All the above would be the answer.
We have known for some time that we are running short. Before the pandemic, the Canadian Nurses Association projected a gap of 60,000. What happened at the outset of the pandemic was people deferred retirement, and in fact, people “unretired”. A lot of the pandemic response was from nurses, physicians and others who came back to work. Now we have a circumstance of people going back to retirement, deferred retirements happening, and we have a retention problem as the environment, the workplace, becomes that much more challenging.
There are two categories of things we need to do. The first is we need to keep the people we have. For sure, there are issues about remuneration, working conditions and so on. The second is we need to increase the pipeline and we need to increase enrolment. We need to make it easier to bring people in. We have eight physicians, mostly Americans, but also from elsewhere in the world, who are ready to start working at CHEO, who will help us with our wait-lists. For example, Jim talked about urology. We have funding for three urologists. We have one on staff now. We have two vacancies. We have a urologist waiting to come to us from California. We need to speed up from an immigration perspective. We need to speed up from a credentialing process perspective, bringing people in. We have people in Canada who could work. We need that to be expedited as well.
Frankly, Canada is one of the only countries in the western world that doesn't actually have a national health human resources strategy, so that's a gap.
Jim and I were talking before the meeting, As with many things, given the specialized nature, there are probably about 30 pediatric neurosurgeons in all of Canada. If two or three retire, that's a significant impact on wait-lists.
We need both a global strategy and a child HHR strategy.