has a hotline for have shorter waiting times may not be comparable to those of compulsive gamblers (866 767-5389). other provinces because of the rela- to see specialists? tively small number of specialists in the Milk banks: The coordinator of province. Canada’s only breast milk bank is call- According to the 2004 National Physi- These survey results suggest that, ing for other regions to establish similar cian Survey Database, provinces with first, there are factors affecting the effi- banks. “With the increased research on the greatest gross domestic product ciency of our provincial health care sys- the benefits of human milk, there’s (GDP) per capita (Alberta, Ontario, tems other than the number of special- greater demand,” says Frances Jones at Saskatchewan and British Columbia) ists per capita and, second, the richer BC Women’s Hospital in Vancouver. Its had among the longest wait times for provinces (in terms of GDP per capita) bank supplied 63 recipients in 2000 and urgent referrals to a specialist, in par- are not performing the best in this 255 recipients in 2004. She believes ticular Alberta (Fig. 1). Prince Edward measure of health care efficiency and more people would take advantage of Island and Quebec had the shortest access. — Mark O. Baerlocher and Al- the service if they were aware of it. About wait times, despite having lower GDPs. lan S. Detsky, Toronto

100–120 donors supply the bank with Aside from Quebec, which had milk, which is screened for infections, among the shortest wait times for ur- DOI:10.1503/cmaj.0513620 0

pasteurized and shipped to infants who 0

k need it, based on medical priority. 0 60 000 120 0 w Groups in Ontario, Montreal and $

GDP per capita Specialists Wait time ≤ 1 wk 1 ,

Saskatchewan are considering setting 1

r a 50 000 100 t ≤ ≤ ≤ ≤ up similar banks. Without milk banks, e i

p p e women often go to friends or even buy a s

40 000 m 80 breast milk from strangers they contact t c i

s t i over the Internet, says Jones. “The recip- r

l t e a ients often, especially if it’s over the In- i

30 000 i 60 p a ternet, have no knowledge of the c P w e donor’s health or history and they don’t D p 20 000 f 40 s G actually know for sure if they are getting o

human milk,” she says. — Laura Eggert- f % o

10 000 20

son, CMAJ . o

Reddoch case: The Yukon Medical 0 N 0 Council has apologized to CMA past PEI NB NS MB QC BC NL SK ON AB president Dr. Allon Reddoch for the loss Source: Statistics Canada and 2004 National Physician Survey. of files that were stolen while in the Council’s keeping. The files pertained to Fig. 1: Provincial wealth (in terms of gross domestic product [GDP] per capita), number Reddoch’s appeal of a YMC finding of of specialists per 100 000 population, and percentage of wait times that were 1 week or “unprofessional conduct” after the less from referral to consultation with specialist. death of a teenage girl under his care in

CMAJ • February 14, 2006 • 174(4) | 447