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Evidence of meeting #6 for Human Resources, Skills and Social Development and the Status of Persons with Disabilities in the 41st Parliament, 1st Session. (The original version is on Parliament’s site, as are the minutes.) The winning word was process.

A recording is available from Parliament.

On the agenda

MPs speaking

Also speaking

Doretta Thompson  Principal, Education and Communications, Canadian Institute of Chartered Accountants
Jylan Khalil  Director, Chartered Accountants Qualification, Canadian Institute of Chartered Accountants
Mathew Wilson  Vice-President, National Policy, Canadian Manufacturers and Exporters
Carole Presseault  Vice-President, Government and Regulatory Affairs, Certified General Accountants Association of Canada
Claudia von Zweck  Executive Director, Canadian Association of Occupational Therapists
Katya Masnyk Duvalko  Chief Executive Officer, Canadian Alliance of Physiotherapy Regulators
Carole Bouchard  Executive Director, National Association of Pharmacy Regulatory Authorities

5 p.m.

Conservative

The Chair Conservative Ed Komarnicki

All right.

5 p.m.

Chief Executive Officer, Canadian Alliance of Physiotherapy Regulators

Katya Masnyk Duvalko

Sorry if I'm over time. I'm trying to speak slowly.

The alliance, like other smaller organizations, has been hampered in its work by insufficient technological supports. Contemporary information management systems and updated technology could greatly increase both the effectiveness and efficiency of our credentialing and examination processes, including empowering applicants to self-manage their credentialing and exam registration processes through the increased use of web-enabled technologies.

Looking to the future, we would like to see increased coordination of projects across the country and increased information-sharing across professions. Much duplication still exists. The alliance staff and board feel that we're missing important opportunities to learn from others who have successfully addressed credentialing challenges in different ways than we have. Additional workshops, discussion fora, electronic information exchanges, and the like would help address remaining barriers.

Thank you for the opportunity to come and speak with you today. We look forward to ongoing fruitful partnerships and collaborations.

5 p.m.

Conservative

The Chair Conservative Ed Komarnicki

Thank you for your presentation.

Ms. Bouchard.

October 20th, 2011 / 5 p.m.

Carole Bouchard Executive Director, National Association of Pharmacy Regulatory Authorities

Thank you, Mr. Chair.

Good afternoon, mesdames et messieurs and members of Parliament.

It is my great pleasure to appear today before the committee. Our association understands that the committee is looking for feedback on foreign credential recognition, particularly in our experience with the foreign credentials recognition program of Human Resources and Skills Development Canada.

Let me first explain to you who we are. NAPRA is our acronym and it stands for the National Association of Pharmacy Regulatory Authorities. It is a not-for-profit organization that was established over 15 years ago and represents all provincial and territorial pharmacy licensing authorities, whose mandate is, as you know, the protection of the public. Our membership also extends beyond the traditional geographic border to include the Canadian Forces pharmacy services. One of the fundamental goals of the organization is to enable our members to take a national approach in addressing common issues.

Our members play a key role to ensure that optimal regulatory practices are in place for a safe practice environment for the benefit of all Canadians. Over 33,000 pharmacies are licensed by our members across the country to practise pharmacy and operate within specific regulatory practices and requirements. NAPRA members are responsible to set the licensing requirements for the practice of pharmacy in their respective jurisdictions. They also have to ensure that the persons seeking licences qualify and meet core practice requirements. These core practice requirements are set by our members and can be found in our association's mobility agreement for Canadian pharmacists, which was renewed in 2009.

With regard to the internationally educated pharmacists, in addition to the need for meeting the core practice requirements they are also encouraged to first familiarize themselves with the way in which pharmacies practise in Canada. They can then move to the first mandatory step, which is the evaluation of the individual's educational background, which is conducted by the Pharmacy Examining Board of Canada, or l'Ordre des Pharmaciens du Québec for candidates applying in that province.

Once the candidate's documents are evaluated and the education level and knowledge area successfully compared against the Canadian pharmacy program, the internationally educated pharmacist will determine the most appropriate next step. For instance, some individuals may wish to immediately apply to write the national examination administered by the Pharmacy Examining Board of Canada. However, for others, perhaps pursuing the mastering of English or French language skills might be more appropriate to do next. Pharmacy bridging programs, geared specifically for internationally educated pharmacists, are also offered in a few locations throughout the country for people who wish to strengthen their knowledge and skills prior to writing the national exam.

Taking a step back for a moment, I mentioned that while NAPRA's members worked on the renewal of the mobility agreement for Canadian pharmacists, they also identified a need to examine issues surrounding internationally educated pharmacists who definitely want to become licensed to practice pharmacy in Canada. During this time our members had access to a report generated as part of the initiative, entitled “Moving Forward: Pharmacy Human Resources for the Future”. This initiative was led by our colleague association, the Canadian Pharmacists Association, with funding from the federal government. This report specifically examined at that time the barriers and facilitators for the integration of international pharmacy graduates into the Canadian pharmacy workforce. In order to overcome the challenges observed regarding the integration of internationally educated pharmacists into the pharmacy workforce in Canada, specific recommendations were formulated in this report.

In building upon those recommendations found in the report and the need to look at approaches to continue improving our members' licensing processes, particularly in the context of labour mobility, NAPRA applied to the foreign credentials recognition program in 2009 to seek funding for the project we call the “International Pharmacy Graduates' Gateway to Canada Project”.

This is the only project NAPRA has under this program, although we have had others under the labour mobility component of HRDC. The filing of our association's application coincided with the development of the pan-Canadian framework on the assessment and recognition of foreign qualifications developed by federal, provincial, and territorial governments.

I would like to provide you with some information about the project and our experience with the program. The project's overall goal is to help our members continue to provide a fair, accessible, transparent, and rigorous service that will continue optimizing the effectiveness and efficiency of registering the international pharmacy candidates. The project also aims to standardize or streamline the processes on the path to licensure.

The project consists of developing a plain-language website that functions as the single point of access for international pharmacy graduates wanting to become licensed to practise pharmacy in Canada. The funding also provides for the development of on-line self-assessment tools to help international pharmacy graduates evaluate their skills and make decisions to determine whether they are ready to initiate the licensure process.

In addition, a national, shared database is being developed that will serve to create an applicant file, collect general information, and provide reporting statistics. At this time, it's too early to speak about the results of the project, as it is set to conclude by the end of June 2013. I can, however, mention that the benefits of this project will be important, as the gateway is designed to offer a single-window and pan-Canadian approach to licensure, to provide quick access to clear and up-to-date information on licensure requirements, to help our internationally educated pharmacists to manage their expectations with regard to the reality of Canadian pharmacy practice and the licensure process, and to help them identify any skills gaps that they may have.

Our experience to date with the foreign credential recognition program is very positive. I can point to the excellent guidance provided by government representatives throughout the entire process. We have not had any problems navigating through the process, including the program's requirement for rigorous reporting and audits.

Our association is appreciative of the opportunity we have, under this funded project, to undertake this innovative initiative on behalf of our members. This initiative would have probably not been possible otherwise. We look forward to continuing to work with HRDC as the project evolves.

Before closing, I'd like to take a look at the future. We believe there should be a constant re-examination of the labour market's information on supply and demand. It's currently being discussed among pharmacy organizations and it's been recently communicated to the foreign credentials referral office of Citizenship and Immigration Canada and Health Canada that although the issue of labour shortages was previously identified for pharmacists in Canada, recent developments appear to have had an impact on the labour market.

Two examples of these recent developments are the expansion of the scope of practice for pharmacists and the increase in the number of students accepted into our Canadian pharmacy programs. We believe that an ongoing pharmacy manpower study would be useful in understanding the impact resulting from these developments.

In conclusion, we would like to thank you again for giving us the opportunity to speak about the program. Thank you, and I'm pleased to answer any questions.

5:10 p.m.

Conservative

The Chair Conservative Ed Komarnicki

Thank you. We appreciate the presentation.

Keeping time in mind, we'd like to give everybody a round and finish with Mr. Cuzner.

So let's start. I'll give you a bit of a heads-up as we get closer to the time limit.

5:10 p.m.

NDP

Carol Hughes NDP Algoma—Manitoulin—Kapuskasing, ON

Perfect.

Thank you very much for your presentations. We don't get to ask all the questions we would like to ask because of the time allocations, but I was just wondering what the shortage is, given the fact that you're integrating people into the profession to our standards, basically.

I come from Elliot Lake, in northern Ontario, where there are a lot of seniors. Elliot Lake is a retirement community, and I know that the province had been pushing and the federal government had been working to try to limit wait times for operations and stuff. Some of the big frustrations arise because although we're doing all these hip and knee replacements, when people are coming out the services just aren't there to help them heal properly and quickly.

Could you explain the shortage to me and explain how much of this program has been implemented, how many of those people are being integrated into that workforce, and whether there is something that is preventing Canadians from going into that professional field?

5:10 p.m.

Executive Director, Canadian Association of Occupational Therapists

Dr. Claudia von Zweck

Thank you. I appreciate your recognition of the value of the profession, and I agree that there are shortages of occupational therapists.

When we look at the distribution of occupational therapists in Canada, we see that about 95% of occupational therapists work in urban areas. When you go to smaller northern communities, you're not going to see many occupational therapists. So there is an issue in terms of distribution.

How can we facilitate internationally educated occupational therapists going into some of these areas? We've been looking at what kinds of resources we can provide that would allow them to participate, if they do go to an area, to help them so they don't have to be in an urban setting to be able to access resources. The bridging program we have been working on is available online, but we also try to set them up with mentors in their community to allow them to be able to develop their skills where they are.

I think that is important. We don't have that many people coming into the country. We have probably about 50 to 100 people coming each year, so we really try to centralize and have one common curriculum and one common program across the country, and to provide it online, because if we tried to do a separate program in each jurisdiction, it would be very difficult to manage in terms of costs. If we make it as accessible as possible, people can participate.

5:15 p.m.

NDP

Carol Hughes NDP Algoma—Manitoulin—Kapuskasing, ON

Could each of you answer as to whether there's a shortage in your profession right now?

5:15 p.m.

Executive Director, Canadian Association of Occupational Therapists

Dr. Claudia von Zweck

I would say there are pockets of shortages, certainly in rural areas, and there are shortages in particular provinces that don't have a good supply of seats for occupational therapy education programs, such as British Columbia, Saskatchewan, and Newfoundland.

5:15 p.m.

Chief Executive Officer, Canadian Alliance of Physiotherapy Regulators

Katya Masnyk Duvalko

In terms of physiotherapy, there are huge challenges to measuring the appropriate supply of physiotherapists and determining whether or not there are actually shortages. The CIHI project on human resources for professions outside of medicine and nursing is still fairly new. It has taken some time to develop the proper definitions and the proper way of collecting this information. I think we have really good information about supply but not about demand, and you need to have both elements of that equation to determine whether there's a true shortage. That being said, as is the case with occupational therapists, we are seeing real issues with the distribution of physiotherapists, so that rural and remote areas will have only one or two practising physiotherapists and urban areas will have significantly more.

I would say that the alliance would really support further work on health human resources planning for the professions we've been talking about, just as my colleague Carole mentioned, because right now that data is not there. There isn't a definitive answer.

5:15 p.m.

Conservative

The Chair Conservative Ed Komarnicki

Thank you, Mrs. Masnyk Duvalko.

We will move on to Ms. Leitch.

5:15 p.m.

Conservative

Kellie Leitch Conservative Simcoe—Grey, ON

Thank you very much for your presentation. It is greatly appreciated.

I have two questions that maybe I could ask all three organizations to comment on.

First, in your interactions with HRSDC and with CIC, do you have any recommendations with regard to whether there should be a single organization or separate organizations? As you know, we have the FCRP with HRSDC, and the foreign credential recognition office. Would it help if it were one-stop shopping?

Second, as a health care professional myself, I know about the challenges some of the fellows I've met have had when they hit Canadian soil. They wonder why they can't get a job. Should we be doing more pre-certification and pre-licensure in countries of origin so people are better prepared once they make it to Canadian soil?

5:15 p.m.

Executive Director, National Association of Pharmacy Regulatory Authorities

Carole Bouchard

I'm going to go first.

I think you asked for feedback about the two organizations, HRDC and also CIC. I would say that so far I have not encountered any issue in dealing with the two, but definitely, having one-stop shopping could be a benefit to our activities. Knowing exactly who does what and in which circumstances could also be useful.

With regard to the second question, on the pre-certification and pre-licensure and maybe doing that overseas, we are all working in a very complex area. If I look at what we are developing under the international pharmacy graduate project, people from overseas will have access to the gateway and also to the online tools, which will allow them to at least elaborate on the expectations for the licensing process in Canada, but also to have an indication of the skills gap they have before coming.

Another organization in Canada, the Pharmacy Examining Board of Canada, is looking at examination. I know I cannot speak on behalf of them, but this is probably one area they will be examining with regard to administering exams overseas. Again, this is not my specific organization, so I cannot really speculate on where they are going.

5:15 p.m.

Executive Director, Canadian Association of Occupational Therapists

Dr. Claudia von Zweck

Speaking to your first question with regard to HRSDC and CIC, we've worked very cooperatively with both of them. I feel that although they provide complementary services, our experience has always been very positive.

In relation to your second question, I would very much agree that the more information you give to people before they come to Canada, the better. I think it's very, very important.

We see that there is some difference in the educational qualifications in occupational therapy around the world, so people do need to be prepared if they are coming from some source countries to do some extra preparation to work in Canada. We have developed a web portal and put on a number of different resources. We have a self-assessment tool. We have videos of occupational therapists, showing what they do in their daily practice. As I mentioned in my presentation, we're now working on a mini version of our certification exam that would give people instant feedback as to how they would do on an exam that is similar to the certification exam.

5:20 p.m.

Conservative

The Chair Conservative Ed Komarnicki

Thank you.

Do you have a brief comment, Ms. Duvalko? If not, we will close.

5:20 p.m.

Chief Executive Officer, Canadian Alliance of Physiotherapy Regulators

Katya Masnyk Duvalko

I don't have anything further to add. I agree.

5:20 p.m.

Conservative

The Chair Conservative Ed Komarnicki

Okay, thank you.

We will move on to Mr. Patry.

5:20 p.m.

NDP

Claude Patry NDP Jonquière—Alma, QC

Thank you, Mr. Chair.

Ms. Bouchard, I see that the funding for your website is $3.7 million. That's quite a website.

I would like to know how many foreign pharmacists want to work in Canada and how many of them use that tool. I also want to know whether, once they decide to come to Canada, they are allowed a transition period—a period of supervised learning to prepare them for working as pharmacists here in Canada.

5:20 p.m.

Executive Director, National Association of Pharmacy Regulatory Authorities

Carole Bouchard

Yes. I would be happy to answer you.

I just want to clarify something first: our project is not completed. So the website is not up yet.

There will be many other components besides the website. I mentioned that assessment tools and a database will be available to candidates. The fact of the matter is that the project's value covers many subcomponents.

As for the number of foreign-trained professionals who come to Canada, given that the association is made up of colleges of pharmacy, it has no direct information. Actually, there are other organizations people can use to take the national exam and have their documents assessed. However, I can tell you that, based on the statistics compiled by the Pharmacy Examining Board of Canada, the number of applications submitted annually as part of the first step has increased. That step consists of document authentication and comparison with the Canadian program on pharmaceutical competencies. That number, which was slightly over 800 in 2007, went up to 1,651 in 2010. There are other steps that follow, but this still gives you some idea.

5:20 p.m.

Conservative

The Chair Conservative Ed Komarnicki

Mike.

5:20 p.m.

NDP

Mike Sullivan NDP York South—Weston, ON

Thank you.

Thank you for coming.

Ms. von Zweck, in your presentation you suggested that for five health professions, including occupational therapy, the average foreign-educated professional requires three to five years to become certified, and that a properly financed bridging program would cut this period down to as little as one year.

Can you explain how that works, and whether it's true of occupational therapists that they all need three to five years? Or is that just an average of those five professions?

5:20 p.m.

Executive Director, Canadian Association of Occupational Therapists

Dr. Claudia von Zweck

Not all occupational therapists would require three to five years, but as I mentioned before, there are, for some source countries, people who do have to do some upgrading in order to practise and they do struggle in order to meet entry-to-practice requirements. So during that period of time they may not be able to work as an occupational therapist, so they're working in a number of different types of jobs. We often see people who are working in child care or in the service sector carrying two or three jobs, sending money home, taking care of family, and they just don't have the time to commit to the types of bridging programs that we're offering. That's why we're suggesting that if they would be able to have funding to participate in those programs and they would not have the extra stress of having to earn income at the same time, it would allow them to concentrate on their studies and to integrate.

On the same study, the preliminary findings have indicated that once people are in the workforce, they do very well. The difficulty is that transition time. And if we can facilitate that, we anticipate they would do very well in the long term.

5:25 p.m.

Conservative

The Chair Conservative Ed Komarnicki

Thank you.

We're going to maybe do another four minutes with Mr. Cuzner, and with that we'll conclude.

5:25 p.m.

Liberal

Rodger Cuzner Liberal Cape Breton—Canso, NS

I'll just throw a question out here and let you take us home.

Ms. von Zweck, you had mentioned in your comments that we are just not producing enough people in your field to accommodate the demand.

And Madame Bouchard, you had indicated that you've increased the number of seats within your profession so that there are more students who are coming out and you're still not able to meet the demand.

Where can we go? When we have a youth unemployment rate of 18%, how can we address this? Yes, we need professionals, but where's the disconnect among the young people in this country, the job opportunities that are there, and the educational institutions that are charged with the responsibility of impacting these young people and developing these young people? Where's the disconnect? Are we getting good cooperation from the educational institutions? What's going on?

Could I just get your views on that?

5:25 p.m.

Executive Director, Canadian Association of Occupational Therapists

Dr. Claudia von Zweck

I would say that we have seen a growth in the number of seats in occupational therapy in Canada.

For example, in the province of Quebec two new programs have started up in the last two years; in Ontario a number of the programs have increased their seats. But there are still some provinces in which there are no programs, and there are some programs that have a very small number of seats, and they are really at a disadvantage.

Among the issues, I guess, is that because these are expensive seats to fund, it's a matter of sometimes people feeling that it may be easier to bring people in from other countries—that is one solution—or to bring people in from other provinces. This is something we are working on with those jurisdictions, working with governments to understand the need for more people in the profession.