Human Resources Committee on Nov. 1st, 2011

[Michael Brennan]

Specifically for physiotherapy, the gap is likely to widen. When we consider baby boomers' demand for graceful aging, which includes mobility and so on, the demand for physiotherapy is increasing, and we see a broadening gap. Programs are ramping up in Canada for training in Canada, but we're likely not going to meet the demand over the next 10 years.

So certainly we see the importance of immigration to physiotherapy and rehabilitation. And certainly, just from a population perspective, immigration is key to Canadian growth as a whole, so we support that relationship.

If I can put my HEAL hat on for just a moment, we also recognize that there are some concerns about the appeal of certain health professions, the work-life balance issues that are becoming more prevalent in our conversations, and our concern is that there are not as many Canadians who are now interested in choosing these careers for themselves. That too makes it imperative that we look at immigration as a potential solution to that problem.

So I think there's consensus pretty much in the health profession community that immigration and recognition of foreign credentials is key to making sure our workforce is sustainable.

[Joe Daniel, Conservative, Don Valley East, ON]

Is the shortage so acute that we have Canadians training abroad and then would have to face the same requirements when they come back in?

[Michael Brennan]

Not in physiotherapy, but I can't speak for the others.

[Joe Daniel, Conservative, Don Valley East, ON]

I'll turn to Dr. Murphy.

How do you recruit your students? Do they come directly from other countries to you? Do they come in and you evaluate them? How does that happen? Do you have accelerated programs? I don't know if the bridging program is an accelerated program to help them get through the process.

[Dr. Sandra Murphy]

First of all, the students come from a variety of means. The regulatory bodies refer students directly to us. In the community, the word of mouth is very strong, so students come directly to us. We actually have to meet with them and refer them back to the regulatory body, because that's how they're assessed.

I would say that our strongest marketing is perhaps our previous students. We've offered bridging programs for internationally educated professionals since the 1970s, so it's just a name out there.

I'm sorry, what was the other question?

[Joe Daniel, Conservative, Don Valley East, ON]

I've forgotten, but I'll go on to another question.

You alluded to this sort of scattered or diverse application information process. How do you see it all coming together? Do you work with only Immigration Canada or HRSDC? How do you see the common process coming into place?

[Dr. Sandra Murphy]

I think as an educational body we would have to work with the government as well as the regulatory body, because it's the regulatory body that governs the licensing process.

The whole reason in starting off the assessment while they're in the country, from what I have learned, is that it's very difficult for the proper documentation...authorization of practice experience is very difficult to obtain once you come to Canada. People rely on their family members to follow their process.

If you want to shorten the licensing process, you have to start overseas. I would say that you would need to have the educational partners, the government, and the regulatory bodies as well.

[Joe Daniel, Conservative, Don Valley East, ON]

In addition to that, you would like to see the information available from one site, or one organization, something like that. Would that help to get it together?

[Dr. Sandra Murphy]

Absolutely.

[The Chair, Conservative, Ed Komarnicki]

Ms. Nielsen.

[Christine Nielsen]

To follow up on that, one of the things that has improved knowledge awareness of many of the members of HEAL is the “going to Canada” portal, which is a requirement in some of the source countries for Canada. Someone going to Canada has to go to a Canadian orientation program.

In my own field of medical laboratory science, we have about 15% of our applicants who apply offshore. You're right, Dr. Murphy, it's absolutely critical for them to get the documents while they're at home. As someone who accepts documents and reviews them, it's a much more robust way.

We have policies in place, and some people have identified barriers. For us, it has been the biggest enabler because there are still things that we can evaluate while they're offshore. They can even fill in some of the gaps for my profession while they're offshore. In my profession, we've taken a holistic approach in acknowledging that Canadian isn't the only way to fill a gap.

[The Chair, Conservative, Ed Komarnicki]

Thank you.

We'll move to Ms. Crowder.

[Jean Crowder, NDP, Nanaimo—Cowichan, BC]

A number of you have mentioned the whole problem with practical placement. Do you have any suggestions about how that can be improved? It's not only a problem for Canadian-trained people; it's also a problem for foreign-trained people.

[Christine Nielsen]

I'd love to take this one.

There was a study funded in Manitoba in the nursing field. It's a terrible name, but it was called the Retention of Older Workers Project. The only group that objected to it was the nurses' union.

It was intended to capture people ready to leave the profession who went from being at the apex of their career to allow them to work a few days a week, or in a limited scope, to help train the next generation. There was funding for that program, so of course it's not sustainable.

The evaluations that came from both the student nurses and the facilities were very positive, because it alleviated the workload for the day-to-day nurses and there was someone who was at the height of their career to help with the knowledge transfer. It hit two different areas. It allowed someone who was a retiring worker to still stay connected to the profession they loved, possibly help pass on knowledge, and alleviate the burden in the workplace. But of course it came with some funding requirements.

[Jean Crowder, NDP, Nanaimo—Cowichan, BC]

You said Manitoba?

[Christine Nielsen]

Manitoba, yes.

[Jean Crowder, NDP, Nanaimo—Cowichan, BC]

Mr. Brennan, do you have any comments on that?

[Michael Brennan]

We certainly recognize the need and the problem. We've looked at a number of incentives that may make it more palatable for small businesses, clinic owners, and so on to provide opportunities. I'm always a big fan of using taxation as an incentive. So if there's some way to provide incentives to business owners through tax credits, or whatever the case may be, specifically for people with international credentials, that would be something we would support. We've tried two pilot programs, one in Nova Scotia and one in Alberta, essentially to provide funding from the profession to small business, small clinic owners, and the problem was that the amounts were too small to make it worthwhile.

[Dr. Sandra Murphy]

We are still finding many negative reactions to internationally educated professionals in the clinical areas in the workforce. The research I did for my doctoral studies points out that there still is racism and negative reaction to these health professionals. When we place students into the hospital settings, more of our internationally educated nursing groups are refused than any other of our nursing groups. We've added a manual and some education to our bridging programs for the nurses who work in the health care settings.

I don't know if that transcends other health professionals as well, but that's what we have found. Maybe it's unique to nursing.

[Jean Crowder, NDP, Nanaimo—Cowichan, BC]

Mr. Choquette is going to ask a question to finish this time.

[François Choquette, NDP, Drummond, QC]

Thank you, Mr. Chair. Ladies and gentlemen, thank you for being here today. I have a few questions for you.

We know that the situation involving foreign-trained professionals is a major issue. In Canada, Quebec and my riding of Drummond, there are many highly educated people who arrive in Canada and then work as labourers rather than in their area of expertise. That's especially the case in healthcare. We could be talking about pharmacists, doctors or nurses. You mentioned that quickly, and it's something worthy of our attention. Physiotherapists are also healthcare workers.

A few solutions have been suggested. Would it not be appropriate to integrate those people in the workplace as soon as possible? We are talking about programs, student loans and internship programs. Would it not be appropriate to have a national internship program?

I see that there is such a program in Manitoba. There are similar programs throughout the country, but there appears to be no Canada-wide initiative.

Would it not be beneficial to have something that would allow professionals to integrate themselves more quickly into the workplace? We know that people need to work in their field to maintain their skills, especially in healthcare.

[The Chair, Conservative, Ed Komarnicki]

Mr. Choquette, you may want to ask your question because your time is just about up.

[François Choquette, NDP, Drummond, QC]

Yes, I'm finished.

[Michael Brennan]

A federal program would indeed be desirable. I cannot speak for everyone, but I'm convinced that everyone would be willing to agree to that. However, there could be a constitutional debate involved.

In our opinion, Quebec is an ideal example. We have physiotherapists who arrive in Canada, but do not have the qualifications to practice. We could provide them with a limited work permit that may be based on their skills. We could integrate them immediately into a workplace and provide them with some experience or training. Practical experience would be ideal. However, that would require major changes in terms of legislation and work permits. The federal government and the provinces would really need to come to an agreement.

Earlier, we were talking about strategies. If we want to have a comprehensive strategy, that's really where we need to focus our efforts.

[The Chair, Conservative, Ed Komarnicki]

Thank you, Mr. Brennan.

Maybe you'll get a chance to comment on some of the questions a little later, Mr. Shields.

We'll move to Mr. Mayes.