Question Period Note: Health workforce crisis

N/A

• Canada’s health system is experiencing an unprecedented health workforce crisis. High patient workloads, lack of resources, mandatory overtime and fear for personal safety have led to high levels of burnout, absences, and turnover. The impacts reverberate across all areas of the health system, including the closure of emergency rooms, delayed screenings and delayed surgeries and have been extensively reported in the media.
• The Government of Canada recognizes the immense contributions health professionals make every day and we share their concerns about the health workforce crisis we are facing.
• The Government of Canada established a Coalition for Action for Health Workers that is composed of health system experts who will identify concrete actions to drive pan-Canadian progress on addressing the crisis, informed by real world perspectives.
• The federal government is actively working with our provincial and territorial counterparts, regulators, health workers and Canadians to advance concrete actions to address the crisis.

IF PRESSED ON THE HEALTH HUMAN RESOURCES CRISIS INVOLVING CHILDREN AND YOUTH . . .
• COVID-19 has put Canada’s health systems under enormous strain, leading to staffing shortages and backlogs in services, including for children and youth.
• The Government of Canada continues to make significant investments to help provincial and territorial health systems address pandemic-related backlogs to health services.
• These investments are supporting provinces and territories to reduce backlogs and ensure that Canadians, including children and youth, have more timely access to the services they need.
• To further strengthen health care, the federal government is committed to advancing the priorities of Canadians, including for children and youth, with a focus on better access to primary and mental health care, dental care, home and community care, and the effective use of high quality data and digital systems.

IF PRESSED ON DETAILS ABOUT INCREASING AND MAINTAINING SUPPLY …
• The federal government is committed to working with key partners on efforts to bolster recruitment and retention of the health workforce.
• Recognizing that immigration plays an essential role in addressing the chronic human resource needs in health care, Budget 2022 announced an investment of $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 professionals per year get their credentials recognized and find work in their field.

IF PRESSED ON MENTAL HEALTH AND SUBSTANCE USE SUPPORT FOR HEALTH WORKERS …
• The Government is very concerned about the mental health and well-being of Canadians, and of frontline workers who are working tirelessly to keep us safe and healthy.
• In the previous 2 years the federal government has invested more than $290 million in funding to support the mental health of Canadians.
• This includes investments specific to addressing PTSD and trauma in frontline and essential workers, and the Wellness Together Portal, which features a distinct text line that health workers access by texting FRONTLINE to the number for immediate access to supports.

IF PRESSED ON FEDERAL ACTIONS TO PROTECT HEALTH WORKERS AGAINST HARASSMENT…
• We have heard many stories about physicians, nurses and other health workers who have been threatened and intimidated, in person and online. This behavior is completely unacceptable.
• Our government took action to protect health workers, through amendments to the Criminal Code (under the former Bill C-3), in order to ensure health workers are safe and free from threats, violence and harassment.
• All Canadians, and especially health workers, whose goal is help others, deserve a safe working environment, free from violence and threats.

Canada’s health system is experiencing an unprecedented health workforce crisis. The COVID-19 pandemic has amplified many of the challenges facing the health workforce and it is well understood that the path forward must address the root causes of this crisis. It will require transformative and innovative solutions to problems that have existed for years, with new and different levels of collaboration required across governments and stakeholders.

FPT Collaboration

While the federal government provides financial support to the provinces and territories for health services, the responsibility for the management of health workforces falls within provincial and territorial jurisdictions and their regulators. The federal government has had ongoing engagement with provincial and territorial counterparts on the health workforce crisis. This work has included:

• Better understanding the challenges facing the health workforce through a Health Human Resource symposium convened by Health Canada in May 2022 which included participation from provinces and territories.
• Collectively identifying key areas for action (e.g., recruit, retain, plan and innovate)
• Considering approaches for accelerating pathways for internationally educated health professionals
• Studying vacancy rates for key health occupations to better understand current state and trends related to health workforce.

Health Canada will continue to work collaboratively with provinces and territories to drive concrete steps necessary to address health workforce situation.

Recent Federal Investments

The Canada Health Transfer continues to provide ongoing support to provinces and territories in the delivery of health care. In 2023-24, the Canada Health Transfer is forecast to provide $49.3 billion in support—an increase of 9.1 per cent over 2022-23.

In addition to this ongoing funding, in the previous two years, the federal government has provided provinces and territories with $6 billion in top up funding through the Canada Health Transfer, distributed equally per capita, to help provinces and territories address immediate health care system pressures, including reducing medical backlogs caused by COVID-19.

Budget 2021 provided $45 million over two years to develop national standards for mental health and substance use services, which will provide tools to support mental health providers in delivering high-quality care.

Budget 2021 also provided $960 million over three years to Employment and Social Development Canada (ESDC) for a new Sectoral Workforce Solutions Program to help connect Canadians with the training they need to access jobs in high-demand sectors, such as healthcare.

Budget 2022 reiterated federal government’s commitment to reduce barriers to internal trade and labour mobility through targeted investments, including:
• $115M over 5 years 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
• $26.2 million to enhance student loan forgiveness for providers who practice in rural and remote communities and expand the program beyond physicians and nurses

The Government of Canada continues to provide surge support, including nurses and physicians, where needed across the country to address critical pandemic needs.

Other Federal Government Actions

The federal response to the HHR crisis is focused on sustainably increasing the supply of health workers and helping create healthier workplaces to support retention and the mental health of health workers. Other recent federal actions and investments include:

• On November 1, 2022, the Government of Canada established a Coalition for Action for Health Workers. The Coalition will focus its efforts on identifying approaches to drive pan-Canadian action and progress on policy implementation, informed by real world perspectives.
• The Coalition comprised of representatives from key groups, including nurses, doctors, personal support workers, colleges and universities, patients, and equity-seeking communities will report to the Deputy Minister of Health.
• On August 24, 2022, Health Canada announced Dr. Leigh Chapman as the federal Chief Nursing Officer (CNO). Dr. Chapman will bring nursing issues in focus federally, while working closely with provinces and territories, stakeholders and regulatory bodies.

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.

Mental Health

In September 2022, a Report from the Mental Health Commission noted that it remains critical to break down cultural barriers and mental health stigma in health care organizations and prioritize psychological health and safety beyond the pandemic.

The Government of Canada continues to make significant investments to help provincial and territorial health systems address mental health issues and system capacity. This includes investments through Budget 2017 that provided $5 billion over 10 years to improve Canadians’ access to mental health services. The establishment of a Canada Mental Health Transfer will build on these agreements to provide a permanent and ongoing source of funds for mental health services.

On June 28, 2022 the Government of Canada, announced an investment of $28.2M for nine projects to address PTSD and trauma in frontline and essential workers, and others whose mental health has been significantly impacted by the COVID-19 pandemic.
• These projects will help to deliver and test interventions, develop resources for affected or at-risk populations, and create resources and guidance for service providers and organizations.
• The investment will also facilitate a Knowledge Development and Exchange Hub, which will use data from these projects to help inform mental health interventions and enhance Canadian public health policy and practice.

• There are not enough health care workers to meet the current demand for services.
• This year alone, vacancies among nursing occupations reached an all-time high between April and June 2022, with 23,600 vacancies among Registered Nurses and Registered Psychiatric nurses, as well as 10,800 vacancies among Licensed Practical Nurses. The job vacancy rate in the health care and social assistance sector was 6.4% for Canada as a whole in August.
• The shortage is expected to get worse.
• A survey of Ontario nurses found that between planned retirements and anticipated post-pandemic departures, the workforce could see a 15.6% loss in the nursing profession within the next year (2022-2023).
• According to a report released in September 2022 by the Mental Health Commission of Canada that explored support for psychological self-care and protection from moral distress in the workplace, 40 per cent of health care workers are burned out, 50 per cent intend to leave the profession, and just 60 per cent are satisfied with the quality of care they provide.
• 14.5% of Canadians do not have a primary health care provider. Not only is this harmful to the health and wellness of Canadians, but it also creates problems in other areas of the health system.
• Without a primary health care provider, emergency rooms become the only accessible option for seeking health care - in 2020, 38 percent of Canadians reported their last emergency department visit was for a family health care treatable condition.
• Lacking in both staff and physical space for the increasing patient load, hospital emergency rooms across the country have had to temporarily close their doors, particularly in rural areas.
• Nearly 90% of Canadians indicated that addressing shortages of doctors and nurses should be a top or high priority in a survey conducted by the Privy Council Office in February 2022.