Human Resources Committee on May 7th, 2013

[Rodger Cuzner, Liberal, Cape Breton—Canso, NS]

Each of the slides we were provided with today has background information, and I think the committee would benefit if you could provide us with the information that led to those graphs.

Do you have any way of determining what percentage of older workers we could get back into the workforce should certain measures be taken? Is there any way to assess that?

[Sylvie Michaud]

It's really hard to be able to answer that accurately.

[The Chair, Conservative, Ed Komarnicki]

Particularly if Statistics Canada is gathering statistics and making conclusions based on that, would that be correct?

[Sylvie Michaud]

Yes.

[Tracey Leesti]

More so than trying to project the number we'd get into.

One of the challenges in measuring retirement is that it's a very subjective topic, even when you go to respondents. For example, I could speak to my father. He would tell me, “I'm retired”, because he did retire as soon as he hit 55, but he's been consulting for 15 years. He's actually employed consulting part-time, but he would tell you he's retired.

It's a very subjective measure. People come in; people go out; they come back temporarily. So it's a difficult thing to necessarily measure. I don't know that we could accurately project that based on a response to a survey.

[Rodger Cuzner, Liberal, Cape Breton—Canso, NS]

Go ahead.

[Sylvie Michaud]

On the survey of older workers—that's the last slide—we've provided some of the factors that people told us would make them change their retirement date.

[Rodger Cuzner, Liberal, Cape Breton—Canso, NS]

Yes.

[Sylvie Michaud]

Maybe we can dig down a bit more on that information, but as Diane pointed out, it's really hard to know if they actually would do it. These are the factors they think would influence their retirement date. What the behaviour would actually be would possibly be a different thing.

[Rodger Cuzner, Liberal, Cape Breton—Canso, NS]

Yes.

I'm fine.

[The Chair, Conservative, Ed Komarnicki]

Okay.

Go ahead, Mr. McColeman.

[Phil McColeman, Conservative, Brant, ON]

Thank you, Chair.

Thank you for being here today.

When you went through the graphs of these statistics—of course, stats was never my favourite course in my post-graduate studies. I want to draw trends out of them, which is, I think, the meaning of why you want to take statistics in the first place. Am I correct in saying that? It's a fair assumption. Do you agree with that, as statisticians?

[Tracey Leesti]

Yes. There are two things: you can draw trends or you can get a really big snapshot, a big picture, at a point in time.

[Phil McColeman, Conservative, Brant, ON]

A big picture of what's happening at one point in time. It's safe to say, too, that of course times change, economics change, and this fast-paced society we live in changes daily.

One of the trends that we've known for a long time is that the demographics are changing in our country, particularly the age demographics. How do they come to play in formulating the charts? Does the fact that we're reaching this baby-boom retirement bubble come into play at all in terms of numbers, statistics? How does it come into play?

[Tracey Leesti]

For example, on the data for the labour force survey—as I mentioned, we report monthly—we often see growth in the 55-plus population, and often about half of that is played from demographics. The baby boomers are coming to that age where they are now entering that age category, so part of the growth is just natural as a result of aging, and part of it is as a result of people going out and getting new employment.

[Phil McColeman, Conservative, Brant, ON]

Right.

Now if I take you to the chart that talked about life expectancy and deteriorating health—I don't see the page number here—I think all the other charts set a general trend of the fact that people are working longer. Is that correct, from what you've presented today? Then I looked at this chart as you've mixed it into the presentation today, and I see that people are living longer, and progressively have been living longer, as we know. This is common knowledge and a common-sense understanding of our society. None of these statistics that you're providing today should surprise us—or should they?

[Sylvie Michaud]

I think the slide we've added in there was probably more to indicate that we've seen an increase in life expectancy, but in terms of the labour market, we should probably look at healthy life expectancy. There may be a behaviour from the labour market that may be different if you're healthy versus if you have incapacity, and what we've seen is that there's an age at which you see a decrease in the healthy life expectancy.

[Phil McColeman, Conservative, Brant, ON]

Right. The other thing that's interesting—the one statistic that comes into play—is when you go to page 11, you see outdated skills being such a minor reason, around 8%, that's given for early retirement. That was a surprising statistic. We hear all the time from the aggressive socialist separatist people that these things aren't happening. Their frame of reference, frankly, is that this isn't happening. So when you come to see this, and you start to look at the trends and the demographics and what the real facts are, that people are out there wanting to work longer, and are wanting to postpone.... My age group, the end of the baby boomers, is wanting to postpone retirement for various reasons, and you say it is basically a conscious decision of just wanting to work longer because you feel young—you're 60 years old and you feel like you're 18. You can keep going, and lots of things start happening.

I think these trends are what we need to understand, especially in light of what we're looking at here. What are the opportunities for these people? Are we presenting them with enough opportunities in society?

When you come to the argument that changing the OAS age to 67 is just a natural thing that many countries have done, our chief actuary plots the demographics, plots the life expectancy, plots all that, and then tells us that the reality is that people are living longer. They are healthier and they want to work longer, so it's what most advanced countries have moved toward, that kind of system.

I want to come back to that last trend you're seeing. I know you are statisticians and you don't have the statistics, and I'm talking very subjectively here, but as far as these trends go, is it fair to say again, just to reinforce the facts, that all of these trends are just showing larger numbers of healthier people living longer and working longer? That's what I would call a natural part of the evolution of our society.

[The Chair, Conservative, Ed Komarnicki]

We'll conclude with that, and if you have a response to that, go ahead.

[Sylvie Michaud]

As has been pointed out, we've seen an increase in the labour market participation of older workers. We've seen an increase in life expectancy. The reason for retirement is not a trend. It's what we had in 2007. As we said, we have statistics sometimes that give a picture of what's happening. This is what people reported in 2007.

As we mentioned, it was a multiple-choice question, so people could have chosen a number of reasons. I wouldn't want to infer that if we're asking just one question, the rate would be similar, that if I were asking one question on discrimination the rate would be exactly the same. This is the portrait of what we got in 2007 from among the multiple reasons people could report on why they decided to take their retirement.

[The Chair, Conservative, Ed Komarnicki]

Thank you for that response.

I may mention, as I mentioned to Mr. Boulerice, that these extra commentaries that are somewhat partisan are hardly helpful to the study we have before us, and of course if one member engages, the others do, and it just keeps going that way. So I would ask members to take that into account. It's hardly useful for the study.

Having said that, we've completed a full round, which is something we haven't done in a long time, to the point where it almost seems extraordinary. But we have done that.

I'd like to thank the witnesses appearing before us for providing the information to us. I know you had some undertakings that you would provide some additional information. When you do that, just pass it on to the clerk and we'll be sure it is distributed. Thank you very much for that.

With that, we'll suspend for a few moments.

[The Chair, Conservative, Ed Komarnicki]

Thank you for being here, Ms. Silas. You are appearing on behalf of the Canadian Federation of Nurses Unions. You've been hearing some of the testimony provided by Statistics Canada, so we're looking forward to hearing from you. Of course, there will be some questions and answers following.

Whenever you are ready, you can proceed.

[Linda Silas, President, Canadian Federation of Nurses Unions]

Perfect. I think I came with all my friends, but being a good New Brunswick emergency room nurse, you get a call on Friday to appear and you prepare and do the job. So I'm glad I'm here.

If there are mistakes in my presentation, please accept my apology. You will receive a full brief from us by the end of this month, and hopefully we won't have as many graphs and numbers as Statistics Canada just gave you, but it is a good focus.

I will focus my presentation on the impact of the aging population and workforce and how the federal government can help.

We represent over 200,000 nurses and student nurses across the country. We are the largest profession within health care. We represent about 70% of the workforce. I'll use my time today to address the following needs in our health care system. First of all, it's the boom and bust approach to health and human resources. I was chatting with an MP about his daughter who is into nursing, and there are no jobs right now, but there will be jobs in three or four years. It's because we do not know how to plan in health care. It is the boom and bust approach. I've been around these committees and provincial committees in New Brunswick for a number of years.

We need immediate investment in retention and recruitment strategies, both for the older workers and the new graduates. We need the federal government to take a strong leadership role in workforce planning. Every province and territory could get some help there.

If I look at the nursing shortage and its impact specifically, we know that all governments, including the federal government, and employers have done a lot of work over the last 10 years in increasing and retaining nurses, but the shortage is far from over. The Canadian Nurses Association predicted a shortfall of over 60,000 nurses by 2022. That was in 2009. The study and the numbers haven't changed since then.

We know that the new nurses entering the profession have increased. If you look at the CIHI number, you would think our world should be a lot better, but you have to realize that in 1990 we were graduating 12,000 nurses a year, and we went from 12,000 to 4,000 by the end of 1999. We're up to about 9,000 today, but we still have the bulk of nurses about to retire. The average age of a nurse is 45, but 40% of nurses are 50 years and older.

I'll provide you with a brief snapshot of our workforce. I'm not here to discuss mostly our workforce, but the demographic has to be understood in the context of not only our workforce, but also how our health care system is changing and has to be transformed to adjust and respond to the aging population, new technologies, and new ways of delivering care.

There is greater pressure to meet the needs of a much older patient population with highly acute needs. Today's average life expectancy is over 81. But if I look at just our working-age population—I'm sure Stats Canada gave you those numbers—who are between the ages of 15 and 64, 42% of them are over 45. I just mentioned that for nurses 40% are over the age of 50. So we are older than the average workforce. At the same time, 75% of our nurses work in the hospital sector. If you've been in the hospital sector in recent years, you know we have to change our system and go towards long-term care and home care. We have to change the delivery of services, because a lot of the patients in hospitals do not belong in hospitals.

A recent study done by the Canadian Nurses Association stated that $5 million to $6 million a day is being spent on patients in hospital who should be receiving care in the home. That means they're well enough to be in the home, and if you look at senior people, they want to be in their homes and be taken care of there.

If I look at retention and research, we have done many research projects on retaining our workforce. It is all about working conditions and opportunities for professional development and skills upgrading. If you do that, you will expand the number of nurses extending their career.

We had tremendous success in 2006 and 2011. Our first project was with HRSDC. We had two pilot projects, one in Cape Breton and one in Regina Qu'Appelle. The Cape Breton project was a mentoring project and was unbelievable. We were able to keep the emergency and operating room open by getting experienced nurse training in critical care. In Regina Qu'Appelle it was again a mentoring program.

We followed through with a project with Health Canada in nine provinces and one territory to bring and promote a more positive health care workplace. We've reduced absenteeism by 10% and overtime by 10% with the Health Canada project, which was called Research to Action.

I'm just skimming through it quickly.

There were a number of lessons learned here. It has to be done by partnership. If we want effective and lasting changes, they cannot be imposed from the top down. The program policy needs to be flexible to accommodate the needs of the workplace and the individuals.

What we realized over the last six years of working with health care employers is that when you're implementing a pilot project, or what we're now calling a prototype, this cannot be done at the side of a manager's desk. It must be based on the evidence and research, and it must be evaluated. That's where the federal government can come in and help. We're suggesting this can be done through EI, because they do need financial support. They also need training and professional development in these areas.

Nurses deliver more care than any other group in the health care system. At the same time, we're nearly twice as likely to be absent due to illness and injury than the average of workers in other occupations. That is because of the working conditions. There's a turnaround, which means a nurse is leaving one unit to go to another, mostly because of job dissatisfaction. That happens with 20% of the nurses in the hospital sector. The cost for each nurse is between $25,000 and $60,000 for that employer.

I would stress to you that we cannot replace a nurse with 35 years' experience with a new graduate. The education system has changed dramatically, and so has our health care system. We need to ensure that new graduates benefit from the experience of their older and more seasoned colleagues. This is not a question of retention; it is a question of patient safety.

We know mentorship programs do work. We are recommending that we have programs nationally modelled on the Ontario new graduate guarantees, which support nursing graduates with an opportunity to work with experienced nurses to help enhance their knowledge and skill.

I mentioned earlier how the federal government could help. We believe it is through the EI apprenticeship programs for nurses. We need to have a movement for licensed practical nurses to move up to become registered nurses, or for registered nurses to become specialty nurses or nurse practitioners. And we need to find a way to help employers create mentoring programs to retain older nurses and provide a safe learning work environment for new graduates.

If I had more time I would discuss with you the need to readjust the work hours and work environment for older workers. We will bring you numbers. We know, from workers compensation to long-term care disability programs, that the risk of injury is higher with older workers, especially when modification at the workplace is not done.

To conclude, we believe we need to provide support that will help equip older workers with the skills and competency for the workplace. We need to reintroduce programs such as workplace skill initiatives. We need to support formal mentorship that will encourage the knowledge transfer between workers of generation and skill mix. It is time we moved away from the land of pilot projects to prototypes that will create a culture of safety in health care for all workers, both the young and the more seasoned.

Thank you. I will now answer your questions.

[The Chair, Conservative, Ed Komarnicki]

Thank you very much for that presentation.

We'll start the rounds of questioning.

Mr. Cleary, go ahead.

[Ryan Cleary, NDP, St. John's South—Mount Pearl, NL]

Thank you, Mr. Chair.

Thank you, Linda, for your presentation. I found it fascinating.

I have a few quick questions and only five minutes, so the more succinct your responses, the better.

First, you mentioned some statistics in terms of nursing graduates, that in 1990 there were 12,000, in 1999 there were 4,000, and today, in 2013, we have 9,000.

I know that in Newfoundland and Labrador alone at one point we had I think three or four nursing schools. Now we have just one, offered through Memorial University.

One of the obvious solutions would be to increase the number of nursing graduates, to increase the number of nursing schools. Why don't we do that?