No more silence
During the most recent federal election campaign, the silence around healthcare in the political conversation was disheartening. It was also dangerous.
We are facing a national health workforce crisis, and without strong federal leadership, patient safety will continue to erode, especially in primary care, long-term care and mental health care.
Some claim that healthcare is solely a provincial and territorial responsibility. If the pandemic has taught us anything, it’s that the federal government has a crucial role in our healthcare system: from vaccine procurement to public health leadership, and through its direct provision of care to Indigenous communities, members of the military and incarcerated populations.
The federal government cannot and must not shirk its responsibility.
The truth is that fixing the health workforce crisis requires action across all levels of government and Canadians deserve to hear what our federal leaders plan to do about it. That was true before the election and remains true now that the election is over.
Let’s start with primary care. It is mathematically impossible to meet the need for primary care for all Canadians with family physicians alone. Family doctors are necessary — but not sufficient.
Primary care is best when delivered by a team of health professionals, including nurse practitioners, pharmacists, registered and licensed practical nurses and many other primary care providers. We will need all of these providers to ensure greater access.
We have trained these professionals at great public expense, yet we constrain their practice through outdated regulations and underfunded team-based models.
Federal action could make a difference.
A recent reinterpretation of the Canada Health Act confirms that ‘medically necessary’ services can be delivered by health practitioners other than physicians. This opens the door to expanded models of interprofessional care — which the federal government can support with development and implementation, particularly in underserved rural and remote areas.
The federal government can also be more assertive at addressing the increasing privatization of care through for-profit agencies. One practical tool is to claw back federal transfers that fund these agencies, which have driven up costs and drained resources from the public system.
Another federal lever is support for education and training.
Canada needs more health professionals, and the federal government can act immediately by expanding tuition supports, targeted scholarships and student loan forgiveness, especially for students from Indigenous, rural and remote communities. Rather than trying to lure health workers from cities into remote areas, we should build local health workforces from the ground up.
This year marks the 10th anniversary of the Truth and Reconciliation Commission’s Calls to Action. Yet Call to Action 23, which calls for increasing the number of Indigenous healthcare workers, remains largely unmet. Indigenous health workers are critical to improving outcomes and trust in healthcare systems, particularly in communities that have been systematically underserved.
When the federal government talks about investments in infrastructure, we also need to rethink what we mean by “nation-building projects.” It’s time to invest not just in roads and bridges, but also in the care infrastructure provided by health workers — the backbone of our healthcare system.
Investing in the care infrastructure — which constitutes nine per cent of Canada’s GDP — is an investment into our economy, our communities and our future. Care work, overwhelmingly performed by women, remains undervalued. True economic growth is inclusive of all sectors, and it is time for federal leaders to recognize that.
Sustained federal investments into the health workforce data infrastructure is also needed for more effective and equitable health workforce planning and a nationally coordinated strategy. Organizations across the country have pushed for this for years. Yet Canada remains far behind international standards when it comes to robust planning, support for training and deploying its healthcare workforce efficiently and equitably.
Yes, fixing this crisis will cost money. But doing nothing costs far more.
We currently operate one of the most expensive and inefficient healthcare systems in the developed world. Strategic investment in health workforce planning is not just a health policy issue — it’s an economic productivity issue.
Ultimately, patient safety is directly linked to the strength and sustainability of our health workforce — the cornerstone of our healthcare system. Burnout, short-staffing, excessive workloads and poor mental health among workers are not just workforce issues; they are patient safety issues.
A stronger, better-supported health workforce means better health outcomes, a more resilient economy and a healthier, more equitable Canada.
Photo courtesy of Facebook @KamalKheraLiberal
