Thank you very much.
Good morning, honoured members of the committee. My name is Ivana Saula. I am a research director for the International Association of Machinists and Aerospace Workers. On behalf of the IAM and our members, I'd like to thank you for the opportunity to present our views on this important topic.
The IAM represents workers in a wide range of industries with a growing footprint in health care. The majority of our members in health care are personal support workers, nurses and ambulance drivers working in various facilities across Ontario and Alberta, where attacks on the public sector and on health care in particular have been especially aggressive.
On March 3, 2022, this committee touched on the possibility of automation in response to labour shortages, so I will draw on conclusions from our report on automation and artificial intelligence, “Charting Change”, and point to a useful case study. I'll also briefly comment on the government's and employers' roles in inducing these labour shortages, particularly in health care.
Employers in particular have made precarious employment and non-standard employment—which on the whole erode working conditions—the norm rather than the exception as a feature of the labour market. An employment model that arose out of convenience for employers has eroded working conditions across sectors and has eroded living standards for millions of Canadians.
Personal support workers often work for multiple employers in order to get enough hours to earn a living. This means that one employer can guarantee four hours per week, another 12 hours and a third 10 hours. Wages of personal support workers vary across Canada, with the starting wage in some provinces being as low as $12 an hour. The work of PSWs and all health care workers is also characterized by physically demanding labour, workplace violence, high turnover and high rates of burnout. Not only is the work undervalued, but the framework for employment promotes instability.
In some cases, PSWs work for private companies that earned record profits during the pandemic, but they continue to drive wages and other benefits down. Copious numbers of studies yield the same result on this topic: Compared to workers in standard employment, those with non-standard jobs tend to have lower wages, lower job tenure, higher poverty rates, less education and fewer workplace benefits, such as pensions. Similarly, poverty rates of workers in non-standard employment are two to three times higher than the poverty rates of workers in standard employment. Clearly, this framework of precarious and non-standard employment is one of the key issues affecting recruitment into this field.
Demand for care work in health care is expected to continue increasing, and according to the U.S. Bureau of Labor Statistics, personal support workers and home care workers are expected to be two of the fastest-growing occupations over the next 10 years. If these jobs are in demand and proven to be critical to our economy, why are workers in this sector not adequately compensated? Our members find this work meaningful and are proud of what they do. It's not the work itself that makes recruitment difficult; rather, recruitment is challenging because of low wages and lack of recognition.
I point now to a case study in Japan, a country that has severe issues with labour shortages in the health care system. Labour shortages are especially acute in retirement homes and in long-term care, where the elderly are looking after the elderly. Japan's response to this issue has been automation, making Japan's use of robots the fourth-highest in the world. The use of exoskeletons and interactive robots and the piloting of culturally sensitive robots are becoming the norm, as the country anticipates severe labour shortages coupled with growing demand for workers in long-term care.
Given the immediate need for labour, it seems that an understanding of the impact of automation on quality of care has not been sufficiently studied. In North America, vast amounts of resources are funnelled into studying and developing devices that replace the need for human assistance, such as automated health assessment systems, in-home monitoring systems, smart assistive walking devices and biosensors, just to name a few. These technologies would directly impact personal support workers, health care aides and other ancillary staff. The technological developments in health care go beyond assistive devices, and there are a number of things in the pilot stage right now.
While it's possible to address the gap in labour, it's necessary to assess technology fully. We have yet to fully understand the impact that technology and digital platforms have on the quality of care and the quality of life of elderly and aging clients. Technology may be convenient, but we should not turn to it as a solution without a full understanding of its impact on the health care system, patients and clients.
Our broad recommendations are the following. First, both federal and provincial governments should reform labour laws to provide protections for those in non-standard and precarious employment. We're also looking for protection for workers to join a union and for changes to union certification to match today's labour markets. We're looking to curb the proliferation of non-standard employment. We're also hoping that governments will work among different levels to promote living wages, rather than just minimum wage.
We're also hoping that there can be a thorough study of emerging trends and technologies for use in long-term care. Broadly and ambitiously speaking, we're hoping that long-term care could be included as part of the Canada Health Act.
We also support a national strategy for health human resources in health care, and last but not least, for national standards for long-term care.
Thank you very much.