Health Committee on May 11th, 2010

[Leslie MacLean]

In the eight provinces where we have institutions, we work to have people who hold licences in those provinces. As you would know, for some professions, transferring their licence from one jurisdiction to another is much easier, for example, for nurses. For psychologists, that has been presenting a stumbling block for us because the process to transfer the psychology licence from one jurisdiction to another is not as easy. My colleague in human resources and I have been working with the Professional Institute of the Public Service of Canada to try to address those issues.

[The Chair, Conservative, Joy Smith]

Sorry, I gave you eight minutes, Dr. Bennett.

We'll now go to Monsieur Dufour.

[Nicolas Dufour, Bloc, Repentigny, QC]

Thank you, Madam Chair.

I would also like to thank the witnesses for coming here today.

Continuing in the same vein, I have a question about psychologists. it was said that 50 of them are on contract. You explained briefly what problems that can cause.

As I understand it, you do not have enough psychologists. You say that the vacancy rate is nearly 20%. That must cause serious problems?

[Leslie MacLean]

Our challenge is always to ensure continuity of care for inmates. Certainly staff could meet inmates' needs with more thorough knowledge if they were employees of the Correctional Service.

I would like to correct something, though. I mentioned 50 contracts a minute ago; actually it is more than 50 contracts with doctors and more than 50 contracts with psychiatrists. For psychologists, I don't know the exact number of contracts with them. I can provide that information to the committee members later, however.

For the Correctional Service, not having psychologists among its employees presents a challenge, since there is no continuity among members of the interdisciplinary team. We have to provide high quality service to meet inmates' health needs, so psychologists, social workers, nursing staff, staff, correctional officers and case managers all have to work together. They have to work as a team to respond in an integrated manner.

We are happy the ones on contract are there to help us, but we would certainly prefer to have those services provided by employees.

[Nicolas Dufour, Bloc, Repentigny, QC]

Not having permanent, long-term employees must also create a problem because you can't provide follow-up for an inmate from A to Z. Essentially, there is a risk of their case being handled by several people?

[Leslie MacLean]

That can happen, certainly. When you have contract employees, you try to provide continuity of care. As well, those employees have to document their work with inmates properly, the things they do, because that is definitely part of the professional discipline.

[Nicolas Dufour, Bloc, Repentigny, QC]

I want to talk specifically about the strategy you have adopted. I have a few questions. How are you going to find new staff? You explained it a little a minute ago, but I would like to have more details.

In concrete terms, how does the process work? How did you develop your strategy and how did you get to the challenges you referred to earlier?

[Leslie MacLean]

I would just like to request a clarification. Your question is about our recruitment and retention strategy? Yes, obviously.

We first developed our strategy in 2008, by assessing, based on the knowledge we had at that time, what our main challenges were, and our opportunities, and how to optimize them. We worked with the Federal Healthcare Partnership for the specific purpose of determining the job fairs or exhibitions where we are going to find students this might interest. We would like students to be able to do a placement with us to see what life is like in the penitentiary system, what it's like to work in this kind of interdisciplinary team. Certainly there are areas where you don't have any latitude, because of salary and benefit issues, for example. We are trying to see what aspect of professional development can be used to maximize our employees' strengths, but we are also trying to make the Department be seen as an employer of choice.

[Nicolas Dufour, Bloc, Repentigny, QC]

Can salary be a problem for someone who wants to come into...

[Leslie MacLean]

Possibly, it depends on professional qualifications. It also depends on where positions are available in the country. As my colleague Mr. Macaulay said earlier, we have some penitentiaries that are remote, like the one in Port-Cartier, near Sept-îles, where the availability, education and skills required of staff may present challenges.

[Nicolas Dufour, Bloc, Repentigny, QC]

Do you have contacts with other groups or other agencies, for example the Department of Health, not just in developing your strategy, but in the day to day things, to observe how other agencies that deal with health care professionals recruit?

[Leslie MacLean]

There are two items worth looking at. First, we work in an integrated manner with our colleagues from other federal departments that also provide health care services, precisely so we present ourselves not as six departments that provide health care services, but as the government of Canada that offers widely varying job opportunities.

Second, the Correctional Service also has a committee of professional health associations that advise the Department in relation to our health care services and how we do things. I have presented our recruitment and retention strategy to that committee on several occasions in the past. This was precisely to see whether those health care professionals or representatives of an association of health care professionals had advice to give us for fine-tuning our strategy, to meet the challenges better.

[Nicolas Dufour, Bloc, Repentigny, QC]

Do I have any time left?

[The Chair, Conservative, Joy Smith]

You do. I've given you a little extra time, because I gave Dr. Bennett quite a bit, so go ahead.

[Nicolas Dufour, Bloc, Repentigny, QC]

Thank you.

I just wanted to ask Ms. Scott about the increase in the budget for the program she is in charge of. What might explain how it rose from nearly $35.9 million in 2000-2001 to nearly $90.8 million in the projections for 2009-2010?

[Dr. Lise Scott]

Thank you for your question.

The first thing you can see, if you have your table of program expenditures in front of you, is that the number of clients rose quite significantly. It went from 71,000 clients in 2000-2001 to 128,000 clients in 2009-2010.

We don't have the number, but there has also been an increase in the number of claims per client. Then there is the complexity of the services and the increase in the cost of services. So there is a set of factors that mean that costs have risen, by a fairly significant amount in fact.

[The Chair, Conservative, Joy Smith]

Thank you, Monsieur Dufour.

We'll now go on to Ms. Leslie.

[Megan Leslie, NDP, Halifax, NS]

Thank you, Madam Chair.

Good morning, and welcome. My name is Megan Leslie. I'm a member of Parliament for Halifax.

I'd like to pick up on your conversation with Mr. Dufour, specifically with recruitment, not retention. You talked about institutions in remote areas, so that might be an example of why somebody may not want to get involved in working in this environment. Help me understand, because I'm not a health care worker in a federal penitentiary. What are the recruitment problems? Is it remoteness of location? Is it also wages? Is it fear of the population? What are the other key issues?

[Leslie MacLean]

For some people it may be all of the above.

[Megan Leslie, NDP, Halifax, NS]

Are there others?

[Leslie MacLean]

One of the principal issues, from my perspective, would be that our salary package is not as competitive as we would wish it to be in some parts of the country for some professions. Occasionally we're also looking for special skills. If I could take nursing as an example, in Nova Scotia, where we do the reception for the entire Atlantic region, we're often looking for bilingual staff in our Springhill location, but that may be difficult to find in the area. Of course, for psychologists we'd love to find people who've got qualifications not just in clinical but in forensic as a specialty.

There is no question that not all health professionals go to school and think that when they grow up they're going to work in a penitentiary.

My colleague and I were speaking about this, and certainly from front-line staff I've heard enormous understanding of why their work is important, how they contribute to public safety. So it's where for us the placements of students...having nurses come through for a six-week practicum is enormously helpful for them to see what the work practice is like, understand that it's often a very autonomous practice, and for them to get a good understanding of what the pros and cons are.

[Megan Leslie, NDP, Halifax, NS]

What are the challenges of retention? I assume they're different. The autonomous practice may come into your answer.

[Leslie MacLean]

They can be. I would turn to Mr. Macaulay if he wishes to add.

The work environment can be stressful. I would have spoken about it in my opening remarks. The health workforce is like other parts of the Canadian workforce: it's also aging, and we're having more people eligible to retire. So those are the sorts of things.... I also think there are issues in the workplace around professionalism, putting in place appropriate training and development so that people can be supported and comfortable to respond to an emergency situation if and when it happens. Those are important ways we can reach out to our workforce and make sure we're providing a healthy workplace where our employees are valued.

Mr. Macaulay.

[C/Supt Fraser Macaulay]

I would just add that nursing is also very much focused on part-time work, the shift work. These things all impact. Professional development is a big one when you start looking at developing part-time staff.

A whole series of things play off each other, inclusive of the environment. We still can't lose the fact of the environment we're working in. It's a difficult environment, and it's the altruistic values that are brought to the employees. That's the key when you talk to them. That's what shines through. The diversity of the work is key, but also their contribution to Canadian public safety.

So it's now a matter of winning the hearts and minds more than anything else. If you look at our retention, our retention is good once we click through that. The actual discussion we had coming down was.... One of the things we've heard is that a lot of managers can tell within five minutes if these people are going to stay. They either love it or it's time to go. It's that clean.

[Megan Leslie, NDP, Halifax, NS]

Do you have problems when people might apply for a job in one institution because there's a vacancy or because there are many vacancies--I see you looking down already--and then they try to transfer to other institutions because it's where they'd rather be? Do you have problems with particular institutions?