Canada does not have a national system for tracking or preventing shortages of nurses and other medical workers, which health leaders say has contributed to hospitals across the country temporarily shuttering emergency rooms and intensive-care units this summer.
The lack of a federal health care planning and data-collection agency, they say, means there is no way to track how many medical professionals are working in various specialties, or which regions they are working in. For instance, there is no way to tell how many critical care or emergency nurses are working in hospitals in different parts of Canada, or how many more might be needed in the years ahead to keep up with growing demand for medical services.
Katharine Smart, president of the Canadian Medical Association, said the absence of federal data collection stands in the way of meaningful improvement in Canadian health care.
“We’re at the end of many years of poor planning and lack of planning,” she said, adding that many health care workers have left their jobs and not been replaced during that time. “Now suddenly we’re in a dire situation.”
“We are facing a crisis. It’s important that we plan correctly, having robust data that will support provinces and territories. All governments must work together.”
Across the country, patients are experiencing record waiting times in emergency rooms and a lack of available hospital beds. But Ontario Health Minister Sylvia Jones told reporters this week that it is “completely inappropriate” to say the health care system is in crisis. She pointed to vacationing health care workers as a contributing factor in the staffing shortages that have led to the recent hospital closings.
Federal Health Minister Jean-Yves Duclos declined a request for an interview. In a statement, Health Canada spokesperson Mark Johnson wrote that the federal government recognizes that the health work force is facing a crisis, which is why it hosted a symposium earlier this year to look at new strategies. The statement also noted that the government is reinstating the position of chief nursing officer.
Dr. Smart, who has been working as a physician for 20 years, said she believes the health care system is in the midst of a collapse. She said leaders across the country need to develop a health work force plan and commit to other important fixes as quickly as possible.
“It’s time to think like we think in a resuscitation,” she said. “A team of people descend and work together to reverse the problem with a sense of urgency and organization. Why are we not seeing that politically?”
While some information about the existing health work force is collected across Canada, those data are incomplete, and can even lead to misleading conclusions, said Ivy Bourgeault, a research chair in gender, diversity and the professions at the University of Ottawa, and lead of the Canadian Health Workforce Network, a research group that studies health human resources.
Much of Canada’s health work force information comes from regulatory colleges, which grant licences to health professionals. But this information doesn’t give an accurate picture of what the health work force looks like, because it doesn’t distinguish between professionals who are working directly in health care and those who are working in academia or administrative roles, Dr. Bourgeault said. And because each province and territory collects work force data differently, it is challenging to get any real sense of what the overall national picture looks like, she added.
The lack of health work force planning affects not only nursing, but every health profession.
While several premiers have promised in recent weeks to hire thousands more nurses and other health professionals to respond to this summer’s staffing crisis, medical leaders say the gaps in the country’s knowledge of its health work force mean those pledges aren’t connected to the reality of what the system actually needs.
“Public sector workers who are essential: how do we know how many there are and how do we make sure that we always have enough of those essential workers available?” said Morgan Hoffarth, a past president of the Registered Nurses’ Association of Ontario. “The governments have left it up to the individual employers, but that’s not helping the health care system.”
And simply promising to hire more staff without a plan for the future is going to result in failure, Dr. Bourgeault said. That’s because health work force planning requires careful consideration of how to keep people on the job. Across Canada, almost all of the focus is solely on recruitment and hiring.
“If you recruit a bunch of folks into a sector that’s bleeding, that’s akin to giving someone a blood transfusion and not doing anything about the gaping wound,” Dr. Bourgeault said.
Offering better salaries and ensuring staffing levels are adequate so people aren’t overworked are two possible ways of preventing nurses and other health professionals from burning out and leaving their jobs, she said.
Dr. Bourgeault noted that the federal government helps fund a work force planning strategy for the construction industry, called BuildForce. She believes something similar could easily be done for the health industry.
“It’s egregious how poor the data are and how we really have no robust instances of planning,” she said.
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