Health Committee on May 13th, 2008

[Lui Temelkovski, Liberal, Oak Ridges—Markham, ON]

Thank you, Madam Chair.

Thank you to all the presenters.

The 10-year plan committed government to increase the number of health professionals, including targets for training, retention, and recruitment, and making their plans public—it asked that everybody make their plans public. Also, the federal government agreed to expand assessment of internationally trained graduates, make efforts in aboriginal communities, reduce the financial burden on students, and so on.

Mr. Davis, you mentioned that there's a shortage of laboratory staff. Have your membership numbers increased in the last three or four years, or have they remained relatively similar?

[Kurt Davis]

In our organization, the membership numbers have been holding steady because of the reality that the retirees have not been leaving as fast as was originally anticipated, so the number of new graduates coming into the system is basically keeping pace. I think the mutual fund meltdown of 2001 is keeping professionals in the workforce more than they originally planned.

But I know that right now we actually have a problem, this week, in that we have too many job ads coming in. Our staff can't keep up with the postings on our website.

[Lui Temelkovski, Liberal, Oak Ridges—Markham, ON]

What is the situation with the pharmacists, Mr. Poston?

[Dr. Jeff Poston]

One of the positive things that came out of the plan was funding for the Canadian Institute of Health Information. Pharmacists are one of the health care professions for which CIHI is building a better database, so that we can get a better understanding of numbers.

We still see shortages, though; we still have shortages in practice. I think the one concern is that we're far from being self-sufficient as a country. We're heavily dependent on internationally trained pharmacists.

[Lui Temelkovski, Liberal, Oak Ridges—Markham, ON]

So we're still short.

[Dr. Jeff Poston]

We're still short, and I think what's happening—the other concern—is that we're becoming increasingly dependent on foreign-trained pharmacists.

[Lui Temelkovski, Liberal, Oak Ridges—Markham, ON]

And what is the case for the nursing association, Madam Silas?

[Linda Silas]

The shortage is in a crisis situation. In 2005-06, a report was given on the HHR pan-Canadian strategy. But we have to realize that CIHI counts a nurse like me and a doctor like Dr. Bennett, and we haven't touched a patient in a while. That doesn't help in the numbers.

Just in the city of Winnipeg, there are today 870 vacancies in nursing positions. In Edmonton and Calgary, it's 2,000 vacancies. We spend 18 million hours of overtime per year. That's equal to 10,000 full-time jobs in nursing. So there is a crisis.

[Lui Temelkovski, Liberal, Oak Ridges—Markham, ON]

So from the three organizations, what I hear is that there's a crisis in terms of numbers of professionals who are needed. Yet we have a report that says everything is rosy.

I don't get it. I don't get it because for me it's very simple: if you don't increase the number of pharmacists, if you don't increase the number of nurses, if you don't increase the number of technologists, how are these wait times being improved? Who's improving them? Do we have better machines? Are they working 36 hours a day? Where is the misunderstanding, or is there information that's not coming through properly?

[Dr. Jeff Poston]

I think the report on wait times identified better utilization of existing staff as one of the key things--actually taking a very critical look at how existing staff is being used. There has been some research work around that, and certainly some of the improvements around administration of waiting lists and those types of things have been critical. So I think there have been some administrative changes made, in utilization of staff and administration, that have improved wait times.

But you're correct. The underlying problem is simply going to get worse, as we all I think have aging workforces. As I say, from our perspective we're becoming heavily dependent on foreign-trained pharmacists. The situation is going to get worse unless we have some significant new investment.

[Lui Temelkovski, Liberal, Oak Ridges—Markham, ON]

Mr. Moist, could we hear from your union?

[The Chair, Conservative, Joy Smith]

I'm sorry, Mr. Temelkovski, we're out of time now.

I'm going to have to go to Monsieur Malo.

[Lui Temelkovski, Liberal, Oak Ridges—Markham, ON]

I'm sure he will continue.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Thank you, Madam Chair.

I am going to continue along the same lines as Mr. Temelkovski and talk about human resources. You all deal with human resources. As I understand it, every sector has a shortage of human resources.

In the Strategic Health Human Resources Action Plan that is part of the 10-year plan to strengthen health care, there is an important commitment to, and I quote:

targeted efforts in support of Aboriginal communities and Official Languages Minority Communities to increase the supply of health care professionals for these communities;

So, efforts must be much more targeted. In fact, we spoke earlier about First Nations communities and the lack of data. Do you know if the objective has been achieved in First Nations communities? As a professional association and perhaps as a trade union, are you part of the effort to achieve that very specific objective?

[Paul Moist]

I would say baby steps have been taken. Our biggest success story is with the Government of Saskatchewan and the health authorities in Saskatchewan. We've taken aboriginal employment for support workers in an acute care setting from 1.8% of the employees to 11%. One hundred percent of the employees have received aboriginal cultural training to prepare Saskatchewan health care workers, but that's the exception, not the norm.

We have had sitting on the federal minister's desk, for about a year apparently, an approved partnership agreement for CUPE to take similar initiatives to workplaces across Canada to employ aboriginals, but we haven't been able to get it signed off on. I would say we have taken some very good baby steps, but there is still much to do yet.

[Linda Silas]

The only provinces where real progress is being made are Saskatchewan and Manitoba, where funding really is made available for First Nations people to study to become nursing assistants or nurse practitioners. Funds and programs are in place. There is similar funding for doctors, but I do not have all the details.

As Paul said, there have already been committees in the past on health resources in First Nations communities, but everything has been put on hold.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

Why?

[Linda Silas]

We do not know. Among the witnesses here, I notice that there is not one representative of a First Nations organization. It is difficult to prepare a presentation for the committee. This is 2008; we have to come up with research, not fancy words. Communities and associations, like nurses, for example, do not have the research resources to be able to prepare very quickly. It is a big problem. It is a big problem also in the light of the $115 million they have received.

[Luc Malo, Bloc, Verchères—Les Patriotes, QC]

So you are telling me that the committee will never hear a First Nations group because it is incapable of preparing for its appearance here.

[Linda Silas]

I cannot say that. I can say that it is difficult enough for a large organization like ours to prepare a presentation in the time we had. It is even more difficult for a small organization.

My recommendation to the committee would be to conduct a study exclusively on the situation of First Nations and to give the witnesses much more time to prepare to appear before the committee. I am not aboriginal and I cannot speak for them. But it is a problem.

[Barbara Byers]

Can I just add something there?

Over a long number of years, the Canadian Labour Congress has proposed a system of training insurance under EI. We were trying to get some pilots going across the country to address specifically the question of aboriginal workers who may be in the health system, who may be in support work, and who want to train for some other types of jobs, and also the question of new Canadians, immigrants, and so on.

That's something we will continue to push--that currently employed workers should have access to their EI system in order to increase their skills so that they can move into other jobs within the health care system as well.

But one of the things we have to also recognize--and Romanow recognized it in his report--is that Canada has a responsibility not to poach from other countries in terms of immigration.

[The Chair, Conservative, Joy Smith]

Thank you, Ms. Byers.

Ms. Wasylycia-Leis.

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

I want to pick up on that point. It seems to me that the only pan-Canadian strategy this government has for dealing with the human resource shortfalls in the health care field is to bring in, open up, or change priorities with respect to immigration, making it possible to bring people in with foreign temporary work permits and scrapping any good programs that were working, such as the one in Saskatchewan to train aboriginal folks in the health care field, to increase education places, to recognize foreign credentials. All of the things that would deal with the shortage are not on the books, but this immigration proposal is.

Is that your stance? And what's the problem with it?

Barb? Linda?

[The Chair, Conservative, Joy Smith]

Ms. Byers and Mr. Davis have indicated.... We'll hear Ms. Byers first and then Mr. Davis.

[Judy Wasylycia-Leis, NDP, Winnipeg North, MB]

And also Linda Silas.