Thank you.
I am Pamela Foster and I am a policy adviser with the Canadian Federation of Nurses Unions. I apologize on behalf of Linda Silas, our president, who was hoping to be here tonight but wasn't able to come.
I'd like to thank the standing committee for the opportunity to share our views.
We represent 156,000 nurses and student nurses across the country and we work in hospitals and communities, in long-term care, and in homes.
I want to focus on three issues today. I want to talk about improving patient safety and outcomes by addressing nurse staffing standards, moving beyond the hospital walls to support changes not only in Canada's aging population but in Canada's population health, and the importance of investments in early childhood education and care.
Hospitals across this country are working at 100% capacity or more, yet the generally accepted standard of safe hospital occupancy is 85%. The results of overcrowding in our hospitals include compromised care, high rates of hospital-acquired infections, and unnecessary rates of hospital readmission. Another result is dangerous levels of nursing workload and the resulting vicious circle of nurses working short.
Two decades of national and international research have consistently demonstrated a clear relationship between inadequate nurse staffing and poor patient outcomes. Hospital-acquired pneumonia, urinary tract infections, sepsis, hospital-acquired infections, pressure ulcers, gastrointestinal bleeding, medication errors, falls, failure to rescue, and longer-than-expected length of hospital stays have all been measured as a result of overwork.
The link between nursing workloads and patient safety is as clear in long-term care as it is in the acute care sector. The more direct the care, the better the resident outcomes. This includes lower mortality rates, improved nutritional status, better physical and cognitive functioning, better lower urinary tract infection rates, fewer incidents of pressure sores, and fewer hospital transfers.
By now I'm thinking some of you may be asking yourselves what the federal government has to do with nursing workload and safe staffing standards.
We are requesting that you consider implementing the Senate committee recommendation from their review of the 10-year accord that asked that the federal government establish a Canadian health innovation fund to identify and implement innovative and best practice models. This would include safe staffing models in health care delivery and the dissemination of those examples across the health care system.
We'd also encourage the federal government to work with the provinces and territories on the development and deployment of data indicators to track nursing workforce and workload, including undertaking regularly the national survey of the work and health of nurses that was done by Canadian Institutes of Health Research, Health Canada, and Statistics Canada in 2005.
The innovation fund should also support workplace models that improve patient safety, support the kinds of innovations identified by the premiers' working group on health-care innovation, and support innovations that involve integrating care beyond the hospitals.
You've heard at this year's budget consultation, and in previous years, about the calls for a healthy aging strategy and a continuing care strategy. We echo that recommendation.
As part of the national strategy for continuing care, we would be remiss not to look once again at pharmacare and access to affordable, safe medicine. We were encouraged that the federal health minister expressed interest in joining the premiers on bulk pharmaceutical purchasing, following the FPT health ministers' meeting last month, and we hope to see some indication of federal leadership on bulk purchasing in this federal budget.
Last, we recommend funding for a national early childhood education and care program. The nurses first passed a resolution calling for a national child care program at their convention in 1991. Fast forward to 2012.
I have three children. I live here in Ottawa. I spend $29,000 a year on child care. I'm able to do this, and I work four days a week, so I'm not even full time. I'm spending over 50% of my take-home pay on child care.
Research shows that public investment in early childhood education and care pays off for governments and it pays off for families. Quebec has a child care program that serves about half of Quebec children under the age of five. Nationally, Canada is about 20%; Quebec is at 50%. The Quebec program has allowed an additional 70,000 women with young children to enter the labour force, which has led to a 3.8% increase in women's employment overall. The ripple effect of this is incredible, with $5.2 billion added to the provincial economy, increasing Quebec's GDP by close to 2%. Furthermore, the impact of working mothers increases purchasing power and taxes and means that Quebec recovers $1.05 for every $1 it invests in child care, and Ottawa another 44ยข.
Nurses join with others in recommending that the universal child care benefit be pooled across the population and that savings in terms of direct transfer then be used to assist provinces and territories to expand their accessible, affordable, and quality child care spaces.
Thank you.