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Is N.L.'s doctor shortage illegal? A bioethicist weighs in

As a long-standing doctor shortage across Newfoundland and Labrador stretches on, physicians continue to warn that the health-care system is crumbling beneath them.
A doctor examining a patient.
About 98,000 Newfoundlanders and Labradorians are without a family doctor, the province's medical association says — and the longer the shortage continues, the more likely it could be viewed as a legal violation of the right to health care, one bioethicist says. (iStock)

As a long-standing doctor shortage across Newfoundland and Labrador stretches on, physicians continue to warn that the health-care system is crumbling beneath them — and one bioethicist warns the lack of access to family doctors could even be considered illegal.

The province's doctors' union, the Newfoundland and Labrador Medical Association, has repeatedly reported that 20 per cent of people in the province don't have a family doctor, a statistic that's remained stagnant since at least 2019.

Jennifer Flynn, an associate professor of bioethics at Memorial University, points to that longevity as a red flag for the public.

The Canada Health Act contains a legislative requirement for governments to provide "reasonable access" to health care for all residents, Flynn says — but vacant physician jobs in rural areas and overflowing medical clinics in the metro region may be enough to infringe on that law. 

"I would say most people would think that that violates that reasonable access standard," Flynn said in an interview Tuesday.

Governments have an obligation to provide access to health care, she added — regardless of any complex demands. And if the experts and public decide a government is ignoring its obligation, she said, they can hold them accountable through the media and electoral decisions.

"I think the longer that [the shortage] goes on, the less likely the public is to think that the obligation is being taken seriously," Flynn said.

Doctors themselves echo Flynn's concerns.

"My office, the phones are constantly ringing," said Dr. Shawn Metcalfe, a family physician in St. John's.

Metcalfe said he's at a loss as to where to direct people who need a general practitioner, and said people with often severe and untreated illnesses are turned away.

Health Minister John Haggie acknowledges doctors' frustrations, but says new clinics will relieve some pressure on the primary-care system. (Patrick Butler/CBC)

"You end up saying yes to more people than maybe you should" and are unable to effectively look after them all, said Metcalfe.

He sometimes sees 40 patients in a single shift, he added, attributing it to mass retirements and an ineffective recruitment plan from the province, adding to his clinic's burden.

"We hoped from a primary-care perspective that we would see the leadership recognize the struggles that family medicine has been facing," he said. 

"We've either seen silence on the part of the premier and, beyond that, outright almost combativeness from the health minister."

Relief in 'embryo form': Haggie

Premier Andrew Furey declined to speak to CBC News on the doctor shortage issue, with a spokesperson citing his membership in the NLMA as reason he's "recused from discussions."

Health Minister John Haggie, meanwhile, told CBC News on Tuesday that retention in rural areas "will not be solved overnight."

But he pointed to an announcement last month that his department would open four new collaborative-care clinics across Newfoundland by March.

Each of those clinics can handle 5,000 patients, according to the Health Department, signalling relief on the horizon.

"It is coming. It is there in embryo form," he said.

Read more from CBC Newfoundland and Labrador

With files from The St. John's Morning Show