Thank you.
Good morning, Chair and members of the committee. My name is Lisa Little and I am here today on behalf of the Canadian Nurses Association.
We appreciate the committee scheduling this panel of national groups representing health professionals and employers. Our collective purpose this morning is to highlight issues of the health workforce pertaining to employability. CNA will speak to the issue of mobility of workers. Our perspective has three dimensions: mobility between urban and rural, from one province or territory to another, and across international borders.
First let me offer some demographic information about the registered nursing workforce related to the three types of mobility. There are over 250,000 registered nurses in Canada. Of those nurses, 40% are eligible to retire within the next five years and 18% of nurses work in non-urban areas, compared to 22% of the Canadian population.
Saskatchewan, Prince Edward Island, and Newfoundland and Labrador lose 30% of their nursing graduates to work in other provinces and territories across the country. As many as two in ten nurses leave the country within three years of graduation, and most go to the U.S. for full-time employment. According to Industry Canada, during the 1990s Canada witnessed a gross outflow of over 27,000 registered nurses through permanent emigration to the United States.
With those numbers as a backdrop, let me now turn to the issues related to mobility in terms of urban and rural. One of the characteristics of working in rural and remote areas is professional isolation--limited opportunities to network with peers and experts for advice and guidance on evidence and research to inform practice. Further, professionals working in non-urban areas face challenges accessing continuing education. These challenges include distance, cost, as well as lack of replacements.
Research conducted by the Canadian Medical Association and the Canadian Nurses Association identified effective strategies in promoting recruitment of workers to rural and remote areas of Canada. These strategies include investments in electronic information and communications to support work in rural Canada. This is particularly important in light of the recent report by CIHI highlighting the health disparities and mortality rates between rural and urban Canadians.
I will now speak to the issue of interprovincial mobility. Nursing is a mobile workforce. As I previously mentioned, three of the provinces in this country lose 30% of their graduates to other provinces. You should note that this movement of workers is a feature of other health professions as well. Newfoundland, Quebec, and Saskatchewan are net losers of physicians, while Ontario, Alberta, Manitoba, and British Columbia benefit from interprovincial inflow of physicians. You can see this from the graphs I have provided in the speaking notes.
The issue, of course, lies in the fact that each province does its own planning related to education and employment. Each independently projects future health needs. The value of uncoordinated efforts in the area of employability is diminishing. Canada needs to pull together to recognize the growing mobility of health professionals and others. We were pleased to read the recent announcement by governments identifying interprovincial mobility as a policy priority. This has implications for professional bodies, and we encourage this committee to recommend that governments engage appropriate stakeholders to ensure this happens in a timely manner.
Finally, I will speak to the issue of mobility across international borders. The Organization for Economic Cooperation and Development predicts that Canada and the United States will face the worst nurse shortage of all OECD nations within a decade from the perspective of employability. Canadian-educated nurses are an attractive commodity for the U.S. and other recruiters. The projected shortage in the U.S. is one million registered nurses by 2012. This poses a tremendous threat to the Canadian nursing workforce and the health system.
Of the current registered nursing workforce, 6% are internationally educated nurses. CNA projects that proportion will not increase over time due to the global nursing shortage and the U.S. appetite for internationally educated nurses. Federal, provincial, and territorial governments and individual employers are competing with one another in this arena as well. Canada needs a coordinated retention strategy to keep as many nurses as possible in light of the global nursing and U.S. shortage. We must also look to repatriate Canadian nurses from countries they emigrated to in the 1990s.
In summary, CNA supports the call for a pan-Canadian approach to health human resource planning that considers the mobility of nurses and the technologies needed to recruit and retain nurses in all areas of the country.
Thank you. I'm quite willing to take questions when appropriate.