Canada needs to better manage health care system’s workforce

A new health accord must include the establishment of a dedicated health workforce agency

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OTTAWA, Ont. Jan. 4, 2016/ Troy Media/ – The growing talk of a new health care accord between the federal government and the provinces and territories is great news, but any accord won’t be a success unless it includes the establishment of a dedicated health workforce agency in Canada.

Such a workforce agency is a reality in pretty much every other country except Canada, and we need one badly.

The reasons should be obvious, since we all experience our health system through its people, our health workers.

Care is delivered by a health worker or, more often, a group of health workers, each offering their skills and expertise. In simple economic terms, the workforce makes up the bulk of health system costs – from doctors’ fees to nurses’ salaries, from personal support workers in long-term care centres to dieticians in the community.

And that is why it is surprising that we put so few resources into planning how the people who make up our health system can best work, and best work together, to better meet the needs of patients.

Why do we not dedicate even a fraction of what we put pay health workers into co-ordinated planning for their services?

Don’t forget that for many Canadian health workers, the taxpayer also provides public funding for their education. But too often when the newly-minted health professionals are ready to work, only those patients who have private health insurance can access their services.

It is surprising how little Canadian governments plan for the number and type of health workers we need now and in the future. The list runs from the medical specialists for an aging population with multiple chronic conditions, to the physiotherapists, occupational therapists and personal support workers to enable older adults to remain independent in their own homes.

A dismayingly tiny fraction of the $1 billion a year spent on health research goes toward better understanding its most valuable resource — its people, the health human resources.

And here’s the kicker: pretty much every country in the world has an agency or organization dedicated to knowing as much as it can about its health workforce so they are best able to meet the needs of that country’s population. Rich countries and poor countries alike have these organizations. Such agencies are especially important for poor countries because they have to make the most out of the few health workers they have.

But Canada, it seems, can afford to get it wrong, over and over again.

Canada certainly does have a number of organizations doing a small part of the job of a health human resources agency, but it is far from a co-ordinated and sustained effort. For example, we have had three task forces in the past 20 years dedicated to examining the physician workforce. Yet we still have highly-trained surgical specialists who have difficulty finding operating room time. And many Canadians still go abroad for medical training. And too many communities still don’t have family physicians.

We don’t need another short-term task force to manage the health worker supply. We need effective and ongoing management of our entire health workforce.

The health human resources crisis is not simply a supply problem. There are issues with how the workforce is best utilized. Some of that is about distribution – getting the right kind of workers to the right places to treat the people who can most benefit from their skills. There are also issues with how we can better enable health staff to work with each other and better address the increasingly complex health issues our population faces. Finding the best evidence to support the best approaches to more equitable and efficient use of the whole health workforce is what a national agency could examine.

So when the various stakeholders gather to discuss what should go into a new health accord, this time the health workforce should be front and centre.

Ivy Lynn Bourgeault is an expert advisor with EvidenceNetwork.ca, a professor in the Telfer School of Management and the CIHR Chair in Gender, Work and Health Human Resources at the University of Ottawa.

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