Good afternoon.
On behalf of Canada's quarter of a million registered nurses, I really appreciate the opportunity to speak to you today concerning health labour force issues.
Evidence of a nursing shortage in Canada has long been clear, from frustrating wait times in clinics and hospitals to poorer results for patients. The negative impact of the shortage of registered nurses and other health professionals is something that Canadians face every day.
Current research puts Canada's shortage of registered nurses at approximately 11,000 full-time equivalents. Left unaddressed, that shortage is projected to reach 60,000 full-time equivalent RNs by 2022, a reality that stands to risk future health outcomes. That my colleague said that the numbers are increasing is a good sign. However, there are still some other matters that need to be addressed.
A labour shortage implies an imbalance in both supply and demand. Comprehensive thinking about the supply of registered nurses will help us better meet the health needs of Canadians. We need to go beyond the narrow thinking of strict numbers of nurses and think about their participation in the workforce based on the level of activities—that is, whether they are full time or part time—the rates of absenteeism, and how productive the workforce actually is. The number of services that registered nurses can actually supply in a day is affected by the model of care delivery in place, the composition of health teams, and how efficiently health teams work together. It also includes whether or not barriers exist that prevent health professionals from offering the complete range of care for which they are qualified—that is, working to their full scope of practice.
Productivity gains can be made through facility design, use of technology, and health delivery innovations. We see productivity gains with nurse practitioners in Newfoundland and Labrador, who are supported by teams and telehealth technology while providing care in rural and remote communities. By doing things differently we can enhance the use of the existing supply of nurses already working within the system, all the while providing more patient-centred care. As you can see in our brief, implementing measures to increase RN productivity by 1% per year would have a dramatic and immediate effect on the shortage.
We can also improve our access to and use of labour market information through the Canadian Institute for Health Information. To ensure that we have accurate information on where registered nurses are working, a national unique identifier should be employed. This in essence would be a number assigned to a registered nursing student that would enable us to track when and where they are entering the workforce, and their practice patterns. Implementing this identifier would significantly improve our ability to track the mobility of our nursing workforce both internally between provinces and territories, and externally, for example, when nurses leave Canada to work in the U.S. or other countries.
To better understand the capacity of the nursing workforce, a national study on the health and work of nurses should be repeated. When CIHI conducted a study of this in 2006 it revealed that registered nurses had an absenteeism and sick rate that was double the Canadian average of seven days. These 2006 survey results have led to some innovations in creating healthy workplaces. Repeating the survey now would provide us with current, accurate data, and allow us to evaluate the effectiveness of these innovations.
A third recommendation deals with pan-Canadian health human resources planning and mirrors one of the main recommendations made recently by the Senate Committee on Social Affairs, Science and Technology in its review of the 2004 health accord. The federal government should conduct a feasibility study to determine the benefit of establishing a pan-Canadian health human resource observatory.
Health human resource observatories have been implemented in some European and South American countries to analyze trends and health human resources needs and to identify opportunities to implement best practices, which ultimately lead to more value and better care within our health care system.
The opportunity exists to build this innovation into existing federal agencies to ensure that health human resource planners have coordinated resources and best information at their disposal to better meet the planning challenges of Canada's multi-jurisdictional health care system.
While it is important to explore ways to increase the supply of nurses, it is also critical that we take opportunities to reduce demand for health services, through illness prevention, health promotion, and especially the prevention of chronic diseases like heart disease, diabetes, and cancer.
Canadians benefit from federal programs that encourage smoking cessation or healthier living. CNA is concerned about cuts to these programs, the results of which are as threatening to the supply curve as the shortage of surgical nurses or emergency room doctors.
The stable and sufficient supply and deployment of Canada's health professionals continues to be one of our greatest health care challenges. By looking at these recommendations in concert with a comprehensive view to reducing demand through health promotion and disease prevention, we can take steps to address the nursing shortage and enhance the health of Canadians.
Merci beaucoup.