We would like to talk about two things today: OT workforce issues and challenges, and making the case for universal access to OT.
The OT workforce in Canada has grown from some 7,500 therapists in 1997 to over 20,000 in 2021. Although we have seen good growth, this is absolutely not enough. OTs are an essential part of the primary care team, supporting seniors to age in place, providing vital mental health services, supporting kids with autism, helping to tackle the opioid crisis, supporting indigenous communities and providing long COVID rehab services, to name a few.
Only 3.7% of our workforce is in rural settings, which is very misaligned compared to the 20% of Canadians who live rurally. Eighty-five per cent of our workforce is frontline professionals, delivering vital care in hospitals, community health and long-term care settings.
Demand continues to grow exponentially, and supply simply has not kept pace. The 2013 national survey of 60,000 Canadian physicians found that over 70% expressed difficulties in referring patients to publicly funded OTs. In addition, the Government of Canada's Canadian occupational projection system validates that OT is one of the professional categories where demand will exceed supply until at least 2028. During this time, OT job openings are expected to outpace the workforce by at least 20%. Further validation comes from our provincial and territorial OT associations, who consistently report difficulty in securing therapists for vital positions. For example, earlier this year in Edmonton alone there were over 70 OT positions that were posted and couldn't be filled.
In a 2021 report, Canada's chief public health officer said that COVID provides an opportunity to address long-standing gaps in the health care system, and we could not agree more. OTs, because of their education, competencies and scope of practice, can make an invaluable contribution to transforming the current expensive hospital-centric medical and sickness care model to a less expensive patient community-centric health and wellness model of care. The latter, emphasizing health promotion, disease and injury prevention and management, is well within the scope of function and occupation-focused OT practice. COVID has also demonstrated the critical need for interprofessional, team-based primary care models that include OTs.
So what's the problem? OT services are not widely covered as part of public and private extended health benefits plans, with only five major insurance companies having OT coverage listed as a flex option, meaning that it's not automatically included in plans. Many employers, including the Government of Canada, do not cover OT services in their health benefits plans. With so little coverage, we are seeing Canadians incur out-of-pocket expenses to access services for their autistic child, their teenager who may be struggling with suicidal thoughts, or their parents who want to age in place and need home modifications, to name only a few scenarios.
What's the solution? Occupational therapy must be part of the basket of publicly administered, universally provided health care services. The status quo is absolutely not acceptable and inaction is no longer an option. Canada needs a comprehensive and integrated primary care strategy that includes OTs on all primary care teams across Canada. This will positively impact the health care system by improving the patient experience: the right quality of care, the right time, by the right regulated health professional in communities where Canadians live, study, work and play. This also delivers positive health outcomes, all while reducing per capita health care costs.
At no other time has the impact of disruption on daily lives and function been more apparent. Everyone has been affected by COVID. OTs are function- and occupation-focused regulated professionals. This is in our DNA. Ensuring that Canadians have access to this necessary service is critical to their health.
The time is now. OTs should no longer be considered a nice-to-have option in health care. OTs are must-have health care professionals who can help transform the health care system to better meet the needs of Canadians.
Thank you very much for the opportunity to present to the standing committee today.