Health Committee on Oct. 30th, 2025

[Valerie Grdisa]

Because it's provincial and territorial, every single province and territory would have a different percentage point. Recently, I heard from the chief nurse of Ontario, Dr. Karima Velji, that they are nearing less than 15%. They've been filling the vacancies post-COVID.

I think we're actually having a conversation about shortage when we also have to look at workforce optimization and the conditions. There have been recent reports that our young, highly talented new graduate nurses are leaving the workforce because of the conditions within the workforce. We can keep saying we can throw more money at it, but 12.4% of GDP spend is on health care right now. That's astronomical in terms of the increase of over $100 billion in just a decade.

There are other solutions and other health systems that better optimize the workforce, have more innovative models of care and team-based models of care. Actually, we're seeing the end result of us not innovating, not responding to nor fully optimizing our highly educated and talented workforce. It's not only our domestic supply, but obviously it's bringing in the internationally educated health professionals to ensure they're fully optimized, have a better enculturation experience and have roles.

Thank you.

[Burton Bailey, Conservative, Red Deer, AB]

I was looking for a number. It's been reported that 60,000 is the shortage that we're facing across Canada. That's a very big number.

Do you know how many nurses who were trained in other countries are currently not employed in nursing?

[Valerie Grdisa]

I don't have the exact percentage, but there's a guesstimate that it could be upwards of 21%.

[Burton Bailey, Conservative, Red Deer, AB]

My understanding is that Alberta changed the way it is doing language testing for immigrant nurses because of the fact that it was being done in the States. Have other provinces taken that lead?

[Valerie Grdisa]

The nursing regulators are all working together to have a Canadian solution, so yes. Some of them are even clearing out the rigorous language testing in that there are other opportunities for them to prove their ability to deliver care in one of the two official languages.

[Burton Bailey, Conservative, Red Deer, AB]

Is it safe to say that we're working on that backlog of nurses who are here in Canada and who aren't able to work as nurses?

[Valerie Grdisa]

Yes. Over the last three years, there has been substantive effort by the nurse regulators to shorten the time period from application to actually getting the licence to be able to practise. As I mentioned in my opening remarks, there are several enculturation programs. Is it enough? No. The reality, though, is that the bigger issue is that once they get into the workforce, we're struggling to retain them. We're not creating the conditions for enculturation and actually stamping out racism and discrimination, because that occurs for internationally educated nurses here in Canada.

[Burton Bailey, Conservative, Red Deer, AB]

Certainly.

One of the things we're finding in our areas is that nurses have been replacing so many different positions in hospitals, and they've become data collectors. A lot of the senior nurses who are not computer-friendly are retiring. Is that a fair statement?

[Valerie Grdisa]

There's a huge administrative burden. We're in the world of technology and advanced technology. The fact that there is so much documentation and record-keeping, when we believe only 20% of any data that's actually collected from patients and through diagnostics, etc., is actually utilized, yes, that is a huge burden on the workforce.

I would say that the nurses who are more senior—

[The Chair, Liberal, Hedy Fry]

There's one minute left.

[Valerie Grdisa]

Sorry.

[Burton Bailey, Conservative, Red Deer, AB]

One thing KPMG indicated was that once some of these data systems are in place, we'll have too many nurses. Would you care to comment on that?

[Valerie Grdisa]

These are projections and scenario generations. To go back to an original point I made, until we actually have a current understanding of our supply, and we map that against population health needs and look at where the supply is distributed, we can't even make those projections at this point in time with the data we have in our nursing reports.

[Burton Bailey, Conservative, Red Deer, AB]

Has immigration ever contacted the nursing association and discussed numbers so that we can hire enough nurses and have enough staff in our hospitals?

[Valerie Grdisa]

I do work with the Chief Nursing Officer for Canada. She works with all the different bodies of nursing to try to get the supply question that you're asking, but—

[Burton Bailey, Conservative, Red Deer, AB]

So she has contacted you.

[Valerie Grdisa]

Definitely. We communicate bimonthly, at minimum.

[The Chair, Liberal, Hedy Fry]

Thank you.

We'll now go to the Liberals.

Ms. Sidhu, you have five minutes, please.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you, Madam Chair.

Thank you to the witnesses for coming in and giving your testimony.

My questions will be for Dr. Grdisa.

Thank you for the work you are doing, and thank you to all the nurses for the work they are doing on the front line. I really admire that.

First of all, I know that health care delivery and professional licensing fall largely under provincial and territorial jurisdiction, but from your experience, what do you see? What are some of the key challenges that arise because of the shared responsibility between the federal and provincial governments? How could coordination be improved without overstepping jurisdiction and boundaries? You talked about a national IEN task force. Can you elaborate on that?

[Valerie Grdisa]

Again, at the end of the day, the interface between patient and clinician is where it matters. Patients and families don't really care what's happening in terms of the structure of our health system. What we know is that across this nation there are exemplars, great examples of what's working well. We need to actually, in a systematized way, coordinate and harmonize those efforts to ensure that every internationally educated health professional has the best possible experience of coming to our nation, achieving their goals in coming, and meeting the needs of Canadians as we continue to have population growth and demographic shifts.

[Sonia Sidhu, Liberal, Brampton South, ON]

A challenge we have heard about in a past meeting is the lack of consistent data, for example, on how many internationally trained professionals are already in Canada but not practising. How important is better data sharing among the federal government and provincial governments, and regulatory bodies—which is also important—to address these challenges?

[Valerie Grdisa]

I would hope that as a taxpaying Canadian the sentiment we are seeing around the security and trade tensions that exist, the geopolitical tensions, we would also have around the health of Canadians.

From my perspective, for an example, the federal government has invested in the nurses' database, which is for the regulatory bodies to actually have a standardized database so that we would then have an understanding of the full workforce and could then capture which ones are actually in the publicly funded workforce versus potentially still keeping their RN or NP but not actually contributing within that workforce. Then we can actually start the planning. It has to be coordinated federally, provincially and territorially. There's no other way.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you.

We have also seen some provinces beginning to pilot a faster credentials recognition program or a bridging pathway. Could you share some examples, if you know of them, of promising provincial initiatives that could be replicated or scaled across Canada?

[Valerie Grdisa]

There is a federal grant to the Canadian Association of Schools of Nursing that is a bridging pathway. When a nurse comes from another jurisdiction and might not have the educational qualifications based on the program and maybe there were some gaps in terms of content or skills, there's a bridging program that allows them actually to fill those knowledge and skill gaps. That should be better funded across the nation. Right now, it sits within CASN. Also, and I mentioned this in my opening remarks, there are organizations implementing their own programs, but at an organizational level, which then contributes to the inconsistencies and inequities across the nation.

[Sonia Sidhu, Liberal, Brampton South, ON]

Thank you.

Can you give an example of which province is doing a great job on this?