Health Committee on June 20th, 2022

[Marcus Powlowski, Liberal, Thunder Bay—Rainy River, ON]

[Technical difficulty—Editor] interested in doing this. In my understanding as to why it is so hard for foreign graduates to get licensed, there are a couple of things. Perhaps it's protectionism within the medical community, although, having recently spoken to the former, present and future presidents of the CMA, they all expressed an interest in making it easier for foreign graduates.

The other thing I've heard as a potential obstacle is that provinces do not want to issue more billing numbers, because more billing numbers equals higher health care costs. Do you think the provinces are really interested in licensing more foreign graduates?

[Andrew Brown]

I would like to jump in and respond to that question. We really need the provinces to weigh in on where they are there. Certainly, we are seeing the pressures. We know they are feeling the pressures as well. Responding to the labour market situation and these shortages, both in a broad sense and, specifically, with respect to the health care sector, is something that will take an intervention by the federal government, as well as intervention and collaboration from the provincial and territorial governments, particularly with respect to the health care sector, given provincial-territorial mandates, if you will.

So—

[The Chair, Liberal, Sean Casey]

Go ahead. Finish your thought, Mr. Brown, and then we'll move to Mr. Garon.

[Andrew Brown]

I'll just say that this area is one where we are continuing to work with the provinces and territories. We believe collaboration is part of the solution.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Brown and Dr. Powlowski.

Mr. Garon, you may go ahead. You have six minutes.

[Jean-Denis Garon, Bloc, Mirabel, QC]

Thank you, Mr. Chair.

Mr. Brown, I'm curious as to how many projects in Quebec currently receive funding through the FCRP.

[Andrew Brown]

Thank you for your question.

I don't know the numbers off the top of my head.

Ms. Connell, do you know the answer?

[Erin Connell]

I can. We do have a contribution agreement with the Government of Quebec, the Province of Quebec, for a loans project agreement.

As Mr. Brown mentioned in his opening remarks, we do have loans projects with 11 organizations across the country. With Quebec, we have signed a four-year contribution agreement so that they can administer their loans in the manner they see fit.

[Jean-Denis Garon, Bloc, Mirabel, QC]

Thank you.

That ties in with the question I wanted to ask you. Quebec's asymmetrical jurisdiction over labour force training has long been recognized, since the 1990s, in fact. Government workers were even decentralized further to that change. That was when Emploi-Québec was established.

Can you explain the asymmetrical nature of Quebec's agreement with the federal government specifically recognizing Quebec's jurisdiction over labour force training? It is quite an asymmetrical relationship.

[Andrew Brown]

As far as the agreements with the provinces and territories are concerned, there are two agreements with the Province of Quebec relating to the labour market and training, and another relating to workforce development. Those agreements go back quite a few years.

In budget 2022, the federal government announced its intention to modernize those agreements with the provinces and territories to give them more flexibility, allowing them to develop their own training and employment support programs.

[Jean-Denis Garon, Bloc, Mirabel, QC]

I'm delighted to hear that the other provinces may take a page from Quebec's book with the recognition of their own jurisdiction in the area.

The idea of using so‑called federal spending power is being floated around here. It's often used to sweeten the pill. The government would use its spending power to somewhat force the provinces to change their approach, specifically with respect to immigration and the way in which they deal with foreign candidates in the medical profession such as nurses.

It is well known that Quebec wants even more control over immigration. Quebec is already responsible for its own economic immigration. That, too, is an example of its asymmetrical jurisdiction.

Does the federal government intend to place conditions on health transfers, or other funding, to influence Quebec's economic immigration decisions, particularly when it comes to selecting candidates in the medical profession?

[Andrew Brown]

It's hard to answer that question because it pertains to immigration and the agreement with Quebec. I work for a different department, Employment and Social Development Canada. I think the two governments are still in talks to conclude a new agreement, but the federal government certainly intends to fulfill its commitments under the current agreement.

[Jean-Denis Garon, Bloc, Mirabel, QC]

Obviously, like always, we hope those commitments include respecting Quebec's jurisdiction.

Finding people to work in health care is hard because the health system lacks funding, which makes working conditions especially challenging. I'm talking about Quebec's health system, specifically.

Nurses have to work mandatory overtime. Things have only gotten worse with the pandemic, so much so that, in the government's last budget, the Minister of Health was forced to make $2 billion in urgent health care funding available. There were no strings attached to the transfer, which was meant to help the provinces address the backlogs of delayed surgeries.

Do you think inadequate federal funding for health care, coupled with the government's refusal to provide transfers unconditionally and the fact that working conditions are worsening as a result, is a barrier to recruitment?

Who wants to work in an underfunded health care system with poor working conditions? Do you think that hinders recruitment?

[Andrew Brown]

Thank you for your question.

Clearly, the working conditions can make it harder to recruit people. That said, you would be much better off talking to Health Canada officials about health care.

What I can say is that establishing a human resources strategy for the health sector is extremely important. That's where our department can play a role. The focus needs to be, first, on people who are in Canada and who can obtain training to find a job in the health field and, then, on people outside the country.

It's important for Canada to find a way to recognize those individuals' credentials as well as their foreign experience so they can help meet Canada's needs.

[The Chair, Liberal, Sean Casey]

Thank you, Mr. Brown.

Next, we have Mr. Bachrach, please, for six minutes.

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

Thank you, Mr. Chair.

Thank you to the committee for allowing me to be here on behalf of my colleague Mr. Davies.

Thank you to our witnesses as well.

I'll start with a pretty general question about the issue of overqualification.

I'm wondering, Mr. Brown, if you can speak to whether your department has the proportion of recent immigrants to Canada who are currently working in jobs at skill levels that are below what their credentials would allow for, and is that a statistic that's easily available?

[Andrew Brown]

Again, thank you for that question.

On that, I am not certain of the response.

I wonder, again, Ms. Connell, if you may be able to help out with this, if we have such information.

[Erin Connell]

I'm afraid I don't have that statistic handy, but we would be happy to provide it in writing.

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

Maybe on just a general level, would you say that situation of overqualification is more common among recent immigrants to Canada than it is for Canadian-born individuals with comparable educational credentials?

[Andrew Brown]

I think that would be a fair statement to make, with the rationale or reason behind that being the need for people who have trained abroad to have their credentials recognized or in fact to pursue some retraining here to then be recognized as a professional in Canada. It does add an additional barrier for someone who is trained abroad as to someone who is trained here in Canada.

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

Thank you, Mr. Brown.

You mentioned that budget 2022 provides $115 million over five years, with $30 million ongoing, to expand the foreign credential recognition program and help up to 11,000 internationally trained health care professionals per year get their credentials and be recognized in their field.

On average, how many professionals have their foreign credentials recognized in Canada each year currently?

[Andrew Brown]

Thanks again for the question.

Certainly, of course, provincial and territorial governments and regulatory bodies are responsible for that review and accreditation.

I don't know, Ms. Connell, whether we have figures that have been compiled from those jurisdictions and agencies.

[Erin Connell]

I don't have a macro number because, as mentioned, it is a provincial and territorial responsibility. There are 150 regulated occupations.

One figure I could offer is that, through our loans project, which has the goal of helping immigrants through the foreign credential recognition process, to date we've helped 30% of the people who have received loans acquire their credential recognition. An additional 30% found work in their field of study.

[Taylor Bachrach, NDP, Skeena—Bulkley Valley, BC]

Thank you, Ms. Connell.

I guess what I'm trying to get at is this 11,000 number. What is it based on if it's not based on a comparison to how many are currently being credentialed? Without knowing how many are currently being credentialed, how did we set this target of 11,000 internationally trained health care professionals per year?

I guess what I'm trying to get a sense of is if that is a reasonable target. Is it ambitious? How does it compare to the current pace? If we're currently credentialing 5,000 per year and we want to get to 11,000, that seems like a pretty achievable thing—I have no idea—but if we're currently credentialing 50, then it's much more ambitious. Do you have any sense, even in ballpark numbers, of how many foreign-trained professionals are being credentialed?

[Erin Connell]

Again, I can't give a ballpark figure. We can certainly take that back, but it's very difficult to extract that data. Some provinces are better than others at reporting that.

To achieve our target of 11,000 per year, we intend to do that through our project-based funding. That is through systems improvements that will help skilled newcomers get their credentials recognized, through our loans, where a number of skilled newcomers receive loans and support services, and through the participation of skilled newcomers in our Canadian work experience projects, in mentorship programs, work placements and wage subsidies.

It's a collection of our interventions at a project-based level.