Health Committee on Nov. 4th, 2025

[The Chair, Liberal, Hedy Fry]

I call the meeting to order.

Welcome to meeting number 10 of the House of Commons Standing Committee on Health.

We recognize that we are meeting on the unceded territory of the Algonquin Anishinabe peoples.

Today's meeting is taking place in a hybrid format, pursuant to the Standing Orders.

I want to remind participants about the usual points. Please wait until I recognize you by name before you speak. For those of you participating by video conference, please turn off your microphone when you're not speaking. If you click on the microphone icon, you can get your interpretation going and choose floor, French or English. If you look at your computer, you will see that icon.

All comments should be addressed through the chair. To members in the room, if you wish to speak, please raise your hand. The clerk and I will try very hard to pick you up quickly and get you in the right order. I will manage the speaking order.

I will also tell you that I will give you a one-minute and a 30-second hint to wrap up when you are speaking.

Pursuant to the motion adopted on Tuesday, September 23, 2025, the committee will resume its study of the impact of immigration policy on health care and barriers to integrating internationally trained professionals.

[Dan Mazier, Conservative, Riding Mountain, MB]

Chair?

[The Chair, Liberal, Hedy Fry]

Yes, go ahead, Mr. Mazier.

[Dan Mazier, Conservative, Riding Mountain, MB]

I have a question. Actually, it's a point of clarification.

I would like to move the following motion upon the request of the clerk—

[The Chair, Liberal, Hedy Fry]

May I finish starting the meeting?

[Dan Mazier, Conservative, Riding Mountain, MB]

No, I have the floor. This is a quick motion.

I move:

That the clerk distribute to members the witness lists submitted by each party with personal information redacted, and the corresponding work plan related to the committee's study of women's health in the 44th Parliament, no later than October 31, 2025.

This is a motion that was requested by the clerk for clarification. We did pass this motion by unanimous consent before at this committee, but it was just in words. It wasn't written down on paper. This is just a point of clarification for the clerk.

I'm seeking UC if possible.

[The Chair, Liberal, Hedy Fry]

Is everyone on side with this?

(Motion agreed to)

I have unanimous consent, so we can continue with the order of the day.

I want to welcome our witnesses.

We have, from the Town of Oliver, Martin Johansen, mayor, and then we have, virtually, Jodi Hall, chief executive officer of the Canadian Association for Long Term Care.

Each of you will have five minutes.

We will start with Mayor Johansen.

Mayor Johansen, I will give you a one-minute and a 30-second hint so that you can wrap up. If you don't get to finish everything you want to say in your five minutes, I'm sure you can flesh it out during the question and answer sessions.

Begin, please, Mayor Johansen. You have five minutes.

[Martin Johansen, Mayor, Town of Oliver]

Good morning, Madam Chair and members of the committee. It's a pleasure to be here today.

My name is Martin Johansen. I'm the mayor of the Town of Oliver. In addition, I sit as chair of the Okanagan Similkameen Regional Hospital District. I also sit as vice-chair of the SOS Health Care Society—“SOS” stands for South Okanagan Similkameen. I'm a board member of the SOS PCN steering committee.

My involvement in health care started when I was elected as mayor in 2018 and has evolved over time, with increasing involvement due to the frequent and ongoing closures of the South Okanagan General Hospital—30 this year and counting. Unattached patients, estimated to be 4,500 in the south Okanagan—that would be the Oliver/Osoyoos area—continue to be a barrier to timely physician visits and access to essential health care services for our residents.

Rural communities across the South Okanagan, including Princeton, Osoyoos, Keremeos and Oliver, face mounting difficulties in recruiting and retaining family physicians. Despite strong local collaboration, long-term primary care is strained by gaps in training, locum support and community infrastructure like housing and child care, which is needed to attract and retain providers.

Retaining and recruitment of providers are further challenged by the workload associated with rural practice. In small towns, one doctor may cover emergency, maternity, long-term care and clinic patients with limited backup. To manage the excessive workload, the lack of work-life balance and the mental health challenges associated with burnout, providers are reducing their level of service, such as giving up their hospital privileges or leaving for more urban communities.

ED closures in rural communities are unfortunately becoming the norm. There was an ED closure earlier this year in Delta that created a huge uproar, calling for immediate action from the provincial government; however, a few hundred rural community ED closures throughout the year barely make the news anymore.

Is there a solution? Well, for sure there is no silver bullet that’s going to address the issues of recruitment and retention overnight. However, it’s becoming increasingly clear that there's an opportunity to address the shortfall of available health care resources through residents, international medical graduates, Canadians studying abroad and internationally educated health care professionals living in Canada who are not working in their profession. These professionals want to practise in Canada and are ready and willing to come to rural communities, where they are desperately needed.

Increasing the resources available to evaluate candidates in a timely manner, top up training programs and streamline the credentialing process should be priorities. In addition, I think it's critical that part of the solution needs to be making sure that these professionals land in communities where the need is highest.

The health care system is under considerable strain, and I think rural communities are facing some of the biggest challenges in this country. Our aging population, with their increasing level of complex medical concerns, the administrative burden on physicians and the lack of timely care being available are adding to the sickness level and the advanced stages of diseases for residents.

Thank you for the invitation to come here today. I look forward to any questions the committee members may have.

[The Chair, Liberal, Hedy Fry]

Thank you.

My goodness, you have one minute and 44 seconds left. That was efficient. Thank you, Mr. Johansen.

I now go to Ms. Jodi Hall.

Ms. Hall, you have five minutes, please. Welcome.

[Jodi Hall, Chief Executive Officer, Canadian Association for Long Term Care]

Thank you, Madam Chair and committee members.

Thank you for the opportunity to appear before you today to discuss Canada's long-term care sector and, specifically, the challenges that we face with workforce shortages and the opportunities that we see through immigration policy.

The Canadian Association for Long Term Care advocates on behalf of Canada’s long-term care sector with a vision for a sustainable system that delivers quality long-term care for all, ensuring that residents live and age with dignity.

I would like to take a moment to express my sincere appreciation for the frontline staff and long-term care leaders who continue to deliver compassionate care and support to residents and families every day in spite of the challenges they face.

Today, I would like to share the current state of long-term care and highlight the specific opportunities for improvement through immigration.

Currently, estimates indicate that nearly double the number of long-term care home spaces will be needed by 2035, and Canada's population aged 85 and older is expected to double by 2040. Wait-lists for long-term care homes are at record highs, with many waiting in hospital beds. This is a direct impact on the broader health system, limiting hospital capacity and often resulting in cancelled surgeries and delayed care due to unavailable beds.

According to Statistics Canada, in the third quarter last year, there were nearly 25,000 vacant positions in the long-term care sector. There is work under way nationally to improve workforce data in long-term care, and this will support longer-term planning and domestic solutions; however, our workforce needs are immediate.

Right now, many internationally educated health care providers begin their Canadian careers as personal support workers in long-term care homes while working through foreign credential recognition processes. Long-term care providers often provide extensive settlement supports, such as assisting with housing, transportation, child care and credential recognition, largely from their own resources.

There is significant interest in working with the economic mobility pathways program to bring skilled refugees to Canada to work in long-term care homes, but the processing delays are significant and the costs make it challenging for many long-term care home employers to consider.

Programs such as the temporary foreign worker program play a critical role in addressing many workforce shortages. However, recent changes to the temporary foreign worker program, including the new labour market impact assessment requirements, have created significant administrative and financial burdens for employers, as they need to complete the same process for each temporary foreign worker every 12 months. This is despite the fact that the labour market impact assessment is meant to assess labour market impact, and in long-term care the shortage is already clear and nationally recognized.

However, there are opportunities to strengthen the long-term care workforce through targeted immigration policies. We ask that we expand and simplify immigration pathways, for example by creating a health care-specific pilot for long-term care. This could build on strengths and lessons learned from the home care worker immigration pilot and the Atlantic immigration program.

We ask that we create a health care-specific work permit that is exempt from the labour market impact assessment. The francophone mobility work permit is a proven model, and it addresses the significant Canadian interest in supporting official-language minority communities. The same regulatory authority could be applied to health care, another sector of national interest.

Prioritize immigration processing in all programs for individuals already working, or committed to working, in the long-term care sector, while reducing the administrative burden for long-term care employers.

In closing, we recognize that Canada’s immigration system must balance many priorities. However, it is essential that we preserve and strengthen what is working, particularly in programs that enable long-term care homes to recruit and retain vital workers.

To illustrate, I’ll share a real-life example that's happening right now. An internationally trained long-term care provider with six years of experience in the Philippines began working at a long-term care home in Prince Edward Island in November 2024 under an open work permit. Her permit expired in July 2025, while her Atlantic immigration program application was still in process. Unfortunately, the open work permit was not renewed, and she is now preparing to return to the Philippines, despite having a full-time position available.

This is precisely the kind of situation that we must avoid. If we want a sustainable long-term care system, we must ensure that immigration policy supports—not hinders—the ability of long-term care homes to meet workforce needs.

Thank you once again for the opportunity to speak with you today.

[The Chair, Liberal, Hedy Fry]

Thank you very much.

Now I'm going to go to the question and answer segment. The first round is a six-minute round. The six minutes are for the questions and the answers, so I'm going to ask everybody to be as concise as possible so we can get in as many questions as possible. Thank you.

I will begin with the Conservatives and Ms. Konanz.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

Thank you, Chair.

Mayor Johansen, I want to thank you for attending today in your role as the chair of the Okanagan Similkameen Regional Hospital District. I think it's important that parliamentary studies like the one we're pursuing here include voices from regions across the country and rural regions.

Specifically in the case of South Okanagan General Hospital, we both know that we've heard from residents and media multiple times about sudden closures of emergency room services. How many closures have there been in the last year, roughly?

[Martin Johansen]

There have been exactly 30 closures within the last year, from September 30 to October 1.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

Yes, when I counted from last September, I counted 37, but there are a lot.

That's pretty serious, the closure of an emergency room. How much notice are you or residents of South Okanagan given about the closures, which occur very regularly?

[Martin Johansen]

We're given one to two hours at the most when we hear that the hospital is being closed.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

One to two hours before the doors are closed, the local government finds out and then media is alerted.

[Martin Johansen]

I should clarify that it's not one to two hours before the doors are closed. We get one to two hours' notice of a closure, and usually that closure happens.... Depending on the day, sometimes we get notice in the late afternoon that it's going to close in the morning. It's those types of things. There's not much notice, though. It's not enough time for it to really get out to the public to make sure that they're aware, so that if somebody can't go to SOGH anymore, they can go to Penticton.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

How do you let the people of the region know that the doors are closed and locked, and that if their child falls and breaks their arm or hits their head, they can't go to their local hospital at that time?

[Martin Johansen]

The only notification is through the media, through Castanet news, with a PSA from Interior Health.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

It sounds very dangerous to me, last-minute closures.

Have you witnessed serious situations when people have shown up to the door and needed someone right away but had no one to help them at the hospital?

[Martin Johansen]

For sure, I have gotten calls from residents telling me stories of tragedies that have almost happened when they've gone to the hospital and the hospital's been closed, and they've had to head up to Penticton.

Of course, the ambulances are aware of that, and they do transport as well, but you're half an hour away, at a minimum, for that transport.

That's about all I can say on that.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

How long would it take for an ambulance, if they were called suddenly, to get to the hospital if someone showed up to the hospital doors? Penticton is, depending on traffic, 45 minutes or an hour away.

[Martin Johansen]

Penticton is 35 to 45 minutes away, and then, of course, the ambulances are available as they are available. If they're responding to calls within the area, they may be delayed as well.

Anybody with that level of sickness, I would hope, is calling an ambulance to their home, as opposed to showing up at the hospital and then calling an ambulance.

[Helena Konanz, Conservative, Similkameen—South Okanagan—West Kootenay, BC]

Why are these closures happening? In your role as the chair of the regional hospital board and the mayor of the local community, can you say why these closures are happening?

[Martin Johansen]

It's basically a lack of physicians. We've had enough nurses through our travel nurse program to be able to support the hospital, but a lack of physicians is where it comes from.

Probably 40% of the resources to keep our hospital open come from outside of the town of Oliver. The real root cause of the problem is that we do not have enough physicians in our community who are able to support the hospital as part of their practice in the Oliver area, so doctors have to come from outside of our community to support the hospital.