Merci. Good afternoon.
On behalf of CIHI, the Canadian Institute for Health Information, I would like to thank you for inviting us to participate in this round table on health human resources.
CIHI—that is the English acronym—is an independent, not-for-profit corporation that provides essential information on Canada's health system and the health of Canadians. Established in 1994, we are funded by federal, provincial and territorial governments. We report to an independent board of directors representing government health departments, regional health authorities, hospitals and health sector leaders across the country.
CIHI works in partnership with stakeholders to create and maintain a broad range of data bases, measurement tools and standards on health information. We produce reports on health care services, population health, health spending and health human resources.
While it is not our mandate to make policy recommendations, we hope our impartial information will assist you with your work.
More than one million people in Canada--6% of the total Canadian workforce--are employed directly in the health care sector. Women represent about 80% of this health care workforce.
CIHI has been collecting detailed information on physicians and nurses since its inception. In response to the pan-Canadian health human resources strategy that Kathryn McDade from Health Canada discussed with this committee, CIHI has created new databases that provide detailed demographic and workforce information on occupational therapists, pharmacists, physiotherapists, medical laboratory technologists, and medical radiation technologists. CIHI also collects aggregate data for an additional 17 health occupations, including chiropractors, midwives, and psychologists.
We did distribute to members a copy of the report that includes a profile of those 24 professions. And since our most comprehensive data are on physicians and nurses, the majority of my remarks will focus on these professionals.
In terms of demographics, the number of physicians in Canada has increased slightly faster than the population since 2003. In 2007, the latest year available, there were nearly 64,000 active physicians in Canada. The number of new physicians entering practice has also been increasing since 2003.
The average age of physicians in Canada was nearly 50 in 2007, with one in five physicians aged 60 or older. Their retirement patterns tend to be different from many other workers in Canada. Many studies have revealed that physicians tend to phase slowly into retirement rather than just leave at a precise age.
Younger physicians and female physicians, regardless of age, tend to practise differently from their older peers. They place more emphasis on work-life balance.
While Canada has a smaller ratio of doctors per 1,000 inhabitants than the OECD average, it has a higher ratio of nurses. This is likely due to differences in models of care. Central European countries tend to have more physicians, while the British model, which more closely resembles Canada's, relies more heavily on nurses.
Regulated nurses represent the largest group of regulated health professionals in Canada, with more than 332,000 members. The growth rate of this entire workforce was 7.5% between 2003 and 2007. During this time, the Canadian population grew at a rate just above 4%. The average age of regulated nurses is 45, about 5 years younger than physicians. Almost 22% of them were 55 or older in 2007.
With respect to inter and intraprovincial migration, a CIHI study on migration patterns of health professionals in Canada shows that more than 18% of them moved between 1996 and 2001, which is about the same percentage as for the general Canadian workforce during that time. This data is based on the 2001 census.
Our study also found that migration happens primarily within a province. Health professionals tend to relocate to where there is an economic boom—just like the Canadian workforce in general.
What about movement in and out of the country? For the fourth year in a row, the number of physicians who reported returning to Canada in 2007 was greater than the number who reported leaving. When it comes to internationally-educated professionals, our data show the proportion of regulated nurses educated abroad has been relatively stable over the past 30 years, at around 7% of the nursing workforce. The rate of international medical graduates was nearly 23% in 2007—down from 33% in the late 1970s. We have noted, since then, a gradual decline in the number of internationally-educated physicians in the physician workforce in Canada.
As an organization dedicated to improving, standardizing, and providing information on health and health services in Canada, CIHI appreciates your interest in its work on health human resources.
I would be pleased to answer any questions you may have in the official language of your choice.
Thank you. Merci.