Question Period Note: HOSPITAL/HEALTH CARE SYSTEM IMPACTS

• The ongoing management of the COVID-19 pandemic has led to impacts on the health care system, such as the cancellation of elective surgeries. There are also concerns about the health care system’s capacity to cope with the current wave of the virus.

• The Government of Canada recognizes the incredible contribution that health care providers have made and continue to make in Canada’s response to the pandemic.
• The Government of Canada has made significant investments that are helping provincial and territorial health systems respond to the pandemic, and address backlogs.
• It is also working closely with provinces and territories to help address shortages among key health care providers.

IF PRESSED ON THE HEALTH HUMAN RESOURCES CRISIS…
• We know that the people that deliver health care to Canadians are exhausted, and as a result, we are seeing staffing shortages in the health care system.
• The Government of Canada understands the need to sustainably increase the supply of health care workers and create healthier workplaces to support retention and the mental health of health care workers.
• Health Canada, along with other federal departments, has taken an active role in working with provincial and territorial governments and key health system stakeholders, such as health care educators, to identify both immediate and longer-term solutions to address significant health human resources challenges, such as access to health care services in rural and remote communities.
• This is why Budget 2022 is proposing to increase the number of doctors and nurses in communities that need them most and by helping internationally trained health care professionals get their credentials recognized and find work in the health care system.
• In an effort to address supply shortages in rural communities where staffing challenges exist, Budget 2022 announced $26.2 million in funding to increase the forgivable amount of student loans for doctors, nurses and other eligible practitioners who practice in rural and remote communities. In addition, the current list of professionals eligible to the program will be expanded.
• Budget 2022 also proposes to provide $115 million over five years, with $30 million ongoing, to expand the Foreign Credential Recognition Program and help up to 11,000 internationally trained health care professionals per year get their credentials recognized and find work in their field. It will support initiatives aimed at reducing barriers to foreign credential recognition for health care professionals.
• On March 25, 2022 the Government introduced Bill C-17 in the House of Commons, which will provide an additional $2 billion one-time top-up to provinces and territories, distributed equally per capita. This amount—in addition to the $4.5 billion Canada Health Transfer top-up provided since the start of the pandemic—will further help provinces and territories to address immediate pandemic-related health care system pressures, as well as address longstanding HHR challenges.
• Health Canada will continue to collaborate closely with other federal departments, provinces and territories and health care system stakeholders to address these pressing health workforce challenges

IF PRESSED ON HOW MODELLING IS HELPING TO INFORM DECISIONS ABOUT HEALTH SYSTEM CAPACITY…
• Data plays a key role in planning hospital capacity. We have worked with provinces and territories to track and model potential pressure points related to the availability of hospital beds and medical equipment, which in turn is informing decisions on how to allocate resources.
• Governments continue to work collaboratively to model demands on health systems under different modelling scenarios, both at the provincial level and at the national level with support from the Canadian Institute for Health Information.
• Governments are also tracking health care system backlogs, which have worsened over the course of the pandemic, and are assessing capacity needs, including health workforce, equipment, and beds.

• Provinces and territories continue to take a range of actions to increase system capacity and meet projected needs as the pandemic unfolds. This includes cancelling elective surgeries, physically reconfiguring spaces to fit more beds and create more isolation areas, and transferring patients to other settings.

• Provinces and territories have also increased use of publicly funded virtual care services and online screening assessments. This can help reduce pressure on emergency departments and is also complementing physical distancing measures. Provinces and territories are also running training exercises and simulations, and are hiring or rehiring staff to meet health system needs.

Federal investments

Safe Restart Agreement
On July 16, 2020 the Prime Minister announced a federal investment of more than $19 billion to help provinces and territories safely restart their economies and make the country more resilient to possible future waves of the virus. New federal funding is addressing seven priority areas:
• enhanced capacity for testing, contact tracing, and data management and information sharing to mitigate future outbreaks;
• investments in health care to respond to the pandemic, including support for Canadians experiencing challenges with substance use, mental health, or homelessness;
• support for vulnerable Canadians – including those in long-term care, home care, and palliative care – who are at risk of more severe cases of COVID-19;
• funding to secure a reliable source of personal protective equipment (PPE), and to recover some of the costs from previous investments made by provincial and territorial governments;
• support to ensure that safe and sufficient child care spaces are available to support parents’ gradual return to work;
• joint funding with the provinces and territories to support municipalities on the front lines of restarting the economy, including by putting in place precautions for public spaces and essential services to reduce the spread of the virus, as well as a dedicated stream of funding for public transit; and
• a temporary income support program that will provide workers who do not have paid sick leave with access to 10 days of paid sick leave related to COVID-19.

2020 Fall Economic Statement
The Fall Economic Statement of November 30, 2020 proposed new measures to support Canadians through the pandemic and to continue Canada’s COVID-19 response:
• Ensuring that federal and provincial laboratories continue to receive sufficient testing supplies and supporting the roll-out of new rapid COVID-19 tests and innovative approaches to testing;
• Continuing to procure PPE and provide warehousing and logistics support to deliver critical PPE and medical supplies to provinces, territories and Indigenous communities, as well as maintaining the readiness of the National Emergency Strategic Stockpile;
• Establishing a new Safe Long-term Care Fund that will provide up to $1 billion to help provinces and territories protect people in long-term care (LTC) and support infection prevention and control to protect seniors and the most vulnerable;
• Investing in additional measures to support infection and prevention and control in LTC;
• Reaffirming the Government’s commitment to work with provinces and territories to set new, national standards for LTC to make sure seniors and those in care live in safe and dignified conditions;
• Investing to provide additional mental health and virtual care supports for Canadians;
• Continuing to respond to Canada’s opioid crisis to support community-based organizations responding to substance use issues, including to help them provide frontline services in a COVID-19 context; and
• Supporting the continuing efforts of the Canadian Red Cross to respond to COVID-19 and other emergencies, and for a humanitarian workforce to provide surge capacity in response to COVID-19 outbreaks and other large-scale emergencies.

Budget 2021
Budget 2021 confirmed the Government’s continued support for provinces and territories, including addressing urgent health care needs, with an additional $5 billion in direct support to provinces and territories for health care and vaccination roll-out.
• The funding includes a one-time payment of $4 billion through the Canada Health Transfer, distributed equally per capita, to help provinces and territories address immediate health care system pressures. This funding could be used for a variety of urgent needs, including clearing the backlog of medical procedures, patient care, and access to primary care put on hold due to the pandemic.
• A one-time payment of $1 billion, distributed equally per capita, is also being provided to the provinces and territories to support and accelerate COVID-19 vaccine roll-out campaigns.

2021 Economic and Fiscal Update
On December 14, 2021 the Government of Canada tabled its Economic and Fiscal Update outlining measures to finish the fight against COVID-19 and support Canadians through a robust recovery. The Economic and Fiscal Update sets out a range of measures to support Canadians through the pandemic including:
• $1.7 billion to increase access to rapid testing supplies across Canada;
• $2 billion to procure lifesaving COVID-19 therapeutics and treatments;
• $409 million to continue the ongoing COVID-19 pandemic response, including strengthened surveillance, laboratory research, and emergency management operations;
• $599 million to support and maintain ongoing COVID-19 border testing capacity and operations; and
• Up to $4.5 billion to respond to the Omicron variant, including border measures, and income and business supports.

The update provides proposed funding for safer travel. It also provides funding to provinces and territories through the Safe Return to Class Fund, and to First Nations for on-reserve schools, to improve ventilation. It also commits additional investments to support ventilation projects in public and community buildings such as hospitals, libraries, and community centres.

Additional investment to clear backlogs
On March 25, 2022 the Government introduced Bill C-17 in the House of Commons, which would provide an additional $2 billion one-time top-up to provinces and territories, distributed equally per capita. This amount—in addition to the $4.5 billion Canada Health Transfer top-up provided since the start of the pandemic—would further help provinces and territories to address immediate pandemic-related health care system pressures, particularly the backlogs of surgeries, medical procedures and diagnostics.

Federal action to respond to the Health Human Resource Crisis

To help bring more workers in the health system, Budget 2022 proposes to provide support for internationally trained health care professionals to fill these gaps and for doctors working in underserved rural or remote communities to ensure that Canadians receive the health care they deserve where they live. This includes:
• $26.2 million over four years, starting in 2023-24, and $7 million ongoing, to increase the maximum amount of forgivable Canada Student Loans by 50 per cent. This will mean up to $30,000 in loan forgiveness for nurses and up to $60,000 in loan forgiveness for doctors working in underserved rural or remote communities. In addition, the current list of eligible professionals under the program will be expanded.
• $115 million over five years, with $30 million ongoing, to expand the Foreign Credential Recognition Program and help up to 11,000 internationally trained health care professionals per year get their credentials recognized and find work in their field. It will also support projects—including standardized national exams, easier access to information, faster timelines, and less red tape— that will reduce barriers to foreign credential recognition for health care professionals.

All Canadians, and especially health care workers, deserve a safe working environment, free from violence and threats. To this end, the Government took action to protect health care workers, through amendments to the Criminal Code (under the former Bill C-3), in order to ensure health care workers are safe and free from threats, violence and harassment.

The Wellness Together Portal, a digital tool to support Canadians’ health and well-being during COVID-19, features a dedicated text line for frontline workers that provides immediate access to supports. Budget 2022 proposes to provide $140 million over two years, starting in 2022-23 so it can continue to provide Canadians, including health workers with tools and services to support their mental health and well-being.

Health Canada is providing $4 million over four years to the National Consortium on Indigenous Medical Education to provide leadership and implement Indigenous-led projects that create tools and resources to support culturally safe health care delivery, as well as the recruitment and retention of Indigenous physicians.

A Health Human Resources Symposium of national stakeholders and partners was held on May 10 and 11, 2022 and provided an opportunity to hear from experts, practitioners, health care educators and PT officials on challenges, vision and areas for action to tackle the HHR Crisis from a pan-Canadian perspective.

On February 1st, 2022, Health Canada announced a recruitment process for a federal Chief Nursing Officer (CNO) for Canada. This individual will have the opportunity to bring nursing issues in focus federally, while working closely with provinces and territories, stakeholders and regulatory bodies. An announcement is expected in the spring of 2022.

Health Canada is working closely with federal departments, as well as PT partners through the FPT Committee on Health Workforce to share best practices and identify opportunities to scale and spread promising practices across the country.

KEY FACTS
• On March 25, 2022 the Government introduced Bill C-17 in the House of Commons, which would provide an additional $2 billion one-time top-up to the Canada Health Transfer to address backlogs, distributed equally per capita to provinces and territories.
• Bill C-17 supplements the significant investments made by the Government of Canada to provinces and territories since the start of the pandemic to bolster health care systems, address surge capacity needs, and alleviate backlogs, through the Safe Restart Agreements, the Fall Economic Statement 2020, Budget 2021 and the Economic and Fiscal Update 2021.