[01-31-23] Ontario hospital nurses start contract talks, plan ‘escalating actions’

The Ontario Nurses’ Association (ONA), representing 60,000 hospital nurses and health-care professionals, and the Ontario Hospital Association (OHA) began negotiations on Monday to renew the collective agreement which expires on March 31 of this year. Negotiations are scheduled to take place during the week of January 30 and at the end of February. Outstanding issues will be referred to mediator Colin Johnston on March 1 and 2 and, in the absence of a settlement, the parties will proceed to arbitration before William Kaplan on May 2 and 3. The OHA hopes to achieve a “voluntarily, mutually agreed-upon collective agreement.” ONA’s top bargaining issues are staffing shortages and wages, and it is planning a series of “escalating actions” ranging from nurses wearing stickers to a protest, but nurses will not engage in illegal walkouts.
thestar | news release

[01-31-23] Canadian doctors spend 18.5 million hours on unnecessary paperwork, says new report

According to a report entitled “Patients before Paperwork” by the Canadian Federation of Independent Business, Canadian doctors are collectively spending approximately 18.5 million hours on “unnecessary paperwork and administrative tasks” every year, which roughly equate to 55.6 million patient visits. The report uses data from a 2020 Nova Scotia study to estimate the total physician “red tape burden” in each province and territory, as well as the number of patient visits that may have been lost on account of this burden. The report finds that reducing physician red tape by 10% “could reduce physician fatigue and burnout, improve the quality of patient care, and save the equivalent of 5.5 million patient visits a year.” The Nova Scotia government has already committed to making this 10% reduction by 2024.
globalnews | news release | report | cbc | vancouver.citynews | ckfm | cbc | theglobeandmail | thestar | winnipegfreepress

[01-30-23] Focus on retaining nurses before recruiting nurses from other provinces

In response to recent attempts by some provincial governments to recruit nurses from other provinces, Sylvain Brousseau, President of the Canadian Nurses Association, said that “poaching” nurses will not solve the current health-care crisis. Unless working conditions improve, Brousseau explains, “new nurses recruited from other provinces may find themselves wanting to leave their jobs” as well. Ivy Bourgeault, a professor at the University of Ottawa, echoes Brousseau’s sentiment that a long-term solution to the nursing shortage must begin with a focus on retention, stressing, on the one hand, the importance of mandatory nurse-to-patient ratios and, on the other, the need for “better data for workforce planning.”
thestar

[01-30-23] Doctors say surgical training, delayed by the pandemic, continues to be affected

According to the Canadian Institute for Health Information, the number of estimated surgeries plummeted by 600,000 during the first 18 months of the pandemic. Medical schools responded to this change by expanding virtual care and reassigning learners to COVID-19 and vaccine-related work. The recent spike in hospitalizations due to respiratory illnesses has contributed to further delays in surgical training in a variety of elective and other surgeries, including cancer and plastic surgery. While most surgical residents are continuing to graduate and enter the workforce “on schedule,” they may be doing so without the “speciality skills” they would have acquired otherwise, and many “learners are concerned they will not receive enough training if surgeries don’t return to normal volumes soon.”
thecanadianpressnews

[01-30-23] More nurses and doctors priority for Ontario under possible federal health deal

Premiers across Canada are scheduled to meet with Prime Minister Justin Trudeau on February 7 to negotiate changes to the Canada Health Transfer. According to a statement by Premier Doug Ford on Friday, under a new health care deal, Ontario will prioritize hiring more nurses and doctors, as well as making investments to address its surgical backlog. Ford also said the province is looking to put more money into long-term care and home care.
thecanadianpressnews | theglobeandmail

[01-27-23] Alberta considers training doctors for rural practice in smaller centres

On Thursday, the Alberta government announced that it will address rural physician shortages by investing $1 million in delivering medical education outside Edmonton and Calgary through regional institutions. The government is currently exploring the feasibility of operating health training centres at the University of Lethbridge and Northwestern Polytechnic in collaboration with the Universities of Calgary and Alberta, which currently operate the province’s only medical schools. The province hopes that the opportunities created by this program will support the retention and recruitment of physicians in rural areas and increase access to physician services. Health Minister Jason Copping expects that this training program will begin to show results in six to eight years.

globalnews (video) | globalnews (video) |  thestar | calgary.ctvnews | calgaryherald | press release | cbc

[01-27-23] Job vacancies decline in health care and social assistance sector

Statistics Canada reported that the overall number of job vacancies fell by 2.4% in November, their lowest level since August 2021. The job vacancy rate, which measures the number of vacant positions as a proportion of total labour demand, was 4.8% in November, the lowest rate since June 2021. With respect to the health care and social assistance sector, the number of vacancies fell by 12.8% and the vacancy rate decreased by 0.7% during the same period. Despite this decline, however, the number of job vacancies in the sector was 44.8% (+40,800) higher than in January 2021, and 82.5% (+59,600) higher than in March 2020, at the onset of the pandemic.
statcan | theglobeandmail

[01-26-23] Manitoba Nurses Union concerned about future of sexual assault nursing program at HSC

In April 2022, the Manitoba government announced that it would introduce a new Forensic Nurse Examiner (FNE) program that builds upon the existing Sexual Assault Nurse Examiner (SANE) program at Health Sciences Centre (HSC) Winnipeg. The province promised $640,000 annually to fund 5 full-time nurses, including a provincial co-ordinator, by 2023, and undertook to train existing nurses in rural and northern communities. The FNE program is currently staffed by one full-time nurse and 14 casual nurses who hold other full-time positions in other units. At a press conference on Wednesday, Darlene Jackson, president of the Manitoba Nurses Union, announced she is seeking action on the program for failing to hire a provincial co-ordinator and for not making training available to new forensic nurses. Jackson explains that, due to current understaffing, “extremely vulnerable patients have been told to go home and wait, to do their best to preserve the evidence,” and to return “when there is a SANE nurse on shift.” The employer responded that it has been making efforts to develop the program since April 2022, that five forensic nurse examiner positions have been filled with training beginning in February, and that the recruitment process for the manager position is underway.
cbc | winnipeg.ctvnews | globalnews | winnipegfreepress

[01-26-23] Fewer than 100 international nurses registered under new Ontario plan to boost health-care staffing

In October 2022, the Ontario government announced that it would allow the College of Nurses of Ontario (CNO) to register internationally educated nurses (IENs) in a temporary class while they work towards their full registration. According to applicant statistics from the CNO, however, only 67 new IENs have been registered under this category in 2022. Specifically, 27 IENs were registered between November 1 and December 1, 2022, and 40 more between December 2, 2022 and January 1, 2023. The CNO’s statistics show that more than 6,000 internationally-trained nursing applicants are lodged in the province but that they have not been successfully registered.
globalnews

[01-25-23] New Brunswick seeks nurses from Québec amid health-care worker shortage

Horizon Health, a New Brunswick health authority, held a nursing recruitment event in Montreal on Tuesday, despite Québec’s own staffing shortages. Recruiters offered up to $10,000 in signing bonuses, $5,000 in relocation costs, and a number of other benefits to nurses interested in working in New Brunswick. Dr. Ivy Bourgeault, professor at the University of Ottawa, finds this recent attempt to attract nursing staff across provincial boundaries symptomatic “of the challenging situation” in health systems across the country. Damien Contandriopoulos, nursing professor at University of Victoria, adds that such interprovincial competition is an “ineffective” way to solve internal problems. Bourgeault and Contandriopoulos propose, instead, that provinces work on retaining their own health care workers, reduce pressure on hospitals, and manage human resources more effectively.
cbc

[01-25-23] Doug Ford is championing mobility for health-care workers. Some experts say that’s a good idea

In an attempt to ease staffing shortages in Ontario, the provincial government announced last week that it is enabling doctors, nurses, and other health professionals licensed anywhere in Canada to begin practicing in the province immediately. Despite concerns that critics have raised about these recruitment strategies, some experts have welcomed the province’s openness to health-care staff mobility as a first step toward resolving Canada’s health human resources crisis. In its recent report “Taking Back Health Care,” the Public Policy Forum sees “cross-Canada licensure of health professionals, fast-tracking of foreign-trained professionals and [the] adoption of team-based models” as integral to Canada’s solution. It also underscores the importance of enabling health-care workers to practice “both in person and virtually” and maintains that the goal of a reformed health system should be “accessible, timely care” using the best “delivery models, people, technology, data and infrastructure.”
thestar | ppforum | cbc (podcast) | globeandmail (opinion)

[01-24-23] Bill 24 passes in House of Assembly, putting pause on private ambulance workers’ strike

Approximately 120 paramedics and emergency medical responders employed at Fewer’s Ambulance Service, a private ambulance operator, commenced strike action at noon on Friday. The issues in dispute include poor working conditions, wage imparity with the public sector, and the absence of a pension plan. On Monday, Newfoundland’s House of Assembly held an emergency sitting to table and debate Bill 24, the Essential Ambulance Services Act. The Bill, which passed shortly after 9 p.m., requires the members of Teamsters Local 855 to return to work immediately until an “essential services agreement” is reached that will specify what type of workers are deemed essential and how many are required to “run ambulance services during a strike.” Once the essential services agreement is established, workers will be allowed to return to the picket line in accordance with its specifications. Labour disputes can be taken to the province’s Labour Relations Board, which can refer matters to binding arbitration.
news release | saltwire | theglobeandmail | saltwire | cbc

[01-23-23] Ontario announces plans on health care worker training grants

The Ontario government is expanding its “Learn and Stay” grant, first announced in March 2022, to include paramedic and medical laboratory technologist programs in “priority communities.” Eligible students will receive “full, upfront” funding for tuition, books, and other direct educational costs at select post-secondary institutions in return for a commitment to work a minimum of six months for every funded year of study in the region where they studied. The program will provide funding to 2,500 postsecondary students enrolled in nursing programs in northern, eastern and southwestern Ontario, medical laboratory programs in northern and southwestern Ontario, and paramedic programs in northern Ontario. Grant applications open this spring.
news release | globeandmail | cbc | globalnews | cp24

[01-23-23] Tribunal orders nurses back to the job after illegal strike in Nord-du-Québec

In response to a request from the Centre de santé et services sociaux (CSSS) Inuulitsivik, Québec’s Tribunal administratif du travail issued an emergency order on Friday forcing a group of nurses back to work in northern Québec after they launched a spontaneous work stoppage to protest their working conditions. The Tribunal ordered the nurses to return to work immediately, stating that they did not have the right to strike and that their reasons for refusing to work “are not relevant for the purposes of the dispute.” The president of the Syndicat nordique des infirmières et infirmiers de la Baie d’Hudson (SNIIBH-FIQ) denounced the employer’s decision to turn to the courts, saying that it is not acceptable to demand that nurses “work 32 hours straight” without “a minimum eight hours of rest during each 24-hour shift.” He further explained that nurses cannot “offer quality and safe care” under these conditions. A meeting between the union and CSSS is scheduled for Monday afternoon. The union said that it hopes to see concrete proposals on the table during the meeting.
rcinet  | montrealgazette

[01-23-23] Nova Scotia announces training and retention incentives for emergency room nurses

Nova Scotia Health is introducing a number of new training and retention incentives in an effort to reduce vacancies in emergency departments. The province is planning to launch a “just-in-time” program to make experienced ER nurses available online for consultation to those who are working evening and weekend shifts. It will also introduce a range of professional development opportunities for emergency department nurses, provide grants for nurses with innovative ideas related to workplace improvement, and increase training, clinical practice, and peer support for new nurses.
cbc | 1015thehawk | news release | saltwire

[01-20-23] Ontario to remove registration requirement for out-of-province health care workers

The Ontario government announced on Thursday that it will introduce new rules to allow Canadian health care workers registered or licensed in another Canadian jurisdiction to practice immediately in the province, without needing to register with one of the province’s health regulatory colleges first. Legislation to make these certification changes will be introduced in February. Ontario will also table legislation to enable hospitals and organizations to increase short-term staffing levels by allowing healthcare workers such as nurses, paramedics, and respiratory therapists to work outside their regular responsibilities and settings “as long as they have the knowledge, skill, and judgment to do so.” The Canadian Medical Association called the government’s plans a “promising step to improve access to care” and urges other provincial and territorial governments to adopt similar strategies. Dr. Doris Grinspun, CEO of the Registered Nurses Association of Ontario, said that enabling nurses registered in other jurisdictions to work in Ontario is “absolutely the right move” but that these nurses may not be interested in moving to the province “unless we enable competitive compensation.” The Ontario Nurses’ Association responded that it is “deeply concerned” about the proposals and the absence of information on checks and balances. It further questioned how healthcare organizations might “determine whether staff have the right skills to take on different roles outside their scope.”
news release | thestar | cp24 | thestar | globalnews | cbc | theglobeandmail | newswire

[01-20-23] FIQ and FIQP reject Quebec’s contract offer

At a recent meeting, delegates of the Fédération interprofessionnelle de la santé du Québec and the FIQ Secteur privé rejected the offer the government tabled in mid-December to renew their collective agreements. Quebec offered a 9% wage increase over five years, a lump sum payment of $1,000, and an amount equivalent to 2.5% reserved for “government priorities.” The FIQ, which represents 75,000 nurses and other health care professionals in the province, describes the government’s proposal as “disconnected from the problems” faced by their members, “disrespectful,” and “insulting.” The first negotiation meeting between Quebec and public-sector delegates will take place on January 27. Negotiations are expected to be challenging on account of the gap that separates the parties on salaries, workload demands, and mandatory overtime.
montrealgazette |  montreal.ctvnews | fiqsante

[01-19-23] Poaching of staff top concern for Ontario hospitals over new surgical centres

According to Anthony Dale, President of the Ontario Hospital Association (OHA), preventing the poaching of staff is a “top concern” for hospitals following the government’s recent announcement about the use of private clinics to address the province’s surgical backlog. Although the government has promised to implement measures that will prevent hospital staff from migrating to these new centres, Dale responds that “there is a lot of work to do” to ensure that these measures are “effective enough.” One concern that has been raised by both the College of Physicians and Surgeons of Ontario and the OHA is that these centres may not be able to handle complications that arise from surgeries and that they should, therefore, need to “remain connected to the hospital system” in order to provide “lifesaving care.” Dale further explains that doctors under the new system ought to maintain privileges at a hospital that would not only carry accountability, but also outline “how and when physicians work.”
cbc

[01-19-23] Actions to Improve Emergency Care in Nova Scotia

Following Tuesday’s summit of Nova Scotia officials and health care partners, the government has announced a new action plan to improve emergency care in the province. As part of these measures, it will create doctor-led triage teams that focus on admitting patients more quickly into emergency departments and will assign physician assistants and nurse practitioners to emergency rooms. Care providers and non-medical patient advocates will also be available to support patients in waiting rooms, and virtual care will be offered to those with less urgent needs. Actions to support paramedics include additional training offered by Medavie throughout the province, a tuition rebate of $11,500 for a three year return-in-service agreement, and additional air ambulance support. The province will also ensure that its residents will be able to access medical care more broadly by supporting new and existing collaborative family medicine practices, expanding services in pharmacies, adding hours for virtual care appointments, and enabling out-of-province doctors who are licensed in the province to offer virtual care.
news release | globalnews | atlantic.ctvnews | atlantic.ctvnews | atlantic.ctvnews | thestar | signalhfx

[01-18-23] Quebec appoints mediator after protest by nurses partially shuts down Montreal hospital ER

On Monday night, the emergency room at Montreal’s Maisonneuve-Rosemont Hospital was forced to reduce operations on account of a nurse sit-in. More than 90 of the 115 nurses working in the hospital’s ER signed a petition demanding the resignation of the unit’s chief and threatening to resign en masse in response to the continued use of mandatory overtime. Officials are now promising changes that will reduce the nurses’ workload and have moved the unit chief to another part of the health network. Quebec Health Minister Christian Dubé said that a mediator has been appointed to help balance the nurses’ demands and maintain the hospital’s capacity.

globalnews | cbc | montreal.ctvnews | thestar | globalnews (video)

[01-18-23] Nova Scotia to build transitional modular housing for health care workers

John Lohr, Nova Scotia’s Minister of Municipal Affairs and Housing, explains that limited housing availability in some communities has posed significant challenges to the recruitment and retention of health care workers. In order to address these challenges, the province has announced that it will invest $8 million in transitional modular housing projects to “provide affordable housing for healthcare workers in communities where housing options are limited.” The province will partner with the Housing Trust of Nova Scotia, which plans to engage all stakeholders to place temporary mobile modular homes in areas where there is an acute demand. The Trust will work with government representatives and municipalities to identify locations for the modular homes and will ensure the units are delivered as quickly as possible.
globalnews | news release | 1015thehawk | cbc

[01-18-23] OPINION | Three actions would begin to fix the nursing shortage crisis

Bernie Robinson, interim president of the Ontario Nurses’ Association, and Linda Silas, president of the Canadian Federation of Nurses Unions, offer suggestions on handling the nursing crisis based on three tenets: retention, recruitment, and return. Robinson and Silas explain that the government could prevent nurses leaving the profession by implementing “safe nurse-to-patient ratios” and investing in programs focused on retention. They also suggest that the government boost recruitment by “expand[ing] domestic training programs” and developing ways of supporting student nurses in “securing employment in attractive full-time jobs.” Finally, Robinson and Silas recommend that both the federal and provincial governments work to “bring nurses back to the public sector” through “return-and-recruit initiatives.” In their view, combining these strategies would ensure that patients receive adequate care and that nurses “practice their profession under safe and sustainable working conditions.”
thestar

[01-17-23] Ontario expanding number and range of surgeries offered at for-profit clinics

In an attempt to ease pressures on the health care system, Premier Doug Ford and Health Minister Sylvia Jones unveiled a three-step plan on Monday to deliver more procedures at private clinics. The first stage involves adding 14,000 cataract surgeries through “new partnerships” at centres in Windsor, Kitchener-Waterloo, and Ottawa. It also includes an additional $18 million for existing centres that provide MRI and CT scans, cataract and other ophthalmic surgeries, gynecological surgeries, and plastic surgeries. Subsequent steps will expand the scope of private surgical and diagnostic centres to include more colonoscopy and endoscopy procedures as well as hip and knee replacements. Critics of the plan have raised a number of concerns on issues ranging from staffing shortages to a track record of upselling procedures in private clinics noted in the Auditor General’s 2021 report. 

nationalpost | cbc | news release | pressprogress | torontosun | reuters | cbc | cp24 |  ona | rnao | theglobeandmail (video) | cbc:power&politics [33:19 start] 

[01-17-23] Some Nova Scotia hospital units have 80% nurse vacancy rate

According to Nova Scotia Health, as of December 31, 18 units at the province’s regional hospitals had a nursing vacancy rate of 50% or more, with the highest rate (83%) recorded at Cape Breton Regional Hospital. Nurses in understaffed units must compensate by handling up to double the normal patient load, working 24-hour shifts or six days a week, and foregoing vacation time. The Minister of Health noted in an interview that 1,500 additional nurses are needed in the province, but Janet Hazelton, president of the Nova Scotia Nurses’ Union, responds that retention is the main issue that needs to be addressed, adding that “current working conditions in hospitals are driving nurses away,” with many switching to part-time or travel nursing, or leaving the profession altogether.
cbc

[01-17-23] Alberta accepts 53 recommendations to improve ambulance response times

On Monday, the province of Alberta announced new measures for improved emergency medical services (EMS) response times pursuant to its Health Care Action Plan, accepting all 53 recommendations from the EMS Provincial Advisory Committee report and from an independent dispatch review. Actions include adding 20 ambulances during peak hours, to be divided equally between Edmonton and Calgary, starting this spring. The province will also fast-track ambulance transfers at emergency departments by moving less urgent patients to hospital waiting areas and free up paramedics by contracting appropriately trained resources for non-emergency transfers between facilities in Edmonton and Calgary. Finally, paramedics will be given discretionary powers to assess patients’ conditions on scene and decide whether transport to the ER by ambulance is necessary.

globalnews | edmontonjournal | news release | video of press conference | strathmorenow | calgary.ctvnews | theglobeandmail | cbc

[01-17-23] Tentative contract reached for thousands of health support workers in B.C.

The BC General Employees’ Union representing approximately 13,000 health care support workers reached an agreement with the Health Employers Association of BC (HEABC) on Sunday morning. According to the Union’s statement, the deal represents “substantial gains that workers had identified, such as significant wage increases, protecting workers’ benefits and greater control over working conditions.” While full details of the contract will be released after the ratification vote, the Union says the agreement has a three-year term with general wage increases in each year and a clause for low-wage redress for some workers. HEABC states that the tentative agreement “supports government’s key priorities to improve public services and the health care system, while supporting the province’s continued economic recovery.”
thestar | heabc

[01-16-23] Ontario to expand surgeries performed in private facilities

In order to reduce the province’s surgical backlog, the Ontario government is planning to announce this week that it will turn to independent health facilities (IHFs) for cataract surgeries as well as hip and knee replacements. According to government sources, safeguards will be put in place to prevent an exodus of doctors and nurses from public hospitals. The government claims that IHFs will use their existing personnel and will present staffing plans for vetting in order to ensure that there will be no impact on the broader health care system. 

Perspectives on the Expected Changes

College of Physicians and Surgeons of Ontario:
Dr. Nancy Whitmore, the Registrar and CEO of the CPSO, warns that an expansion of the use of private surgical clinics would “further tax our health human resources shortages” and increase wait times for urgent care. She also maintains that surgical centres ought to be connected to the hospital system to “ensure continuity of care and patient safety.”

Ontario Medical Association:
The OMA advocates for the creation of “integrated ambulatory centres” in order to help address the surgical backlog, but envisions them as non-profits affiliated with hospitals. 

Ontario Nurses’ Association:
ONA calls the new plan “disastrous,” further stating that “nurses and health-care professionals who are qualified to safely work in surgical settings need more support and better funding in the public system, not a plan that will simply divert public dollars into the hands of private shareholders.”

Ontario Public Service Employees Union:
OPSEU emphasizes that public health care staffing is the critical issue that must be addressed to resolve Ontario’s surgical backlogs.

Registered Nurses’ Association of Ontario:
The RNAO worries that expanding the role of private clinics would take nurses away from the public hospital system. They propose instead that additional nursing staff be provided to hospitals in order to expand the use of existing operating facilities.

SE Health:
John Yip, president and chief executive officer of SE Health Care, dismisses the argument that private clinics would have an adverse impact on hospital staffing. In his view, only improved working conditions in hospitals can alleviate the problem of staff who are leaving demanding front-line jobs on account of burnout. 

Ontario Health Coalition:
The Ontario Health Coalition echoes the concern that private clinics will take staff away from the public system, suggesting instead that the government provide additional funds to the public system.

Dr. Michael Warner, Director of ICU at Michael Garron Hospital:
Dr. Warner points out that new physical centres for surgeries are not necessary because the majority of operating rooms across the province are available on evenings and weekends on account of staffing shortages.

thestar | cp24 | theglobeandmail | cbc | thestar | globalnews | opseu | theglobeandmail | thestar | lfpress | jacobin | torontosun

[01-13-23] OPINION | Canada’s response to nursing shortage lacks urgency and co-ordination

The global nursing shortfall was estimated at 5.9 million last year, and provinces across Canada are experiencing their share of this “desperate shortage.” Daphne Bramham explains that while Canada has relied for decades on immigration to solve its labour shortages, this approach does not work in relation to health care, which is provincially regulated. Rather than developing “national standards,” which would expedite accreditation and allow worker mobility, provinces and territories have added to the fragmentation by setting their own accreditation standards that resulted in “a patchwork effect,” pitting one province against another to attract internationally trained nurses and doctors. Provinces are now attempting to address shortages by easing the burden on applicants in different ways. B.C., for example, is waiving the requirement that IENs have their credentials assessed by the National Nursing Assessment Service and has created an organization to help IENs navigate the system. Bramham acknowledges that while these changes are positive, they are only incremental and fail to address this urgent problem structurally. What is needed in Canada is a “concerted, co-ordinated push for a national registration process that simplifies and streamlines” assessment and registration.
vancouversun

[01-13-23] New mental health supports for Peel paramedics

Trillium Health Partners (THP) and Peel Regional Paramedics Services have created a partnership to support the mental health of local paramedics. In a joint press release, the two organizations note that first responders are at high risk for mental health concerns due to the “high demands” and “traumatic exposure” of their work. Paramedics will now have “expedited access” to psychological assessment and treatment services provided by THP’s team of mental health professionals. The support will be offered both in person and virtually and will include flexibility to address paramedics’ needs.
toronto.ctvnews (video) | press release

[01-12-23] How many health-care workers does Ontario need? The province won’t say

Global News is in the process of appealing redactions the province made to internal documents recently released under the Freedom of Information and Protection of Privacy Act. The redacted sections include key information on the number of health care workers needed to fill staffing gaps in the province and of the associated costs. Ministry of Health staff redacted the documents under section 18 of the Act, maintaining that, if released, this information “could impact the [ministry’s] negotiating position when negotiating contracts with health-care workers.” Global News highlights the “systemic shortage of nurses” in the province and the danger of losing a large proportion of PSWs in a single year, both of which were cited in the released documents. The news outlet promises to publish the redacted information “in full” if its appeal to the Information and Privacy Commissioner of Ontario is successful.
globalnews

[01-12-23] Notes on Premier Ford’s press conference

In response to questions about internal briefing notes addressing the impacts of Bill 124 on Ontario’s staffing crisis, Premier Ford maintained that the claims contained in the released documents were “not accurate,” citing “record” hires in the province and insisting that “[t]here are no numbers” on the negative effects of the legislation. Furthermore, although the government is in the process of appealing the Superior Court of Justice’s decision to strike down Bill 124 as unconstitutional, Premier Ford claimed that the legislation had “lapsed” and that it “doesn’t exist.” He also spoke about future strategies to relieve the burden on the province’s health care system by increasing reliance on “independent health centres” for certain procedures. Finally, Premier Ford acknowledged that his government is willing to accept some conditions from the federal government in return for an increase in the Canada Health Transfer, but maintains that the province wants flexibility in how it handles the additional funds.
globalnews | cp24 | thestar | theglobeandmail

[01-11-23] Saskatchewan Health Authority announces new paramedic treatment and referral pilot project

On Tuesday, the Saskatchewan Health Authority launched the EMS Treatment and Referral pilot project in Saskatoon, which expands the scope of practice for paramedics responding to 911 calls over the next six to twelve months. In order to “ensure patients are receiving adequate and timely care while easing pressures on emergency rooms,” the program allows paramedics to consult a virtual triage physician for support in situations where they determine a patient could be referred to another health care provider or be released from care. The program limits paramedics’ discretion to six categories of illness in adult patients: hypoglycemia, heat illness, mild to moderate allergic reactions with dissipating symptoms, falls, minor lacerations or abrasions without active bleeding, and influenza-like symptoms. If successful, the pilot will be expanded to Regina and to additional ambulance services.
panow | saskatoon.ctvnews | news release

[01-11-23] Ontario health minister defends nursing compensation despite internal Bill 124 documents

Ontario’s Health Minister Sylvia Jones defended the government’s approach to nursing compensation following the release of internal documents acknowledging that the wage disparity created by Bill 124 contributed to the current shortage of nurses in the province. Global News reports that Minister Jones “sidestepped the question” when asked about the documents released on Monday, referring instead to the measures the government took during the pandemic. Minister Jones maintained that the retention bonuses given to nurses who chose to remain in the system and the $3 per hour PSW wage increases were offered in recognition of the “challenging time” in health care.
globalnews

[01-11-23] Union files grievance, calls on WRHA, Shared Health to pick up pace on support worker contract rollout

On September 23, 2022, approximately 18,000 health care support workers voted to ratify a seven year agreement reached between CUPE and the Winnipeg Regional Health Authority (WRHA) and Shared Health. CUPE has now filed a grievance claiming that the WRHA and Shared Health have been “too slow to implement some of the details negotiated in September.” In particular, CUPE argues that it has taken over three months to provide the promised shift premiums, vacation scheduling, and coffee breaks for home care workers, all of which were designated as “important for recruiting and retaining front-line health-care workers.” Shared Health has responded that implementation will be concluded within the 120 day post-ratification timeframe that was negotiated by the parties.
cupe | cbc

[01-10-23] B.C. government covering costs for internationally educated nurses to deal with staffing shortage

On Monday, Premier David Eby announced new financial incentives targeting nurses as part of B.C.’s Health Human Resources Strategy. These measures include helping internationally educated nurses (IENs) enter the health care system by covering the application and assessment fees, which exceed $3,700. New financial support will also be available to nurses returning after a period of absence. In particular, the province will waive the $300 application fee, offer financial support of up to $4,000 for applications, assessments, and eligible travel costs incurred to re-enter the workforce, and provide access to bursaries for any additional requisite education to a maximum of $10,000. B.C. Nurses Union president Aman Grewal says the changes offer “hope for a strained and understaffed health-care system.”
globalnews | cbc | news release | globalnews (video) | bc.ctvnews | vancouverisland.ctvnews | thestar

[01-10-23] Internal ministry documents say that Bill 124 poses a challenge to ending Ontario’s health-care staffing crisis 

Internal briefing notes prepared for Ontario’s health minister in May 2022 reveal that “concerns about wage disparity” related to Bill 124, the province’s wage restraint legislation currently under appeal, contributed to the staffing crisis in the health care system. One briefing note explains that although “[h]ealth human resources (HHR) shortages predate the pandemic,” nurse and personal support worker (PSW) shortages “have become worse” and that “wages and working conditions continue as key drivers of attrition.” Other notes acknowledge that wage disparities are causing staffing shortages in home care; that nurses are moving away from front-line care environments, which advocates claim is contributing to widespread burnout; and that staving off attrition and increasing the number of nurses “are required to head off chronic shortages” in the province.
globalnews | cbc

[01-09-23] B.C. paramedics union, government announce tentative deal after talks with veteran mediator

On January 6, the Ambulance Paramedics of British Columbia (APBC), representative of 4,500 paramedics and dispatchers in the province, and the Health Employers Association of B.C reached a tentative collective agreement with the assistance of mediator Vince Ready. The parties’ previous agreement expired on April 1, 2022, and negotiations have been ongoing since October 3. While details will not be released until the tentative agreement has been ratified, Troy Clifford, president of the APBC, notes that key issues, including the ability to recruit and retain paramedics and on-call models, have been addressed in the deal. In a joint press release, the parties state that the new agreement “supports patient care and addresses the priorities of both parties and the Ministry of Health.”

cbc | globalnews | vancouver.citynews | bc.ctvnews | globeandmail | APBC press release | joint news release

[01-09-23] National physicians certification body aims to fast-track certification of more foreign-trained doctors

In response to the country’s doctor shortage, the Royal College of Physicians and Surgeons of Canada, a certification body that sets national standards for specialist physicians, is working to remove barriers to licensing for internationally educated doctors by increasing its capacity to review their applications and grant them exam eligibility. The College is planning to provide more flexibility for foreign-trained doctors who do not meet the Canadian requirements to work in their disciplines by “allowing them to apply their training to more general disciplines.” It is also expanding the Practice Eligibility Route program, which can reduce the amount of time required for an internationally trained physician to be approved to work in their field from seven to two years.
theglobeandmail

[01-06-23] OPINION | A prescription for our health-care system

The “lack of hospital capacity and staff shortages” across the country, Dr. Brian Gore explains, provide good indication about how federal and provincial governments may direct their efforts in order to save “Canada’s floundering health-care system.” In particular, Dr. Gore suggests that the issue of capacity be addressed by a “seven-to-10-year infrastructure agreement” between the federal and provincial governments to build new hospitals and modernize those in existence. These efforts should be complemented by a “multi-pronged revival of our health-care delivery system” that addresses issues of recruitment, retention, education, IT integration, and evaluation and oversight. Dr. Gore assigns the role of providing “demographic and regional infrastructure requirements” to the provinces and that of providing funding to the federal government.
montrealgazette

[01-06-23] New physician assistants to join emergency departments in Bridgewater and Dartmouth

Nova Scotia’s Dartmouth General and South Shore Regional hospitals will each hire four physician assistants (PAs) to work in their emergency departments. Akin to medical residents, PAs may treat basic cases and prescribe medication under the supervision of a doctor, enabling doctors to focus on more complex cases. The Dartmouth General and South Shore Regional positions were created following the hiring of three PAs as part of a Halifax-based pilot program. The PA role was recently introduced in the province in response to increasing demands on the health-care system, but the use of PAs has been well-documented in Ontario, Manitoba, the Canadian military, and the United States, especially in emergency departments.
cbc

[01-06-23] CHEO launches new program to help address healthcare worker shortage

A clinical extern program funded by the Ontario government was recently launched at the Children’s Hospital of Eastern Ontario (CHEO). The program offers 24 four-month positions to senior nursing students hoping to gain “hands-on pediatric clinical experience” at the hospital. Tammy DeGiovanni, CHEO senior vice president, says that students will receive expert mentorship from the hospital staff and hopes that the program will foster the “transition from student to staff nurse” once they graduate. CHEO plans to further expand the program to include other clinical positions and provide opportunities for younger students.
ottawa.ctvnews

[01-05-23] Healthcare workers coming to Nova Scotia from Kenya

As part of its Action for Health, Nova Scotia has extended 65 conditional job offers to continuing care assistants (CCAs) on its first recruiting trip to a Kenyan refugee camp. The CCAs were recruited through the federal Economic Mobility Pathways Pilot, which identifies refugees with in-demand skills who meet regional and provincial immigration requirements. The program is operating in partnership with the United Nations High Commission for Refugees as well as other groups, and it has already been used to support 42 healthcare applicants to the province. The newly recruited CCAs are expected to begin arriving in mid-2023 and will work in the continuing care sector in communities across Nova Scotia.
novascotia | halifax.citynews | atlantic.ctvnews | globalnews | cbc

[01-04-23] What the rest of the country can learn from Ontario’s family doctor payment model

In the early 2000s, Ontario created the Family Health Team (FHT) model which compensated doctors along with their teams of dieticians, pharmacists, social workers, and other health professionals for the number of patients enrolled in their practice. This departure from the fee-for-service model led to a 43% increase between 2006/07 and 2015/16 in the number of Ontarians affiliated with a family doctor. Although experts widely consider the FHT model to be the best way of delivering primary care, Ontario has not opened any such practices in a decade mainly because FHTs lacked accountability. Reports issued by Ontario’s auditor-general published in 2011 and 2016 show that 60% of FHTs were not keeping the number of night or weekend hours required by the ministry and that FHT doctors tended to earn almost double the wages of fee-for-service physicians, despite working, on average, only 3.4 days a week. Last spring, the OMA and the Ontario government reached a new agreement that allows 720 new physicians to join the FHT model. Unlike the previous agreement, however, this one stipulates a timeline for delivering care to patients with time-sensitive conditions and a process to determine capitation models in complex cases.
theglobeandmail

[01-04-23] Paramedics in rural Newfoundland are ready to strike

More than 100 paramedics and ambulance workers represented by the Teamsters Local 855 in rural Newfoundland have been in negotiations since February with the Fewer Group of Ambulances, a group of seven emergency service operators, for a renewal collective agreement. The union has been in a legal strike position since November 18, with employees in five of the seven companies voting unanimously in favour of a strike. 75% of employees in the remaining two companies are also in support of strike action. The union’s business agent hopes to have all of the strike committees in place and their plans drafted by the end of this week. The strike action is scheduled to start with a work-to-rule campaign that entails “pulling all ambulance services for a 12 to 24 hour period in a rotating fashion.” No further negotiation dates have been scheduled. Neither the government nor Fewer Group has responded to CBC’s requests for comment.
cbc | ntv

[01-03-23] OPINION | As pediatric emergency rooms stretch to breaking, nurses have real solutions for health crisis

Linda Silas, president of the Canadian Federation of Nurses Unions, explains that nurses want “safe and sustainable working conditions” so that they can give patients the care they need. In order to improve working conditions, Silas proposes that provinces implement safe nurse-to-patient ratios, invest in retention initiatives, expand domestic training programs, and diversify the nursing workforce through targeted recruitment. Furthermore, she maintains that the federal government should make investments to support “return and recruitment initiatives” while also establishing a collaborative health workforce council of provincial and territorial health ministries. 
thestar

[01-23-23] More money is a must, but health care delivery also needs a major rethink, doctors say

While Canada’s premiers are asking the federal government to increase the Canada Health Transfer, doctors and administrators say that reform is essential if any new money is going to improve delivery. The healthcare system was already functioning at capacity before the pandemic; if medical staff burnout continues, experts say the system will further deteriorate. One of the main factors contributing to doctor shortage is the “increasing administrative burden” placed on them. According to the Canadian Medical Association, 16 of the average 52 hours worked by family physicians per week are spent on administrative and other non-medical tasks. CBC sources say that pathways to reform should include the addition of administrative staff tasked with non-medical responsibilities, the delivery of health care services outside of hospital settings, and the swift integration of foreign-trained doctors and nurses living in Canada.
cbc

[2022-12-30] Ontario files appeal of court decision striking down Bill 124

On December 29, the Government of Ontario filed a notice of appeal to reverse last month’s decision of the Superior Court of Justice which found that Bill 124 was unconstitutional. In the November 29 decision, Justice Markus Koehnen deemed the wage restraint law to have infringed on the rights to collective bargaining and the freedom of association, declaring Bill 124 to be “void and of no effect.” In Thursday’s notice of appeal, the province argues that the court “erred in holding that the financial impact of the Act’s limits on the compensation increases substantially interferes with the respondent’s rights to a meaningful process of collective bargaining.” The province further maintains that the judgement did not “accept the pressing and substantial objective” of Bill 124, which it characterizes as moderating “the rate of growth of compensation increases for public sector employees” in order to manage the province’s budget. 

The SEIU describes the appeal as an “attack on people serving on the front line of care that will further damage healthcare delivery” and extend “record wait times for health services.” The OFL calls the government’s move to appeal “disgraceful” and ONA expressed its outrage, noting that its members are “beyond angry and frustrated.” The RNAO says the government’s decision to appeal is “shameful” and “demonstrates it has failed to understand the magnitude of the nursing crisis facing the province’s health system.”
cbc | globalnews | cp24 | cp24 (video) | cp24:ona (video) | theglobeandmail|  toronto.ctvnews |  ona | ofl | seiu | rnao

[2022-12-23] Recruitment incentives at Kingston Health Sciences Centre

Between January 1 and March 31, 2023, Kingston Health Sciences Centre (KHSC) will offer recruitment incentives to Registered Nurses (RNs), Registered Practical Nurses (RPNs), and Medical Laboratory Technologists (MLT) who join the hospital’s high-priority areas. These include emergency, medicine, critical care, and cardiac sciences units, as well as medical and critical care resource pools. A one-time signing bonus of $10,000 will be offered to successful full-time candidates, and a half bonus payment of $5000 will be offered to part-time candidates for a two-year commitment. In addition, KHSC will offer candidates who live more than 200 kilometres away from Kingston relocation assistance up to a maximum of $15,000. There will also be a $3,000 referral bonus for staff who recommend a successful candidate for RN, RPN, and MLT positions.
kingstonhsc | globalnews | ygknews

[2022-12-23] Temporary pandemic pay grievances allowed 

In September 2020, CUPE filed three grievances alleging that Health Sciences North violated the collective agreement and Ontario Regulation 241/20 (the Regulation) by not paying temporary pandemic pay (TPP) to 11 renal aides, 4 department aides, and 1 porter. The issue to be resolved was whether the grievors were eligible for TPP and whether they ought to be retroactively awarded pandemic pay. The hospital maintained that the employees in question were not “eligible workers” according to TPP requirements and, during the hearing, pointed to section 3(2) of the Regulation which prevented the expansion of eligibility requirements for TPP. In her award, Arbitrator Christine Schmidt considered the “substance of the job or work in question” in relation to TPP eligibility requirements for each of the disputed positions, deciding that the grievors were entitled to the additional pay and are to be compensated accordingly.
canlii

[2022-12-22] OPINION | My Prediction: More ERs will close and more doctors will burn out

In his 2023 perspective, Dr. Alika Lafontaine, President of the Canadian Medical Association, explains that both staffing shortages and access to medical care “will only worsen” over the next year. He further notes that the current crisis “has been decades in the making,” and that only “major structural changes” in the health care system will improve matters. In addition to enumerating steps that individual health units can take to increase efficiency and improve working conditions, Dr. Lafontaine calls for a “country-wide human resources system dedicated to the health-care workforce” that can allow for “better coordination across our siloed health systems.” Improvements could also be made through a pan-Canadian licensing system that might grant better access to care with the help of virtual tools and “alleviate pressure on local physicans.” Dr. Lafontaine warns that if governments do not take action soon, health care systems across the country “could reach a breaking point in 2023.”
macleans

[2022-12-22] Healthcare Action Plan: EMS response times

As part of its Healthcare Action Plan, Alberta’s government will implement a new strategy for transporting patients designed to improve emergency medical services (EMS) response times and open up acute care beds more quickly. Instead of relying solely on EMS, Alberta Health Services will provide “non-clinical transport” through community shuttles, wheelchair-accessible taxis, and other locally available means “for patients who do not require medical support.” It is expected that 15% of all transports will be diverted through this new program, enabling EMS to respond to approximately 70 additional transports per day. This program has been successfully piloted for six months in a number of jurisdictions, including Calgary, Bonnyville, and Athabasca, and will be “rapidly implemented across the province.”
calgary.ctvnews | calgaryherald | alberta | winnipegfreepress

[2022-12-21] Nurse shortage sends some obstetrics patients in Labrador 500 kms away

The Labrador-Grenfell Health Authority announced that, between December 16 and January 13, obstetrics patients will be diverted 500 kilometres away from Happy Valley-Goose Bay to Labrador City due to a nursing shortage. Yvette Coffey, president of the Registered Nurses’ Union Newfoundland and Labrador, said that Labrador-Grenfell has been hit “particularly hard” by this shortage. According to Coffey, “60% of registered nurse positions in the region are vacant, and 50% of the nurses who are working in the region are casual employees.” The health authority is increasingly relying on private nursing agencies and contract nurses to fill gaps in staffing, but Coffey notes that those solutions are not as widely available during the holidays. While the province has more than 600 registered nurse vacancies, it is currently piloting a travel locum program in Labrador-Grenfell to try to bring more nurses to the area.
thestar | lghealth | cbc | ici.radiocanada

[2022-12-21] New orientation program to welcome 140 doctors

Nova Scotia announced yesterday that it is investing $1.3 million in a new orientation program called the Welcome Collaborative. The program is part of the province’s Action for Health Plan and it was developed by the College of Physicians and Surgeons of Nova Scotia (CPSNS). Its aim is to provide “support, mentorship, and a sense of community” to 140 doctors trained outside of Canada over the next three years. The “successful integration of international physicians into medical practice in the province,” explains Dr. Gus Grant, CEO and Registrar of the CPSNS, “is key” to retaining them. The province is currently evaluating the results of a pilot session it held in October in order to ensure the program’s future success.
novascotia | atlantic.ctvnews

[2022-12-20] REPORT | Job vacancies in third quarter of 2022

According to Statistics Canada, the number of job vacancies across the economy declined by 3.3% to 959,600 in the third quarter (Q3) after having reached a record high in the previous quarter. Q3 also saw the job vacancy rate—i.e., the number of vacant positions as a proportion of total labour demand—drop to 5.4% from 5.7% in Q2. Job vacancies reached an “all-time high” in the healthcare and social assistance sector, increasing by 9.5% to a total of 150,100. The majority of all vacancies in health occupations were for nurse aides, orderlies, and patient service associates (+37.5% to 26,200), licensed practical nurses (+20.7% to 13,100), and registered nurses and registered psychiatric nurses (+17.0% to 27,600).
statcan

[2022-12-20] Update on Saskatchewan’s Health Human Resources Action Plan

The government of Saskatchewan provided an update on its Health Human Resources Action Plan yesterday. As of December 13, the province made a total of 161 job offers to Filipino health care workers, of which 138 are registered nurses (RNs), 21 are continuing care assistants (CCAs), and 2 are medical lab assistants. The Saskatchewan Health Authority has also made progress creating new full-time positions in nine high-priority classifications linked to rural and remote locations that have been experiencing service disruptions, as well as transforming vacant part-time positions into full-time positions. 84 of these have already been filled. The province has further expanded eligibility for the Rural and Remote Recruitment Incentive, offering up to $50,000 for a three-year return-in-service agreement available to new employees in the same high-priority classifications. As of late November, the province has received over 600 applications from internationally educated health care workers within Saskatchewan and Canada.
ckom | saskatchewan

[2022-12-19] Ontario hospitals will face staffing shortages until 2026

A report by the Financial Accountability Office of Ontario (FAO) indicates that the staffing crisis will persist in the province’s hospitals at least until 2026. The Ontario Public Sector Employment and Compensation Report shows that, before the pandemic, the average number of employees per hospital bed was 6.8. This number fell to 6.0 in 2020, increasing to 6.3 in 2021. Over the next ten years, the Ontario government plans to add approximately 1,300 new beds to the existing 35,300. During this period, hospital employment is projected to grow at a rate of 2.3% per year, which suggests that the province will not return to the pre-pandemic staff-to-bed ratio until 2026 at the earliest.
pressprogress | report

[2022-12-19] FIQ reacts to government’s wage offer

On Thursday, the government of Québec tabled its bargaining offer to all public sector employees, including the Fédération interprofessionnelle de la santé (FIQ), which represents 76,000 nurses, nursing assistants, and other care professionals. The province offered a 9% increase over five years: 3% in the first year, with an additional lump sum payment of $1,000, and 1.5% in each of the subsequent years. The FIQ responded that it was offended by the government’s wage offer, describing it as a “slap in the face” to nurses “who have given so much over the past few years.” It is currently demanding 12% over three years in addition to inflation. The union is also asking for the elimination of mandatory overtime and of private employment agency staff, mandated nurse-to-patient ratios, the option to work a full-time position over four days instead of five, and scheduling improvements.
fiqsanté | montreal.ctvnews

[2022-12-19] Hema-Quebec nurses’ protest in Montréal and Québec City

On Sunday, nurses and nursing assistants at Hema-Québec, represented by the Syndicat des infirmières et infirmières auxiliaires de Héma-Québec (CSN) and the Syndicat du personnel infirmier de Héma-Québec (SPI-CSQ), demonstrated in Montréal and Québec City. The members have been without a contract for nearly four years and have received no salary increase since 2018. They are currently demanding salary parity with their counterparts in the public network. 
cbc | montrealgazette | townoflaronge

[2022-12-19] Update on UK health workers’ strikes
Nurses
Nurses in the United Kingdom represented by the Royal College of Nursing (RCN) are due to strike for a second time on Tuesday in parts of England, Wales, and Northern Ireland, following action on December 15. The RCN is seeking a pay rise of 5% above inflation as well as a commitment to patient safety through recruitment and retention of nursing staff. The union warns that there will be more extensive action in the new year if the government does not agree to discuss pay within 48 hours after Tuesday’s strike. Opinion polls show 60% of voters support the nurses’ strikes.

Ambulance Workers
More than 10,000 ambulance workers from the GMB, Unison, and Unite unions in England and Wales plan to take coordinated strike action on Wednesday. The unions are seeking pay increases to keep pace with inflation, which the government deems to be “not affordable.” In order to offset the impact of the strike, the government will dispatch 750 armed forces personnel, with 600 members due to take on ambulance driving roles and 150 personnel providing logistical support. The ambulance strikes will affect non-life threatening calls only. A second strike date by GMB members including paramedics, emergency care assistants, and call-handlers is set for December 28.
globalnews | bbc | theguardian

[2022-12-16] Veteran B.C. mediator Vince Ready deployed to break paramedic contract impasse

The Ambulance Paramedics of B.C. (APBC) have reached an impasse in contract negotiations with the province. The parties began negotiations on October 3 and have completed 25 bargaining sessions since then with “no significant progress.” The union’s key priorities include the wage disparity with police, firefighters, and other health care workers; the pay model for on-call crews; and the mental health and wellness of paramedics. With the help of mediator Vince Ready, the union and the province began a two-day mediation process on Thursday morning. The APBC explains that if no significant progress is made, they will consider going to their membership for a job action mandate. Health Minister Adrian Dix is optimistic that the parties can reach a deal.
globalnews

[2022-12-16] Alberta increases payments to help doctors cover business costs

On Thursday, Alberta’s Health Minister Jason Copping announced that, effective December 16, the province is increasing the payment doctors receive through the Business Costs Program (BCP). The province has committed an additional $20 million annually, which will be used to increase the payment for eligible, office-based consultations from $2.95 to $3.59. On average, each physician will receive an extra $2,300 per year. Alberta Medical Association president Dr. Fredrykka Rinaldi said that rising business costs have been a “major priority” in discussions about doctors’ compensation and notes that, although the new increase to the BCP cannot fully offset recent inflationary pressures for physicians, “it is a step in one direction.”
edmontonjournal | albertadoctors | alberta | edmonton.ctvnews

[2022-12-16] Northern Ontario’s doctor shortage is not improving, says Ontario Medical Association

The Ontario Medical Association (OMA) is raising awareness that the “dire” doctor shortage in northern Ontario is not improving. In 2021, the region was in need of 300 physicians across various disciplines. This number remains unchanged in 2022. Dr. Rose Zacharias, president of OMA, said that the association has been working with the province on one possible solution—licensing internationally trained doctors who are already in Ontario—that could bring “several hundred physicians” into the system as early as this spring. Zacharias also notes that NOSM University, northern Ontario’s independent medical school, could provide a further solution to the shortage by training doctors locally. 
cbc

[2022-12-15] Health ministers agree on improving health care, but premiers holding out

Provincial and federal health ministers met twelve times over the past year to discuss health care funding and system reform. On Wednesday, federal health minister Jean Yves-Duclos said that, in private, ministers agreed on issues relating to recruitment and retention of healthcare workers and on data-sharing initiatives to streamline care, but that premiers have been “muzzling” their ministers in order to put the focus on federal spending. The premiers are insisting that the Canada Health Transfer to the provinces be increased from 22% to 35% with provisions for an additional 6% to be guaranteed every year. They also maintain that they will not agree on a deal with the federal government until the Prime Minister meets with them as a group. On Tuesday, Justin Trudeau responded that he would not commit to such a meeting and that “throw[ing] more money at the problem” would not be “the right thing to do.” Health care advocates, including nurses’ and doctors’ associations, have echoed Trudeau’s call for a plan to transform Canada’s broken system, recognizing the urgency of the situation. “It is absolutely critical that we put aside politicking,” said Linda Silas, president of the Canadian Federation of Nurses Unions,  and focus, instead, on “productive discussions around concrete solutions to the health-care staffing crisis.” A Globe and Mail editorial published on Wednesday also argues that the premiers’ demands for a “strings-free spending spree” could end up “slowing down desperately needed reform of Canada’s overly expensive, underperforming health care system.”
ctvnews | cbc | theglobeandmail | video: theglobeandmail | leaderpost | theglobeandmail

[2022-12-15] New virtual emergency care service coming to Manitoba in Spring 2023

On Wednesday, Manitoba’s Health Minister Audrey Gordon announced that the province will launch the Virtual Emergency Care and Transfer Resource Service (VECTRS) in May 2023 as part of its $200-million health human resources plan. VECTRS will be a “centralized and co-ordinated source for clinical guidance and patient transport support” that responds to urgent calls from health centres across the province. It will offer 24/7 advice from a team of specialists, co-ordinate referrals, and prioritize patient transfers to the most appropriate location for ongoing care. The service is expected to cost $5 million a year. 
cbc | news.gov.mb

[2022-12-15] New reports from the College of Nurses of Ontario

The College of Nurses of Ontario (CNO) recently released two reports documenting an upward trend in nursing registrations. The Gains and Losses Report 2022 records a net gain of 4,041 (2.4%) registered nurses (RNs), registered practical nurses (RPNs), and nurse practitioners (NPs) this year, compared to 2,944 (1.8%) in 2021. Total registrations also grew in 2022, with RNs increasing by 1,934, NPs by 317, and RPNs by 1,762 registrations. Additionally, 2022 has seen more nurses entering public health and working full-time. The First-Time Renewals Report 2022 reveals that, since 2015, at least 95% of nurses have renewed their registration in their first year across all categories and classes.
cno: announcement | reports

[2022-12-14] Hospital considering hiring unvaccinated staff indicative of ‘crisis situation’

Health human resource challenges at Ontario’s South Bruce Grey Health Centre have led to the closure of emergency departments at its Kincardine, Walkerton, Chesley, and Durham hospitals. In order to boost care capacity, the Centre is now reviewing its COVID-19 vaccination policy and has signalled that it is considering hiring unvaccinated workers. According to Dr. Ivy Bourgeault, associate professor at the University of Ottawa, this decision speaks to the “larger issue” that health care units are “failing to attract and retain workers.” Dr. Bourgeault further remarks that the mere consideration of allowing unvaccinated workers into the health care system during a pandemic is a sign that “retention issues have reached a critical stage.”
ctvnews | video: youtube

[2022-12-14] Military and university-trained physician assistants rejected by B.C.’s health system

Physician Assistants (PAs) work under the direct supervision of a licensed physician, performing many of the same duties, including conducting patient interviews and examinations, writing prescriptions, and assisting during surgery. PAs acquire their credentials by completing a two-year training program at one of three Canadian universities (University of Manitoba, University of Toronto, or McMaster University) or through the Canadian Armed Forces. The profession is currently regulated in Manitoba, Alberta, Ontario, and New Brunswick, with pilot projects running in Nova Scotia and Newfoundland. British Columbia, however, has no immediate plans to follow suit. The B.C. Ministry of Health states that while it understands that PAs can contribute to the health care system, adding a new health profession takes “careful consideration” and it will “assess the option of implementing additional professions and occupations.” 
cbc | comoxvalleyrecord

[2022-12-13] Canadian medical grads trained abroad are increasingly giving up on their home country for work

According to a Globe and Mail analysis, internationally-trained medical graduates from Canada could make a significant contribution to filling doctor shortages but are often unable to do so because of the “lack of provincially funded residency positions.” A study by the Canadian Resident Matching Service (CaRMS) estimated that 90% of the 3,500 Canadians who are “going abroad for medical training every year” want to return to Canada to work. Of these, only a small percentage have a chance of securing one of the much-coveted and steadily declining residency spots designated for international medical graduates. The trend to restrict the number of internationally trained physicians in Canada began in the 1990s as a “cost-control” measure, and has coincided, more recently, with a sharp decrease in applicants for these spots. CaRMS reports that there has been a 40% drop in the number of applicants for these positions over the past decade, suggesting that Canada may be losing out to other countries such as Australia, Britain, and the U.S., where the barriers to entry for doctors are lower.
theglobeandmail

[2022-12-13] Saskatchewan Union of Nurses says too many new grads dealing with trauma patient care

Members of the Saskatchewan Union of Nurses (SUN) raised concerns on Thursday that recent graduates working at the Regina General Hospital with trauma patients feel they do not have adequate training, experience, or mentorship. According to SUN’s president Tracy Zambory, new nursing graduates are “not getting the orientation they really require to feel confident in what they’re doing” and to work in “specialized” settings. Zambory stresses that this is a serious matter that needs to be addressed and calls for the province to work with the union to establish a task force to address staff shortages and retention.
thestarphoenix

[2022-12-12] Premiers demand meeting with PM to discuss increased health care funding

On Friday, Canada’s premiers requested that the Prime Minister meet with them in early January to discuss the topic of health care funding. The premiers are asking the federal government to increase the Canada Health Transfer from 22% to 35% with no conditions for the additional funds. While the Prime Minister’s Office declined to comment on the meeting request, federal health minister Jean-Yves Duclos responded that a “funding increase without any conditions is not an option.” 

In a Globe and Mail article, Dr. Alika Lafontaine, president of the Canadian Medical Association, urged provincial and territorial leaders to rethink the message that fixing the system requires more money because “it’s not true” and it risks “leaving patients and health workers feeling hopeless.” Dr. Lafontaine explains that, while funding is an important aspect of health care delivery, provincial governments need to address other issues, including health worker shortages and long emergency-room waiting times.
canadaspremiers | theglobeandmail | ctvnews | globalnews

[2022-12-12] Zero applications for Advanced Care Paramedicine program

The Advanced Care Paramedicine (ACP) program at Winnipeg’s Red River College Polytech (RRC) received no applications for its January 2023 session. The two-year program, which costs approximately $15,000, allows primary-care paramedics to expand their scope of practice by, for example, enabling them to work in hospital emergency rooms when needed. According to paramedics and groups that represent them, interest in the ACP program is currently low because of the lack of advanced care positions in rural and northern Manitoba. The RRC promises that it will “continue to work with” the provincial government to deliver the ACP program, and that any applications it may receive “will be considered for a potential spring intake.”
winnipeg.ctvnews | winnipegfreepress

[2022-12-12] BCNU commences negotiations with HEABC

The BC Nurses’ Union (BCNU) has commenced negotiations with the Health Employers Association of British Columbia to renew the provincial nursing collective agreement that expired on March 31, 2022. During negotiations, the union will focus on recruitment and retention strategies and the creation of safer workplaces. 99% of nurses at BCNU’s provincial bargaining conference in October expressed their willingness to strike in order to see improved staffing levels and nurse-to-patient ratios, work-life balance initiatives, and fair pay included in the next collective agreement.
bcnu

[2022-12-12] British nursing union offers to pause NHS strikes if government joins pay talks

The Royal College of Nursing (RCN) has scheduled strike action for 100,000 nurses on Thursday, December 15 and Tuesday, December 20 in England, Northern Ireland, and Wales. RCN leader Pat Cullen has asked the government to hold “serious talks” with the union or to consent to negotiating through an independent mediator by Monday in order for the union to suspend the planned strikes. The RCN is seeking a pay rise of 5% above inflation, which itself reached 14.2% in October. On Sunday, the government’s foreign secretary James Cleverly said that the health secretary would “happily” talk to the union about improving NHS performance and working conditions, but insisted that the pay increase recommended by an independent pay review body in July—i.e., between 4% and 5%—could not be amended. 
theglobeandmail | bbc | theguardian

[2022-12-09] Nurses haunted by ‘moral distress’ at Alberta Children’s Hospital

The CBC reports that, amid an unprecedented wave of viral illnesses at Alberta Children’s Hospital, a “sense of angst” has become the new normal for front-line health care providers. Jennifer Jackson, an assistant professor in the department of nursing at the University of Calgary, explains that nurses who are unable to provide their expected standard of care or who feel that their work is unsafe can develop moral distress. Moral distress occurs, she says, when there is a “gap between what you want to be able to do and what you actually can do.” It can have serious mental and physical health impacts, including higher rates of anxiety, fatigue, and an increased risk of errors.
cbc

[2022-12-09] Ontario expands scope of practice for pharmacists to prescribe COVID-19 treatment Paxlovid

Ontario health minister Sylvia Jones has announced that, starting on December 12, pharmacists in the province will be able to prescribe the antiviral drug Paxlovid as a treatment for COVID-19. While approximately 4,000 pharmacies have been dispensing the drug, patients previously needed a prescription from a doctor or clinical assessment centre in order to access the medication. The new prescription program will work on an opt-in basis. Justin Bates, president of the Ontario Pharmacists Association, said the expectation is that the majority of pharmacies will participate. Pharmacists will be paid $19 for each Paxlovid assessment.
cbc | cp24 | thestar | news release

[2022-12-08] Newfoundland & Labrador Medical Association calls on province to explain cost for 811 appointments

The government of Newfoundland and Labrador has been outsourcing its 811 HealthLine services to Fonemed, a private company, since March 2022. Fonemed gives 811 callers access to virtual care appointments with nurse practitioners, for which it will receive $31 million over five years. Between 2022 and 2027, Fonemed is expected to handle volume of 72,000 service calls per year, costed at $82 per call in the first year and increasing to approximately $92 per call in the final year of the contract. The government will also pay between $57.50 and $66.10 for each call that exceeds the 72,000 yearly threshold. In contrast, family doctors in the province are limited to $37 for a routine in-person appointment and $47 for a virtual care visit, with a cap of 40 virtual appointments per day. The Newfoundland and Labrador Medical Association (NLMA) says that it is seeking an explanation from the government regarding the discrepancy between the cap it has set for physician rates and what it is currently paying for non-physician virtual care.
cbc | saltwire | NLMA letter

[2022-12-08] Health care providers receive cultural safety training to better serve Indigenous patients

Tajikeimɨk, a new Mi’kmaw health and wellness authority that was officially launched earlier this year, has partnered with Dalhousie University and the IWK Health Centre in Halifax to create a new online course rooted in the concept of “two-eyed seeing.” Two-eyed seeing is a “worldview that brings together two perspectives at once—the lens of Indigenous knowledge and that of Western science.” The course educates health care providers about cultural safety while examining how racism and colonialism have harmed Indigenous people seeking care. There are six modules in the curriculum, including Mi’kmaw language, culture, and geography, focused on helping clinicians contextualise Indigenous experiences and providing lessons on trauma-informed clinical practices. The online course is self-directed and is currently open to 375 staff from the IWK Health Centre, Nova Scotia Health, and Mi’kmaw community health settings, with the goal of making it available across the province. 
cbc

[2022-12-07] Health care workers are facing an epidemic of violence

The Tyee features the ongoing epidemic of violence against health care workers in British Columbia. Between 2010 and 2021, B.C. nurses reported nearly 4,500 injuries stemming from the use of force or violence that caused them to miss work. During a four year period from 2017 to 2021, WorkSafeBC found that workers in health and social services were roughly three times more likely to report a violence-related injury than the provincial average. Aman Grewal, president of the B.C. Nurses’ Union, said that the true number of attacks is “significantly higher” because many incidents are never reported. Indeed, it is estimated that violence affects more than 95% of health care workers through the course of their careers. Union leaders believe attacks on health care workers are the result of staff shortages, a widespread mental health and substance use crisis, a lack of trauma-informed care, a growing reliance on medications in long-term care, and “pandemic rage.” They warn that these problems are pushing health care workers out of the profession, deepening the human resources shortage experienced across the country. 
thetyee

[2022-12-07] More than 2,000 health-care workers needed over the next 5 years, auditor says

In a report tabled on Tuesday, Provincial Auditor Tara Clemett noted that, over the next five years, the Saskatchewan Health Authority (SHA) is projecting a shortage of 2,200 “hard-to-recruit” health care workers. Specifically, the SHA expects to be short 850 continuing care assistants, 520 registered nurses, and 180 medical laboratory technicians. Other challenging positions to be filled include psychologists, respiratory therapists, audiologists, perfusionists, physical therapists, speech language pathologists, emergency medical technicians in rural and remote areas, and cooks. Clemett said that the province has to go beyond “the status quo,” noting that the SHA needs to address the gaps in the workforce. Clemett made a number of recommendations in her report, including optimizing the supply of new graduates to help address staffing shortages, conducting exit interviews to determine strategies for retaining employees, and creating a First Nations and Métis recruitment and retention plan.
cbc | thestar | regina.ctvnews | leaderpost | globalnews | auditor.sk

[2022-12-06] New family doctor residency positions target Nova Scotians who study abroad

As part of Nova Scotia’s Action for Health, the provincial government will make it easier for Nova Scotians who attend medical school outside Canada to complete their residency at home. Previously, the province had designated 6 seats for international medical graduates interested in completing their residency in Nova Scotia. The government has now created an additional 10 seats for medical graduates who completed their studies outside Canada. Priority will be given to those with a “connection” to Nova Scotia, which includes being a resident of Nova Scotia and having attended high school or university in the province for at least two years. If any positions are not filled by Nova Scotians in the first round of placements, the spots will be open to international medical graduates without a provincial connection. After completing their placements, doctors must work in an area of high demand in the province for three years. Moreover, in partnership with Dalhousie University, the province has created 10 new residency seats in family medicine across the province for 2023, which will increase the number of family residency spots to 58.
novascotia | halifax.citynews | atlantic.ctvnews

[2022-12-06] Alberta government surrendering power to impose pay deals on doctors

As part of a four-year compensation agreement with the Alberta Medical Association (AMA) ratified in September, Alberta’s Health Minister Jason Copping tabled Bill 4, The Alberta Health Care Insurance Amendment Act, 2022 on Monday. If passed, the legislation will repeal the section of the health care insurance law that allows the province to unilaterally “terminate and replace” compensation agreements with doctors, a step former health minister Tyler Shandro took in February 2020. In return, once the legislation takes effect, the AMA has agreed to withdraw its $255 million lawsuit against the province for allegedly breaching their Charter rights. Dr. Fredrykka Rinaldi, president of the AMA, said that the introduction of Bill 4 was an important step in “rebuilding the relationship between the government and doctors.” Under the most recent agreement, physician compensation will increase by an average of 4% over the next four years, including a lump sum 1% increase as a “recognition payment” for work over the course of the COVID-19 pandemic.
cbc | edmontonjournal | edmonton.ctvnews

[2022-12-05] New retention and signing bonuses for Yukon nurses

The Yukon territory and the Yukon Employees’ Union (YEU) have negotiated a two-year deal for government nurses. The Yukon’s Minister of Health and Social Services announced that the new $6 million package is in recognition of the work nurses do in the territory, and that it incentivizes new hires while addressing turnover and high vacancy rates. The package includes an immediate bonus of $15,000 for Registered Nurses (RNs) and Nurse Practitioners (NPs), and $8,000 for Licensed Practical Nurses (LPNs), with a second set of retention bonuses in the same amount to be issued on April 1, 2023. Signing bonuses will be offered to new RNs and NPs ($7,500) and LPNs ($4,500), and new nursing graduates will be reimbursed for their exam fees. Finally, the package includes a $10,000 bonus for Primary Care Nurses and Primary Care Nurses in Charge working in Yukon communities. The YEU and territory will continue collective bargaining on December 14.
yukon | yukon-news | whitehorsestar

[2022-12-05] Virtual care in Ontario and B.C.

The province and the Ontario Medical Association (OMA) have agreed on a new fee structure for virtual care that came into effect on December 1. During the pandemic, the province allowed doctors to charge $80 for virtual sessions in an effort to curb the spread of COVID-19. Doctors are currently allowed to bill the province at that rate only if they have had in-person consultation with a patient within the preceding two years. OMA explains that it “believes in the importance of providing virtual care in the setting of an ongoing physician-patient relationship.” Under the new agreement, the revised rate for patients who are not deemed to have an ongoing and pre-existing relationship with the doctor is $20 for a video visit and $15 for a telephone visit. One virtual care platform notes that the “repercussions of the billing changes will likely strain the physical health system further,” emphasizing the current “crisis in access to care.”  
globalnews

In parallel with developments in Ontario, the province of British Columbia and doctors are now discussing possible changes to long-term virtual care. “There is clearly some benefit to (virtual health care) and that is why we are working to make the best clinical decisions,” said B.C. Health Minister Adrian Dix. According to the B.C. government, it could be months until a decision is made about cost.
globalnews

[2022-12-05] Red Cross staff to help CHEO get through respiratory virus season

Ottawa’s children’s hospital (CHEO) has been operating over capacity due to a surge in COVID, RSV, and flu related illnesses over the past few weeks. CHEO responded by redeploying staff from surgical and medical care units, opening a second pediatric ICU, sending some teenage patients to nearby adult hospitals, and asking for extra support from organizations across the region. The Red Cross has answered the call by committing a team of non-clinical staff, scheduled to arrive at CHEO as early as this week, to support the hospital’s clinical teams wherever possible.
cbc | toronto.citynews | ottawacitizen

[2022-12-02] Québec health minister asks nurses to come back to help struggling health care system

At a national assembly press scrum on Thursday, Québec’s Health Minister Christian Dubé called on nurses to help with the province’s Info-Santé 811 phone line, which received approximately 10,000 calls on Wednesday. While the 811 line is “working very well,” the service is experiencing a staff shortage. The province is now looking for nursing students, retired nurses, or nurses currently employed in the private sector to help answer calls. Minister Dubé noted that the telehealth system needs “up to 5,000 nurses to answer the phones” in the next few weeks. The president of the Fédération interprofessionnelle de la santé du Québec (FIQ), which represents 76,000 health care workers including nurses and nursing assistants, responded that Dubé’s plea shows that he is “out of touch… with reality” given the shortages elsewhere in the public health network.
montreal.ctvnews | cbc | ici-radio.canada

[2022-12-02] Unions discuss court ruling Bill 124 unconstitutional

According to experts and advocates, Wednesday’s decision by the Ontario Superior Court of Justice to strike down Bill 124 is a “pivotal moment that exposes long-standing problems.” Bill 124 limited wage increases to 1% for three years, targeting female-dominated professions such as nurses and teachers; police officers and firefighters were not affected by this legislation—a discrepancy that has raised criticisms about the gender disparity embedded in the law. Dr. Ivy Bourgeault, professor at the University of Ottawa, explains that “[t]here is an overarching devaluing of care work that is disproportionately undertaken by women.” Doris Grinspun, CEO of the Registered Nurses’ Association of Ontario, echoes this concern and draws attention to the urgent need to address the staffing crisis in nursing, especially with respect to the issue of compensation. Dianne Martin, CEO of the Registered Practical Nurses Association of Ontario, points out that “nurses go to school for as long or longer than police officers and face more violence on the job,” suggesting that the inclusion of female-dominated professions under Bill 124 is a sign that they are undervalued. The Globe and Mail reached out to the Ontario Minister of Health with questions about the gender disparity represented in Bill 124 but received no response.
theglobeandmail

[2022-12-01] Statistics Canada reports on changes in the healthcare workforce between 2016 and 2021

Statistics Canada reports that, although the number of workers in non-management health occupations grew by 204,000 (16.8%) between 2016 and 2021, the number of vacancies in these health occupations was “at record highs” in the summer of 2022 and have been increasing steadily since 2015. Statistics Canada attributes the challenges in filling these vacancies in part to the “extensive and specialized education required for many health occupations,” noting that in 2021 almost half of non-management health care workers required “a bachelor’s degree or higher” and an additional 22.8% required “two or more years of college or some extended training.” Furthermore, Statistics Canada draws attention to the diverse groups that make up the health workforce, highlighting the contributions of racialized communities to health care and pointing out that women continue to make up approximately 80% of these occupations.
statcan |  cbc

[2022-12-01] More than 10% of Newfoundland & Labrador respiratory therapists resigned this fall

Six of the 56 full-time respiratory therapists employed by Newfoundland’s Eastern Health have quit their jobs since September, and two additional positions could become vacant in the coming months. Staff have indicated that the challenges they face include the general workload, issues related to overtime, and compensation. Gordon Piercey, president of the Association of Allied Health Professionals (AAHP), explains that respiratory therapists have been “stretched thin” during the pandemic, with “two therapists caring for up to 18 patients at a time.” He adds that the current staffing situation is “chaotic” and that staff are being asked to work consecutive shifts with just a few hours’ break in between. With respect to compensation, the AAHP claims that Newfoundland and Labrador respiratory therapists are the lowest paid in country. The union is seeking an immediate labour market adjustment in its collective bargaining with the province. It also questions Eastern Health’s recruitment strategy, pointing out that Nova Scotia has already approached the 2023 respiratory therapist class at Newfoundland’s College of the North Atlantic, offering $10,000 signing bonuses, relocation assistance, and 20% higher pay. Eastern Health responded that it is planning to approach the 2023 graduating class in December, offering a $10,000 bursary and full-time employment to successful applicants in exchange for a two-year service contract.
cbc | saltwire

September 2022

Interest Arbitration Awards

[ON] September 30, 2022; Service Employees International Union Local 1 Canada v Michael Garron Hospital SEIU represents approximately 26 employees at the Hospital’s Withdrawal Management Centre, working as counsellors and day counsellors.  The term of the renewal agreement is from October 11, 2020 to October 10, 2022. The following wage adjustments were awarded: 1% effective October 11, 2020 and 1% effective October 11, 2021.

[ON] September 21, 2022; Chartwell Trilogy Long Term Care v Canadian Union of Public Employees and its Local 4811 CUPE represents approximately 256 employees at the Home who work in an all employee bargaining unit. The term of the renewal agreement is August 1, 2020 until July 31, 2022. Wage increases of 1.5% effective August 1, 2020 and 1.5% effective August 1, 2021.

[ON] September 19, 2022; Canadian Blood Services v Ontario Public Service Employees Union, Locals 160, 200, 210, 477, 5103 OPSEU represents four bargaining units of CBS employees. This decision addresses a preliminary issue, namely whether the Protecting a Sustainable Public Sector for Future Generations Act, 2019 ( “Bill 124”) applies to this collective agreement.

[ON] September 18, 2022: Trafalgar Lodge (Revera) v Canadian Union of Public Employees, Local 4762-03 CUPE represents approximately 50 employees who work in an all employee bargaining unit, in roles including RN, RPN, Guest Attendant, Dietary Aide/Housekeeping, Laundry/ Receptionist Aide and Unregulated Care Professional. The term of the renewal collective agreement is from January 1, 2021 until December 31, 2022. The following wage adjustments were awarded: effective January 1, 2021 all rates increased by 2%; effective January 1, 2022 all rates increased by 2%.

[ON] September 18, 2022: Bough Beeches Place (Revera) v Canadian Union of Public Employees, Local 4987 CUPE represents approximately 44 employees who work in an all employee bargaining unit, in roles including RPN, Resident Attendant, Dietary/Laundry/Housekeeping, Shift Coordinator, Breakfast/PT Cook, and Activity Director/Activity Coordinator. The parties agreed that the term of the renewal collective agreement will be for three years from January 29, 2020 until January 28, 2023. The following wage adjustments were awarded: effective January 29, 2020 all rates increased by 2%; effective January 29, 2021 all rates increased by 2%;  effective January 29, 2022 all rates increased by 2%; and a special adjustment of 3% to be made to all classifications just prior to the January 29, 2022 general wage increase.

Labour Arbitration Awards

[ON] September 28, 2022; Ontario Nurses’ Association v Manitoulin Lodge Arbitrator concluded that there was serious misconduct that warranted significant discipline of the grievor, and that termination of employment was within the range of reasonable disciplinary responses.

[BC] September 26, 2022; Health Employers Association of BC v Health Science Professionals Bargaining Association The Association’s grievance succeeds in part. It established a Me Too claim in the amount of $9,442,000 which must be paid along with interest calculated in accordance with the Court Order Interest Act.

[BC] September 19, 2022; BC Emergency Health Services v Ambulance Paramedics of BC – CUPE Local 873 Arbitrator declared that under Article 13.02(a), the Employer was not entitled to consider external applicants for the purposes of posting and filling community paramedic vacancies. The Employer accordingly breached that Article when it posted Community Paramedic vacancies externally.

[NB] September 15, 2022; New Brunswick Union of Public and Private Employees v Horizon Health Network (ZONE 3) Arbitrator concluded that the decision to terminate the grievor’s employment was unreasonable, because the Employer was not able to demonstrate that her absenteeism was excessive. Grievor ordered to be reinstated.

[BC] September 12, 2022; British Columbia Emergency Health Services v Ambulance Paramedics of British Columbia

[ON] September 9, 2022: United Steel, Paper and Forestry, Rubber, Manufacturing, Energy, Allied Industrial and Service Workers International Union (United Steelworkers) v Conmed Health Care Group  Arbitrator concluded that the collective agreement requires the employer to calculate the vacation pay percentile on all wages paid, which includes the vacation pay. However, the Union’s contention that gross wages includes the uniform allowance and ought to be included in the calculation for vacation pay is rejected.

[ON] September 7, 2022: Sinai Health System (Mount Sinai Hospital Site) v National Organized Workers Union Arbitrator finds that an absence from work while in receipt of disability benefits is not an “unpaid leave”, and that service for purposes of vacation time continues to accrue while absent from work due to disability.

[SK] September 6, 2022: Saskatchewan Health Authority v Health Sciences Association of Saskatchewan Employer violated the collective agreement by its calculation of the annual increment dates for the two grievors that were different than their respective dates of hire.

[2022-11-30] Ontario Court strikes down Bill 124

The Ontario government introduced the Protecting a Sustainable Public Sector for Future Generations Act, commonly known as Bill 124, in June 2019. Bill 124 capped wage increases for Ontario Public Service employees and broader public sector workers at 1% per year. A coalition of unions representing several hundred thousand public sector employees challenged the constitutionality of Bill 124. Hearings for this challenge were held before the Ontario Superior Court of Justice for ten days in September 2022. 

At the hearings, the applicants argued that Bill 124 limits their freedom of association, freedom of speech, and equality rights of their members under the Canadian Charter of Rights and Freedoms. The government of Ontario denied that the Bill infringes on any of these rights and, in the alternative, submitted that if it does infringe on any Charter rights, “it is saved by s. 1 of the Charter as a reasonable limit that is demonstrably justified in a free and democratic society.” 

In its decision released on Tuesday, the Court found that “the imposition of a 1% pay cap has a material effect on the process of collective bargaining.” In the first instance, it limits “the scope of bargaining over wage increases,” interfering with collective bargaining by preventing “unions from trading off salary demands against non-monetary benefits” and preventing “the collective bargaining process from addressing staff shortages.” Furthermore, it “interferes with the usefulness of the right to strike,”  with “the independence of interest arbitration,” and with “the power balance between employer and employees.” Justice Markus Koehnen finds that these “detrimental effects amount to substantial interference with collective bargaining both collectively and individually.”

In response to Ontario’s claim that its infringement is “saved by s. 1 of the Charter,” the Court found that “although there is a line of cases that has upheld the constitutionality of certain wage restraint legislation, those cases are distinguishable” in that they “almost all arise in situations where the government was facing a financial or economic crisis.” Moreover, in those cases, the legislation at issue sets the limit on wage increases “at a level that was consistent with results that were achieved in free collective bargaining negotiations when the legislation was introduced.” In the Court’s view, “Ontario was not facing a situation in 2019 that justified an infringement of Charter rights,” and Bill 124 sets the wage cap at a rate “below that which employees were obtaining in free collective bargaining negotiations.” 

The Court declared the Act to be “void and of no effect,” concluding that although it “does not violate the applicants’ freedom of speech or equality rights under the Charter,” it “infringes on the applicants’ right to freedom of association under s. 2(d),”  and “is not saved by s. 1 of the Charter.” The issue of remedy was deferred to a future hearing.

The Ontario Federation of Labour (OFL) calls the decision “an important victory” and the Ontario Nurses’ Association states that it will be looking to reopen the contracts affected by Bill 124. The OFL and union leaders from the coalition will hold a press conference regarding the Court’s decision on Wednesday morning. 

The Ontario government has announced its intention to appeal the Court’s decision.

full text of decision | theglobeandmail | cbc | globalnews | thestar| pressprogress  | ona | ofl | globenewswire

[2022-11-29] B.C. expanding efforts to recruit and train internationally-educated doctors, and announcing plans to open new medical school

On Sunday, British Columbia Premier David Eby and Health Minister Adrian Dix held a news conference to discuss the latest series of measures aimed at getting internationally-trained doctors to work in the province. As part of its HHR strategy, the province will triple the number of seats in its Practice Ready Assessment Program (PRAP), which helps internationally-educated family doctors to become licensed, by March 2024. International medical graduates (IMGs) will be placed in rural and urban communities that are in need of physicians and will be required to work in those placements for a minimum of three years. IMGs who are not eligible for PRAP will become part of a new class of associate physicians, governed by the College of Physicians and Surgeons of B.C. (CPSBC). They will be allowed to care for patients under the direction and supervision of an attending physician within a health authority acute-care setting. The CPSBC will also prepare bylaw changes to allow doctors who have had a minimum of three years of training in the U.S. to practice medicine in community settings, including urgent and primary care centres, community clinics, and family practices. These changes will be implemented in the coming weeks, with the intention of allowing these doctors to practice in B.C. by January 2023.
news release | vancouversun

On Monday, Eby and Dix announced that another key action in the province’s HHR strategy is opening a new medical school at Simon Fraser University (SFU). The province is investing $4.9 million in start-up funding to support curriculum and space planning, engagement and accreditation, and hiring professional staff to support the SFU medical school project office. SFU has also retained an interim dean, Dr. Roger Strasser, who will provide strategic leadership in the planning and implementation of the medical school. The school is scheduled to open in September 2026 and it will be the second full medical school in the province.
cbc | news release | bc.ctvnews | sfu | thestar

[2022-11-29] Patients wait months for Pap test results as labs juggle high demand, staff shortage

Michelle Hoad, CEO of the Medical Laboratory Professionals’ Association of Ontario, explains that most laboratories were short-staffed even before the pandemic, but that the situation has worsened now that there is an influx of tests, including Pap smears, to process as a result of the return to in-person medical appointments. Two of Canada’s leading lab companies, LifeLabs and Dynacare, which jointly process over 170 million laboratory tests across the country, report increased turnaround times for Pap tests and cite staff shortages as the primary cause for these delays. In particular, the shortage appears to affect cytotechnologists, a highly-specialized subset of lab professionals trained to spot subtle changes in patient samples. While Canada once had multiple schools for cytotechnologists across several provinces, it is now down to one, The Michener Institute of Education at the University Health Network in Ontario, which graduates only 12 to 14 cytotechnologists each year.
cbc

[2022-11-29] British nurses’ strike update

United Kingdom’s Royal College of Nursing (RCN) has announced its first phase of strike action after the UK government turned down the union’s offer of “formal, detailed negotiations.” The strikes, which are scheduled to take place on Thursday, December 15 and Tuesday, December 20 in England, Northern Ireland, and Wales, will be the first in the union’s 106-year history. The union is seeking a pay rise of 5% above inflation, but British Health Secretary Steve Barclay dismisses the RCN’s pay demands as “unaffordable and unreasonable.” The RCN warns that if governments fail to enter into formal negotiations, more strike dates could be announced. The union promises, however, to ensure that strike action will be carried out legally and safely at all times. Plans for strike action in Scotland were paused after the Scottish government resumed negotiations.
rcn | nationalpost 

[2022-11-28] The crisis in the care economy shows no sign of letting up

In a recent labour market update, Katherine Scott, Senior Researcher at the Canadian Centre for Policy Alternatives, notes that while there has been “modest” employment growth in the health care and social assistance sectors, record-high vacancies remain: August’s Labour Force Survey reveals 152,000 vacant positions in these sectors, up 6.4% from July and 19.4% from August 2021. Although different governments are proposing solutions to the “care crisis,” Scott explains that none, in her view, has taken “decisive action to tackle wages and working conditions of care workers.” Between early 2021 and June 2022, RNs experienced a real wage cut of 6.3%, while that of nurses’ aides and orderlies was 3.3%. Scott argues that “addressing the low wages and poor working conditions of care workers is central to any plausible or just strategy for addressing Canada’s care deficit” and further stresses the importance of these issues to women who are an integral part of the care economy.
monitormag

[2022-11-28] British Columbia nurses rally and start new ad campaign

Approximately 200 ER nurses from Vancouver Island attended a B.C. Nurses’ Union (BCNU) rally on Thursday demanding that the provincial government address the ongoing healthcare crisis. The rally was held outside Nanaimo Regional General Hospital (NRGH), Vancouver Island’s busiest hospital, which sees at least 250 patients in its emergency department daily. According to the BCNU, nurses are understaffed, burnt out, and morally distressed, having to balance “dangerous” patient loads on every shift. The union says that the hospital’s staffing levels have not kept up with demands and that more nurses are needed in order to manage the “incredible strain.” BCNU’s Regional Chair Kelley Charters also pointed to other urgent care closures and staffing shortages on Vancouver Island. She said that nurses should be included in decision-making, and that a revised approach to scheduling, new incentives, and access to mental health supports would improve their working conditions. The BCNU recently launched a new province-wide ad campaign highlighting the state of the healthcare system and the impacts of staffing shortages on patient care.
bcnu | vancouverislandfreedaily | nanaimonewsnow | video: globalnews | helpbcnurses | radionl

[2022-11-25] Nursing strike action across Australia

Members of the New South Wales Nurses and Midwives’ Association (NSWNMA) held their fourth statewide strike this year, walking off the job for 24 hours on Wednesday over what they say is a “staffing crisis” in the state’s hospitals. The strike, which included thousands of nurses and midwives, concluded at 7 am, the end of the night shift, on November 24. The NSWNMA is asking for mandatory nurse-to-patient ratios, better working conditions, and “fair pay without a wage cap.” More specifically, it proposes one nurse rostered for every four patients and a one-to-three ratio in emergency departments. The union says the system is at a breaking point and that there are not enough health workers to safely manage patients. 
news release |  abc

Nurses in Western Australia represented by the Australian Nursing Federation (ANF) are planning statewide strike action from 7 am to 9 pm on Friday after members rejected the latest offer from the state government.  This will be the ANF’s first strike in 24 years. Nurses and midwives have been offered a 3% annual pay rise, a one-off $3000 bonus, and the introduction of nurse-to-patient ratios. The union, however, is demanding a 5% pay rise and new talks with the health minister. Western Australia’s Industrial Relations Commission has ordered the state’s nurses to call off planned industrial action, but it is expected that the order will be ignored. The move to strike could see attendees’ pay docked and the potential for further penalties under the WA Industrial Relations Act, including a $10,000 fine for the union for contravening a commission order.
abc | watoday | WA government press release

[2022-11-25] Immediate action needed as physician shortage reaches historic high in Manitoba

According to new data from the Canadian Institute for Health Information (CIHI), Manitoba has the third lowest doctors per capita in Canada, with only 217 doctors per 100,000 residents. The province would need 405 additional doctors to reach the Canadian average of 246 per 100,000 residents. The recent shortage of doctors is the highest reported in over 50 years of monitoring. Moreover, based on an October survey of its members, Doctors Manitoba projects that 43% of practicing physicans plan on retiring, leaving the province, or reducing clinical hours. The organization says that more needs to be done to address the expected exodus and is asking the province to establish a recruitment website and agency to help attract more doctors. Dr. Candace Bradshaw, president of Doctors Manitoba, explains that solving Manitoba’s family doctor shortage is doable “if the process is streamlined and time-wasting paperwork is eliminated to reduce doctors’ workloads.” 
cbc | winnipegfreepress | news release 

[2022-11-24] Ontario asks health clinics to stay open longer to take pressure off ERs

As provincial emergency departments deal with respiratory illnesses that are overwhelming hospitals and forcing the cancellation of surgical procedures, family health team and nurse practitioner clinics in Ontario have been asked to work at “full capacity.” A memo sent by the Ministry of Health on November 21 calls on clinics to “offer clinical services seven days a week, including evening availability, until further notice” to help alleviate the pressure on emergency departments and take the burden off of pediatric hospitals. The Ministry of Health has since clarified that the memo was not intended to be “directive” or “prescriptive.” Kavita Mehta, chief executive officer of Association of Family Health Teams of Ontario, notes that capacity and burnout are serious problems, and that family doctors are busy trying to catch patients up on medical care and screening delayed during the pandemic. She also said that most clinics already offer evening availability Monday to Thursday, and many are open at least once on the weekend.
cbc | globalnews | thestar

[2022-11-24] Nova Scotia doctors to play lead role in convincing doctors to live, work in province

The Nova Scotia government’s strategic plan to improve healthcare in the province, Action for Health, identifies the recruitment of more doctors and other health professionals as one core solution. As part of this strategy, doctors already practicing in the province will begin playing a lead role in persuading other doctors to relocate and work in Nova Scotia. Specifically, six doctors will serve as “MD recruitment leads,” participating in site visits and meeting with potential candidates to share their experiences of living and working in the province. They will also play a key role in helping new doctors set up their practices and serve as a resource for them as they get settled into their new communities. The initiative is expected to cost approximately $376,000 in 2022-23.
news release | atlantic.ctvnews | saltwire

[2022-11-23] Ontario is looking to cut costs in healthcare staffing

Ontario Health is the “super-agency” created by the provincial government in 2019 to find “efficiencies” in the health system. As reported by PressProgress, the business plan for Ontario Health reveals that the system is spending “too much.” The agency states that it is working to find a cost-saving program that quantifies “value-added opportunities for the health system” and identifies savings and efficiencies. Among the agency’s 2021 deliverables was a plan to develop “performance measures” to track new savings on “cycle time”—time spent per patient visit—and “spend per full-time equivalent”—amount spent on staff. Joel Usher, chair of OPSEU’s ambulance division, explains that finding savings “per full-time equivalent” for his union means that employers must “realize cost savings through the deployment of casual and PT workers,” who have “far less job security” and who are entitled to “far fewer benefits” as part of their customary six month contracts. Angela Preocanin, VP of ONA, urges the government to focus on taking “immediate action to retain nurses and healthcare professionals” in order to ensure that patients receive adequate care, and Doris Grinspun, CEO of the RNAO, further warns that nurses “will continue to go somewhere else” if their working conditions and compensation do not improve, leaving patients to “suffer the consequences.”
pressprogress

[2022-11-23] CASN releases Nurses Education in Canada Statistics Report 2020-2021

The Canadian Association of Schools of Nursing (CASN) has released its annual report entitled “Registered Nurses Education in Canada Statistics, 2020–2021.” The report is based on the National Student and Faculty Survey of Canadian Schools of Nursing which was completed by 99 of the 137 schools of nursing in Canada. Although Canada’s health care system is experiencing a critical nursing shortage, the report shows that schools of nursing are graduating more students. In 2021, 12,780 students graduated from entry-to-practice programs for RNs, continuing an upward trend from 4,833 in 2000. Despite the growing number of graduates, the report shows that nursing faculty is shrinking, with 97 permanent faculty members retiring in 2021. The report also provides extensive data on RN and nurse practitioner educational programs, including admissions and graduation numbers, educational program structure, and faculty retention and recruitment.
news release | report

[2022-11-22] Province lifting service cap for Alberta doctors

The Alberta Medical Association (AMA) and the provincial Minister of Health announced at a joint news conference that the daily physician billing cap policy introduced in 2020 will be temporarily removed in accordance with the agreement reached by the parties in September. Previously, a physician who saw more than 50 patients in one day would have received a reduced payment for the additional patients–a cost-saving measure that was supposed to prevent doctors from burning out. The new policy removes the daily cap, allowing physicians to be compensated fully for every visit. According to Dr. Fredrykka Rinaldi, President of the AMA, this change will “allow more physicians to care for more patients while helping to stabilize physician practices.” This new measure applies to general practitioners and specialists including pediatricians and ophthalmologists. The agreement between the AMA and the province also includes a 1% rate increase in each of the next three years and a 1% recognition lump sum payment in 2022-23.

lethbridgenewsnow | albertadoctors | alberta | edmonton.ctvnews | cbc | globalnews

[2022-11-22] The doctors in charge of the most complex health procedures in Canada can’t get a second wind

Burnout among academic physicians “skyrocketed” during the early waves of the pandemic. A recent study published in the Canadian Journal of General Internal Medicine showed that 75% of academic physicians and non-physician faculty members at McMaster’s department of medicine reported burnout in 2021. Another 2021 study published in BMJ Open found that 68% of University of British Columbia physicians experienced burnout, with more than 20% considering quitting the profession. Both studies showed a disproportionate impact on women. As this article explains, academic physician burnout has a significant impact on the health care system as it can diminish the quality of training that medical residents receive, lead to medical errors, and have a detrimental effect on academic health sciences centres. Stephen Archer, head of the department of medicine at Queen’s University, further explains that “high-tech care” in Canada is available through academic health science centres only and that any impairment to these centres will affect the entire healthcare system. 
theglobeandmail

[2022-11-21] REPORT | Sustaining Nursing in Canada 

The Canadian Federation of Nurses Unions (CFNU) released its “Sustaining Nursing in Canada” report on Thursday. According to the report, Canadian nurses are facing “chronic shortages, inadequate staffing, excessive workloads, mandatory overtime, toxic workplaces, and endemic violence.” The pandemic compounded these problems and introduced new issues such as overcapacity challenges and moral distress. In order to address the nursing shortage, the report puts forth a “multi-layered” strategy with three steps:

1. Retain and support existing staff by reducing workloads, fostering a safe and healthy work environment, supporting nurses’ mental health, and implementing targeted strategies across the career-course.
2. Foster the return of those who have left the public sector for other employment opportunities and early retirement, and integrate nurses with international training and experience into the workforce.
3. Recruit and mentor new nurses by expanding domestic training programs and incentivizing them to work in remote, rural, and underserved communities.

The report calls for more comprehensive data on nursing to be collected across the country and stresses that the suggestions it offers constitute an integrated strategy.
ottawacitizen | ctvnews | report

[2022-11-21] UK nursing strike update

A majority of National Health Service (NHS) employers across the United Kingdom may be affected by nursing strike action in the coming weeks. The Royal College of Nurses (RCN), the union representing 300,000 British nurses, is now calling on health secretary Steve Barclay to open formal negotiations on NHS pay and patient safety. According to the RCN, the salaries of nurses have declined by 20% in real terms over the last ten years. The union is now proposing a pay rise of 5% above inflation. If negotiations are not opened in the next five days, the RCN announced that it will proceed with strike dates and locations for December. On Friday, the Scottish government declared that it will reopen NHS pay negotiations and, as such, the RCN has formally paused strike action in Scotland.

A recent survey by IPSOS found that 71% of Britons thought it was acceptable for nurses to go on strike for a pay increase and 74% said it was acceptable to take strike action for better patient care. Despite these high levels of support, however, many respondents believe the requested pay increase is too high.
rcn | ipsos

[2022-11-18] Health workforce in Canada: In focus 

The Canadian Institute for Health Information (CIHI), the country’s national health data agency, released its annual report on the health workforce on Thursday. The report found that front-line professionals logged an unprecedented amount of overtime during the pandemic. This overtime is “both a symptom and a cause of the staffing crisis afflicting hospitals, nursing homes and community health agencies.” The CIHI report reveals that nurses, the largest category of health workers, are in particularly short supply in Canada. There were almost 500 fewer registered nurses (RNs) in long-term care (a 2.2% decline) and over 100 fewer licensed practical nurses (LPNs) in community health agencies (a 0.8% decline) in 2021. Throughout the same period, 1,251 additional RNs (6.5% increase) and 667 additional LPNs (8.2% increase) were employed privately in direct patient care jobs. According to Linda Silas, President of the Canadian Federation of Nurses Unions, overtime shifts, some of which are mandatory, are in part responsible for nurses moving to jobs in the private sector. The CIHI report also shows that nurse practitioners are one of the fastest-growing groups, with supply rates increasing by nearly 10%, while the supply of primary care physicians slowed by 2.1% in recent years.
press release | report | theglobeandmail | cihi | cbc | hcamag | thestar | thestar

[2022-11-18] Nova Scotia spending tens of millions of dollars on private nursing companies for long-term care

Late last year, Nova Scotia’s Department of Seniors and Long-term Care turned to private agencies to supplement staffing at public long-term care homes around the province. While $3.1 million was initially allocated for “travel nurses”, the amount was increased by $18.4 million after the Omicron wave began. The hourly wage for travel nurses is at least double that of public-sector nurses. While unionized RNs with 25 years of service in long-term care earn about $40 an hour and top-end LPNs make under $30 an hour, the private hourly cost is between $134 and $138.60 for RNs and $124.80 for LPNs. The province currently has no end date on the travel nurse program for long-term care, citing patient safety concerns at nursing homes. Janet Hazelton, President of the Nova Scotia Nurses Union, agrees that patient safety is important, but responds that it should be achieved “through educating and attracting more full-time nurses in the public sector.” In her view, travel nurses are “not the answer,” but rather a “Band-Aid” solution. She also points out that some nurses who have worked in the public system are now becoming travel nurses to achieve a better work-life balance. In a related interview with CBC’s Natasha Fatah, Linda Silas, President of the Canadian Federation of Nurses Unions, acknowledges that the difference in pay earned by public and private nurses creates a vicious cycle of dependence on private agencies that can be broken only by improving the conditions for public health care employees.
cbc | cbc newsroom

[2022-11-17] OPINION | The unintended consequences of Ontario’s health-care policies

Dr. Alykhan Abdulla recalls that family doctors were once considered to be “valuable conduits” between hospitals and their communities. He points out that many decisions policymakers took over the years had negative unintended consequences for health care. These decisions included mandating that family doctors should no longer manage their patients in hospitals, forcing family doctors to choose between being emergency doctors or community doctors, placing a cap on physicians’ salaries and forcing unpaid workdays, cutting medical school admissions and reducing the acceptance of international doctors, and slashing family health teams because they were “too expensive.” Dr. Abdulla states that family doctors are now separate entities from hospitals and that, as a result, ERs are at over-capacity or closing down, hospitals cannot discharge patients without community resources, nearly two million patients are having trouble finding family doctors, and waitlists abound for every medical procedure. In his view, the “best way forward is a collaborative approach where those who deliver care”–hospitals, specialists, technical and support workers, and family doctors–work together with policymakers to “anticipate and plan for intended consequences.”
ottawacitizen

[2022-11-17] OPINION | Increasing doctor pay in B.C. could help the shortage, but history suggests otherwise

A group of primary-care researchers questions the efficacy of B.C.’s plan to increase pay for family doctors. While they generally agree with a shift away from the fee-for-service model, they explain that the lack of primary-care access in the province is owing to a “lack of infrastructure and team-based clinics,” a problem that necessitates “co-ordinated health care reform.” In particular, the authors argue that compensation for physicians and other providers ought to be separated from “operational and capital-funding requirements to build successful primary-care systems in B.C. and across Canada.” They also point out that “previous increases to physician pay, without structural change,” such as those implemented in Québec and Ontario, did not produce the desired outcomes. “In an environment with lots of exhausted clinicians,” the authors explain, an isolated pay raise without structural change will encourage doctors “to maintain or increase their income while working less,” making B.C.’s new pay model a risky undertaking that may come at “a substantial cost to the taxpayer” without resolving the root problem of access to primary-care.
theglobeandmail

[2022-11-16] Half of Quebec nursing students fail September licensing exam, probe launched

More than half of Québec nursing students who took the September licensing exam failed to get the minimum passing grade. For those who took the test for the first time, the failure rate was 48.6%, the highest rate recorded in four years. Quebec’s professional nursing order, Ordre professionnel des infirmières et infirmiers du Québec (OIIQ), explains that the exam was comparable to those administered in previous years and suggests that the pandemic may have impacted students’ learning environment. In a news release, the OIIQ said it would offer “additional measures” to support students in their path to admission to the profession but that “relaxing the criteria is not being considered from a public protection perspective.” The OIIQ will focus instead on “targeted support to enable all candidates to pass the exam in future rounds.” Joseph Oujeil, a CÉGEP nursing professor, said that he was surprised by the results, that the current failure rate was not normal, and that his students report the exam did not reflect their clinical training. Québec’s commissioner for admissions to professions has launched an investigation after 27 complaints were received last week about the exam. The investigation will focus on the “various concerns that have been raised about the exam itself and the status of the candidates.” 
thestar | cbc | oiiq | globalnews

[2022-11-16] Province of Newfoundland and Labrador announces steps to increase number of nurse practitioners

Newfoundland and Labrador announced that the regional health authorities will immediately begin recruiting nurse practitioners (NPs) for primary health care, with a focus on rural areas. The health authorities have already begun creating collaborative community teams—that is, multi-disciplinary teams which include family physicians, NPs, nurses, social workers, pharmacists and other allied health professionals—with the aim of establishing 35 collaborative clinics over the next five years, some of which will be led by NPs. The province’s health minister could not yet confirm how many NPs would need to be hired, nor is he able to outline the associated cost, but said that “the province will be recruiting from Canada, the U.S. and abroad.” Yvette Coffey, president of the Registered Nurses’ Union Newfoundland and Labrador (RNUNL), is calling on the government to increase the number of seats in Memorial University’s NP program, which currently graduates about 12 per year, and to support RNs who want to become NPs with bursaries and educational leave.
cbc | press release

[2022-11-15] Almost 20% of Toronto doctors are considering closing their practices in the next five years

On Monday, a study based on a January 2021 survey and published in the Canadian Family Physician journal revealed that almost 20% of Toronto family doctors are considering closing their practices in the next five years. Dr. Tara Kiran, lead author of the study, notes that the proportion of physicians who are contemplating leaving the profession was significantly higher than expected and that it is not clear whether there will be enough new doctors to replace those who leave. A possible shortage in family physicians will further “exacerbate a human resources crisis that is already hobbling medical services from coast to coast,” explains the Globe and Mail. Dr. Kiran also suggests that provincial governments and health-care leaders “identify physicians on the verge of closing their practices” and “offer them support to stay open or help their patients transition to a new doctor.”
globeandmail | cfp

[2022-11-15] Paramedics frustrated support not in HHR action plan

Manitoba’s recently announced health human resources action plan provides no specific support for paramedics despite critical staff shortages and burnout. While the province’s HHR plan makes provisions for adding doctors and nurses to the healthcare system and offers mental-health and burnout support to these professions, there are no commitments to increase the ranks of paramedics or to address their working conditions. Rebecca Clifton, a spokeswoman for the Paramedic Association of Manitoba, warns that the sector is “hemorrhaging” staff to other provinces, to other professions, and to early retirement and that the province must prioritize retaining, training, and recruiting paramedics and dispatchers. At Thursday’s press conference, health minister Audrey Gordon said the province is “continuing discussions” with paramedics and other professions “on how their special expertise can support new and innovative models of care in the province.”
winnipegfreepress

[2022-11-14] Health Sciences Centre in Winnipeg to install ‘amnesty lockers’ to boost safety

As part of Manitoba’s health human resources action plan announced last Thursday, the Health Sciences Centre (HSC) in Winnipeg introduced “amnesty lockers” in its emergency department. Amnesty lockers “allow people to voluntarily lock up things that they may have on their person that might be considered weapons” or any other items they “should not have with them,” said Jennifer Cumpsty, executive director of acute health services at HSC. According to Darlene Jackson, President of the Manitoba Nurses Union, HSC nurses were the driving force behind these lockers, knowing that some of the vulnerable people they help carry objects for self-defence. The amnesty lockers are one measure taken by the province to help hospital employees feel safe while at work. Manitoba’s HHR action plan will also increase the number of peace officers in “large emergency departments” across the province, and work to implement actions to promote staff safety and to provide incentives for emergency departments.
winnipegfreepress

[2022-11-14] Quebec’s workplace safety board finds health and safety violations at Cowansville ER

In November 2021, a complaint was filed by nurses at a Quebec hospital about being overworked in the emergency room. The CNESST, Quebec’s workplace safety board, has recently ruled that the regional health agency (CIUSSS de l’Estrie-CHUS) violated two occupational health and safety laws. Specifically, the board found that the health agency did not put measures in place to evaluate the risks associated with work overload at the hospital and did not adopt any mitigation measures for its workers. Stéphanie Boulet, interim president of the health care professionals’ union (SPSCE-FIQ), says that the “situation has reached a critical point,” as there are currently 75 unfilled nursing shifts in the hospital’s emergency room this month alone. The health agency has refused the union’s proposal to reduce the ER’s operating hours at night.
thesafetymag | cbc

[2022-11-11] Manitoba announces health human resources action plan 

The government of Manitoba has announced a health human resources action plan that will commit $200 million of new funding over multiple years for the retention, training, and recruitment of health care staff across the province. Health Minister Audrey Gordon said that retaining the 40,000 workers in the system is the “first and most important pillar” of the plan. In this regard, financial incentives will be offered to staff who work weekends or in remote areas. In addition, the province has committed to ending the mandated overtime hours for nurses, providing funding for PPE and mental-health services, and working to form a provincial agency that will reduce reliance on private agency nurses. Manitoba will also reimburse the licensing fees of all health care professionals for the next two years and add more safety officers to emergency departments. The training aspect of the plan includes increasing educational program intakes for nurses and doctors and taking new measures to enable retired and international nurses to join the workforce. Finally, Manitoba aims to add 2,000 health care professionals to the system, including allied health, nurses, and support staff. The province will offer tuition rebates for full-time nurses and additional financial incentives to returning nurses and to publicly employed nurses who refer a returning agency nurse.
winnipeg.ctvnews | thestar | cbc | winnipegfreepress | globalnews | theglobeandmail

[2022-11-11] Newfoundland and Labrador announces retention initiatives for more healthcare workers

Newfoundland and Labrador announced on Thursday a number of “short-term financial incentives” for front-line health care workers represented by the Canadian Union of Public Employees (CUPE) and the Association of Allied Health Professionals (AAHP). Initiatives taken by the province to address workforce challenges include retention bonuses for return-in-service commitments and double rate overtime until the end of January 2023. Both these measures will target areas of the health care system that are experiencing retention and recruitment challenges. The province will also reimburse licensing fees for retired staff who wish to return to work. 
cbc | news release

[2022-11-10] Nurses across UK vote to go on strike for first time in dispute over pay

On Wednesday, United Kingdom’s Royal College of Nursing (RCN), which represents more than 300,000 members, announced that it will stage the first country-wide strike in its 106-year history, with strike action taking place at NHS trusts or health boards that have met relevant legal requirements. The results of the strike vote reflect widespread anger among nurses on account of the government’s refusal to increase its offer to raise wages. This offer was made in July and it provided a minimum annual amount of £1,400, ranging between 4% and 5% with some variation across jurisdictions. The RCN says that NHS nurses have seen their salaries fall by up to 20% in real terms over the last decade, and it is currently seeking a pay hike of 5% above inflation, which has itself risen above 10%. Although there has yet to be confirmation of the timing of the strikes, they are expected to start in early to mid-December and take place over two days. Nurses will, however, continue to provide urgent and emergency care during any strike action.
rcn | theguardian | bbc

[2022-10-10] ARBITRATION AWARD | Part-time nurse reinstated to active employment with hospital

The grievor was employed as a part-time crisis intervention nurse at the hospital. She went on medical leave in January 2017 and sought to return to work in late 2020. The hospital questioned the relevance of the grievor’s volunteer work during her leave and declined to return her to work until the College of Nurses of Ontario (CNO) confirmed her registration status. The Ontario Nurses’ Association (ONA) filed a grievance in response. The central dispute in this case is whether the hospital had legitimate grounds to prevent the grievor from returning to nursing duties. At the arbitration hearing, the hospital asserted that the grievor had renewed her license with the CNO under false pretense by claiming that she was engaged in nursing practice through volunteer work during the period of her medical leave. ONA argued that the hospital failed to return the grievor to work for discriminatory reasons. Arbitrator Colin Johnston agreed with ONA, finding that the hospital had discriminated against the grievor based on her perceived disability and violated her rights under the Human Rights Code and the non-discrimination provisions of the collective agreement. He ordered that the grievor be immediately reinstated to active employment in her nursing position with the hospital.
canlii

[2022-11-10] NAPE sounding alarm on shortage of Radiation Therapists

The Newfoundland and Labrador Association of Public and Private Employees (NAPE) states that there is a critical shortage of radiation therapists in the province. According to Jerry Earle, President of NAPE, radiation therapists are leaving Newfoundland “at an alarming rate” because the province is “simply not competitive with other jurisdictions.” Seven therapists have resigned over the past year, with two leaving in the last week alone. This exodus has impacted the province’s Provincial Cancer Care Program, prompting the closure of one of the four cancer treatment units and forcing the transfer of some patients for out-of-province treatment. NAPE insists that the government act “immediately and urgently” to address the issue.
nape | vocm

[2022-11-09] Health ministers’ meeting ends without funding deal 

Two days of meetings between federal, provincial, and territorial health ministers have ended without any agreement to boost health-care funding. Both sides are blaming the other for the breakdown in negotiations. Provincial and territorial ministers had requested that the Canada Health Transfer (CHT) be increased from 22% to 35%, echoing the premiers’ July 2022 demands. On Monday, Federal Health Minister Jean-Yves Duclos said that the government was ready to increase the transfer using “tailor-made” funding agreements on the condition that provinces build a health-care data-collection system and expand the use of common health indicators. On Tuesday, Duclos explained the breakdown was a result of the ministers’ insistence on “an unconditional increase” in the CHT. Duclos also noted that “the premiers are preventing … health ministers from taking concrete and tangible steps that would make an immediate difference in the daily lives of health workers and patients.” B.C. Health Minister Adrian Dix responded that he was “disappointed” in the outcome of the meeting “but not discouraged,” reiterating the demand for an increase in funding and a conference with the Prime Minister to discuss the CHT. 

On Tuesday evening, the Canadian Federation of Nurses Unions and the Canadian Nurses Association issued a joint press release stating that they are “disappointed that no progress or collaboration was achieved” and that “[p]olitical differences must be put aside to prioritize patient and worker needs.”
thestar | ctvnews | cfnu | cbc | nationalpost | newswire | globeandmail

[2022-11-09] Manitoba nurses pessimistic about future of work

The Association of Registered Nurses of Manitoba (ARNM) has released the results of its fall member survey. Joyce Kristjansson, executive director of ARNM, said that all of the evidence shows that nurses are not just overworked, but that they are concerned that the “system they work in is broken and making it harder for them to provide care to patients in all care settings.” Of the 1,600 respondents, over 80% expect that working in the nursing profession will be “somewhat or much more challenging” over the next 5 years, and just as many ranked supporting nurses’ mental health in the workplace and improving quality of care environments above adding staff. 78% of respondents also saw reducing wait times for emergency care as the most important and urgent issue for the health system. Moreover, respondents identified numerous suggestions for improving the health-care system, which range from educating the public with respect to the health system to clarifying the roles of administrative, educational, and licensing nursing bodies. The ARNM is calling on the province to share more details about plans to recruit and retain nurses that were proposed by the Health Minister last week.
globalnews | ARNM

[2022-11-08] Ottawa willing to increase flow of health-care cash to provinces on two conditions

Provincial and territorial health ministers are holding meetings with their federal counterpart, Jean-Yves Duclos, in Vancouver on Monday and Tuesday to discuss the current health-care crisis. On Monday morning, in anticipation of the two-day meeting, Prime Minister Justin Trudeau noted the government’s commitment to investing “significantly more” in health-care, but wanted to ensure that the additional funds support those “on the front lines” and impact the level of care that Canadians receive. At a news conference on Monday afternoon, Minister Duclos confirmed the federal government’s willingness to increase the Canada Health Transfer, specifying two conditions that the provinces must meet to qualify for additional funds: they must “commit to expanding the use of common key health indicators and to building a ‘world-class’ health data system for the country.” Minister Duclos also notes that the federal government “will reach ‘tailor-made’ funding agreements with provinces and territories based on the most urgent needs in each jurisdiction.”
vancouversun | globalnews | globalnews | thestar | cbc | winnipegfreepress 

[2022-11-08] Québec nurses union files its demands with the Treasury Board

The Fédération interprofessionelle de la santé du Québec (FIQ) represents 76,000 nurses, licensed practical nurses, respiratory therapists and clinical perfusionists in Québec. Their collective agreement with the province will expire on March 31, 2023, and negotiations are expected to begin after the holiday period. On Monday, the union filed its demands for bargaining with the Treasury Board, proposing an end to mandatory overtime, the elimination of private agency personnel, and new legislation on safe healthcare professional-to-patient ratios. The FIQ is seeking pay increases based on the consumer price index (CPI) plus 4% on each of April 1, 2023, April 1, 2024, and April 1, 2025, in addition to a catch-up increase for the current year because of inflation. The union also wants consideration of a four-day workweek, improvements to vacation time, and the posting of schedules at least two weeks in advance. The government has 60 days to submit its counter-offers.
montrealgazette | montreal.ctvnews | news release | globalnews | globalnews (video)

[2022-11-07] Doctors, nurses, health care advocates provide ‘prescription for hope’ to governments

On Monday and Tuesday, federal, provincial, and territorial health ministers will hold their first in-person meeting since 2018. In advance of this week’s meeting, the Canadian Medical Association, the Canadian Nurses Association, and HealthcareCAN joined forces and issued their “prescription for hope,” which calls on governments to “put aside jurisdictional and partisan arguments” in favour of a collaborative approach. They state that Canada’s health ministers have an opportunity to stabilize and rebuild struggling health systems by taking “tangible action.” Specifically, they are asking the health ministers to provide retention incentives and strengthen mental health supports for health workers, implement a pan-Canadian health workforce planning strategy, and ensure health care workers are able to work to their full scope of practice. They are also seeking pan-Canadian licensure for doctors, investment in physical and digital infrastructure, improved access to primary care by creating a virtual care strategy, and streamlined immigration and licensing processes to help internationally educated health professionals fill vacancies. 
newswire | ctvnews | globeandmail

[2022-11-07] New benefit to entice N.W.T. doctor and nurses to work over the holidays announced

The government of the Northwest Territories has announced its pilot Family and Friends Travel Program to help address staffing shortages in “hard-to-fill positions” over the upcoming holiday season. It offers to compensate front-line nurse practitioners, RNs, and physicians, including locums, for the transportation cost of having “two loved ones” visit them in the communities in which they work. The program covers the cost of flights and/or travel by privately owned vehicles to a maximum of $2,000 per employee on condition that the employee is scheduled to work for a minimum of five full shifts between December 20 and January 4. Friends and family can travel anytime between December 1 and February 28.
cbc | news release | FFTP

[2022-11-04] Newfoundland to set up health care recruitment desk in India 

Newfoundland and Labrador is facing a significant shortage of healthcare workers with over 600 vacant nursing positions in the province. Premier Andrew Furey acknowledges that work-life balance is an ongoing issue with nursing staff and states that part of the solution is recruiting more nurses. The province announced on Thursday that it is launching a mission to India to recruit internationally-educated RNs to fill nursing vacancies. In the coming weeks, a team of government officials will set up a recruitment desk in Bengaluru, Karnataka. Furey said the province chose the area because Karnataka has more than 100 nursing schools with training similar to the province’s. The team will be joined by a representative of the College of Registered Nurses of Newfoundland and Labrador who will oversee licensing. The team will also meet with officials from nursing schools to raise awareness of the province as an immigration destination.
vocm | cbc | news release

[2022-11-04] New mobile clinic aims to serve Nova Scotians in need of medical care

In response to the “global shortage of health-care professionals,” Michelle Thompson, Nova Scotia’s Minister of Health and Wellness, announced that the province will seek to implement “non-traditional approaches” for delivering care. As a way of meeting immediate primary care needs in underserved communities, Nova Scotia will begin operating a temporary mobile clinic staffed by nurse practitioners and other primary care providers. The clinic—a converted fifth wheel trailer—was initially created in September to serve Sydney in the aftermath of hurricane Fiona, but is now being used to offer a combination of in-person and virtual treatments, including issuing prescriptions. Although the mobile clinic includes the medical equipment needed to quickly set up anywhere in the province, it will not offer emergency or lab and diagnostic services. The CBC reports that the province may create two additional mobile units in the coming months.
news release | cbc | atlantic.ctvnews

[2022-11-03] Flush with Cash: The provinces are richer than they think

David Macdonald, Senior Economist with the Canadian Centre for Policy Alternatives (CCPA), explains that the pandemic revealed many problems with provincial healthcare systems, including shortage of nurses, lack of surge capacity in hospitals, and the shortcomings of long-term care. Many of these problems were a result of chronic underfunding, which has been exposed by COVID-19 over the past two years. Macdonald argues, however, that there is no longer a financial excuse for the provinces to ignore these chronic issues. In the newly released report “Flush with Cash,” Macdonald notes that while the initial combined provincial deficit projections for 2022-23 was estimated to be $48.5 billion, the projection has now been revised to a $7.1 billion surplus on account of underestimated revenue. According to this report, all ten provinces have either seen surpluses since the start of the pandemic or are projecting a surplus within their planning horizons, and nine out of the ten provinces are projecting that they will be in a better financial position than they were before the pandemic.
CCPA news release | policyalternatives | monitormag

[2022-11-03] Immediate solutions to hospital crisis lie in public system, not private

At yesterday’s Queen’s Park press conference, OPSEU, the representative of more than 25,000 hospital professionals, called for the provincial government to take immediate action on the hospital staffing crisis by looking at solutions from within the public system. The union said that hospitals have been operating beyond capacity, resulting in surgery backlogs, prolonged wait times, and ER closures. According to OPSEU’s press release, the high stress work environment and the wage limitations of Bill 124 have resulted in healthcare professionals leaving the field in large numbers. In response to this crisis, the Ontario government has announced that more publicly covered surgeries would be performed at private clinics and suggests that privatization is one possible strategy for addressing staffing shortages. OPSEU’s Laurie Nancekivell disagrees that the problems can be solved by a two-tier healthcare system and insists that the solution lies in “investing in public hospitals and giving hospital professionals a voice in the allocation of that funding.” She adds that nurses and doctors are not the only healthcare professionals at stake, but that this issue concerns “the full team of allied and diagnostic health professionals,” who are also affected by Bill 124.
opseu | blackburnnews | ca.news.yahoo | chch

[2022-11-02] PSWs in Ontario hospitals still waiting on permanent wage increase

The government of Ontario introduced a $2 hourly wage raise in 2020 as a temporary measure to support healthcare workers during the pandemic. This increase has been extended periodically over the past two years, and in March 2022, the government announced that it planned to make the wage enhancement permanent. The wage increase has not been implemented in hospitals, however, due to lack of instruction from the government on eligibility and funding. Several unions said they have been pressuring the government on the matter and note that the province has started to issue these instructions. Unions are now asking the government to expedite payment of the missing wages and explain the delay. Michael Hurley, president of CUPE’s Ontario Council of Hospital Unions, states that retention is a major issue in hospitals, as PSWs can benefit by working in long-term care where the higher hourly wage has been maintained without interruption.
globalnews

[2022-11-02] Quebec to open clinics led by nurse practitioners to ease ER crisis

In consultation with its 20-member crisis management team, Quebec’s Health Minister Christian Dubé has announced a three-point plan to manage ER overcrowding in the province. The announcement was made the same day the heads of Quebec’s emergency departments released an open letter stating that ERs in the province have reached a “breaking point.” The province aims to maximize the use of the 811 line to redirect non-critical patients away from ERs, providing care for them elsewhere. It will also open two specialized nurse practitioner clinics in Montreal in the coming weeks, a step, admitted Dubé, that “we should have taken a long time ago.” Finally, Quebec wants to facilitate the transfer of patients who no longer need hospital care to other care settings.
globalnews  | montreal.ctvnews

[2022-11-01] New payment model for British Columbia doctors

The Province of British Columbia, Doctors of BC, and BC Family Doctors have co-developed a new payment model for family doctors that will take effect in February 2023. This model marks a departure from the current fee-for-service structure to one based on a combination of the time doctors spend with their patients, the number of patients seen in a day, the complexity of the patient’s issues, the number of patients a doctor supports through their office, and overhead costs. It is estimated that a full-time physician working 1,680 hours a year, seeing 1,250 patients with cases of average complexity and carrying out 5,000 visits annually, will earn at least $385,000 under the new model and only $250,000 based on the fee-for-service model. However, family doctors will be able to choose whether they wish to continue under the fee-for-service model or opt into the new payment structure. The province has also reached a tentative three-year physician master agreement with the Doctors of BC, which is yet to be ratified, that increases funding for specialists, funding for rural medicine programs, and after hours on-call rates for doctors.
news release | globalnews | theprovince | cbc | vancouversun  | thetyee

[2022-11-01] Interest arbitration award covering helicopter pilots at ORNGE

Outstanding issues in dispute between ORNGE, which provides air ambulance and medical transportation services across Ontario, and OPEIU, which represents 93 helicopter pilots, went to arbitration on October 12. Arbitrator William Kaplan issued his award on October 25 to cover the renewal collective agreement from April 1, 2020 to March 31, 2023.  The award includes wage increases of 2% effective January 1, 2021, 2% effective January 1, 2022, and 3% effective January 1, 2023. It also provides service recognition payments, and changes to personal days, medical examinations, uniforms, banked sick leave, and aviation helmets.
canlii

Health care workers in need of psychological support

A recent study by the Mental Health Commission of Canada in collaboration with the Centre for Studies in Primary Care at Queen’s University and HEC Montreal’s Healthcare Management Hub surveyed 982 healthcare workers from several disciplines and workplaces across Canada regarding psychological self-care and moral distress. The report reveals that 40% of health care workers are burned out, 50% intend to leave the profession, and only 60% are satisfied with the quality of care they provide. The findings suggest that higher moral distress relates to higher levels of burnout, while increased self-care relates to lower levels of burnout. Survey participants also provided suggestions to improve support for psychological self-care and protection from moral distress, including prioritizing psychological health and safety in the workplace, making every effort to protect sufficient time off, and updating health human resource strategies.

mentalhealthcommission [news release] | mentalhealthcommission [full report]| theconversation 

Alberta Doctors Ratify Agreement with Province

The Alberta Medical Association (AMA), representing 11,000 doctors, has reached an agreement with the province after several years of negotiations.  The agreement, ratified in a members’ vote on September 28, covers four years from April 1, 2022 to March 31, 2026. It will result in a $750 million investment in new funding over the four years to stabilize the health-care system, which includes more than $250 million in targeted funding to address pressures, including recruitment and retention programs. Alberta physicians will see 1% rate increases in each of the first three years (2022-23 to 2024-25), and a 1% recognition lump sum payment in 2022-23. The province has also agreed to repeal Bill 21 — legislation which allows it to unilaterally cancel its contract with doctors — and in return, the AMA will drop a lawsuit against the Alberta government. 

Government of Alberta | Highlights of Agreement | globalnews | cbc | ctvnews | thestar

Manitoba Health Care Workers Ratify Agreement

On September 23, 2022, members of the Canadian Union of Public Employees (CUPE) Manitoba ratified a renewal collective agreement.  The deal, covering 18,000 health care support staff working across Shared Health, the Winnipeg Regional Health Authority, Northern Health and Southern Health, was reached on August 29 as a result of mediation after 21 months of bargaining. 

The renewal collective agreement is effective from April 1, 2017 to March 31, 2024.  Wage increases total 9.6% over the seven-year contract, including 1.25% in 2017 and 2018, 1.4% in 2019, 0.5% in 2020, 1.2% in 2021, and 2% in both 2022 and 2023. The salary increases are identical to those received by the Manitoba Nurses’ Union last year.

The agreement also includes a signing bonus of $500 for all staff, an increase in shift premiums, improvements for the Community Programs/Home Care groups, a more flexible “single-day” vacation system for members, double overtime, and market adjustments.

A copy of the full Memorandum of Settlement is posted to CUPE’s website at: Memorandum of Settlement CUPE and Provincial Health Labour Relations Services

torontostar | CUPEManitoba | CUPE Highlights Document

Constitutional challenge to Ontario’s Bill 124

Bill 124 is a law that was passed in Ontario in November 2019. It limits wage increases to one per cent per year for Ontario Public Service employees and broader public sector workers. The limit is in effect for a three-year moderation period.

On September 12, a number of unions and associations, including ONA, OPSEU, CUPE, SEIU Healthcare, UNIFOR and the OFL , commenced their challenge of the constitutionality of the legislation before the Ontario Superior Court of Justice.  The groups argue the bill violates a section of the Canadian Charter of Rights and Freedoms that protects meaningful collective bargaining. 

According to ONA, “Bill 124 imposes restrictions on all forms of compensation and has undermined nurses’ bargaining power during a crisis shortage of their skilled labour, exacerbated by a global pandemic, that would otherwise have amplified that power.”  ONA also argues the bill is discriminatory against women and violates sex and gender equality in two other sections of the Charter.

The province argues that Bill 124 does not violate the Charter and that it is not discriminatory.  It contends that the Charter protects only the process of bargaining and not the outcome. “That’s what the law does, it constrains an outcome,” said government lawyer Zachary Green. “Within that substantive constraint on what your salary can look like at end of bargaining, the applicants remain free to engage in a process of meaningful bargaining.”

The hearings continue until September 23. Daily Court updates are posted to UNIFOR’s website at https://www.unifor.org/news/all-news/bill-124-charter-challenge-heard-ontario-superior-court. 

ONA |Global News |Toronto Star 

Saskatchewan Launches Health Human Resources Action Plan

On September 7, the Government of Saskatchewan announced its plans for a four-point action plan to recruit, train, incentivize and retain healthcare workers in the province.  The plan will cost $60 million over the next several years.  

“We do know that we need 1,000 health care workers to be able to stabilize our system over the next couple of years and this is what we need to be able to do to meet those challenges that are out there,” said Health Minister Paul Merriman during a news conference. “With the action plan that we’ve laid out today, we can confidently say that help is on the way.”

The plan consists of recruiting hundreds of new healthcare workers over two years from abroad and newcomers interested in working within the healthcare sector.  A provincial call is being put out to unlicensed internationally educated healthcare professionals and others with healthcare experience currently living in the province, and Canada, who may be eligible for training or employment.  

The province is introducing an accelerated training, assessment and licensure pathway for internationally educated nurses that includes supports for overseas recruits to settle and start work in the province. Further program possibilities will be identified with post-secondary partners, including additional training seats and the potential for new professions like Physician Assistants. 150 nursing seats have been added in Saskatchewan’s registered nursing, registered psychiatric nursing, and nurse practitioner education programs.

The province will also launch a new incentive program which will provide up to $50,000 over three years for a return-of-service agreement for hard-to-recruit positions mainly in rural and remote areas.

Respecting retention, 100 new permanent full-time positions will be added and 150 part-time positions will be converted to full-time permanent positions for high-demand professions in rural and remote areas.  As well, new mentorship programming will be created and the Saskatchewan Health Authority will work with partners to create a First Nations and Métis recruitment and retention strategy.

To oversee the process, the province has launched a new independent Saskatchewan Healthcare Recruitment Agency (SHRA).

The Saskatchewan Union of Nurses President Tracy Zambory said the union was not consulted in the creation of the plan.  She states that “this is a plan that unfortunately is going to do nothing to retain registered nurses in the immediate future.”  The NDP’s Health Critic responded that the plan to add 1000 more healthcare workers over two years only meets two-thirds of the of the current job postings on the Saskatchewan Health Authority’s website.

Government of Saskatchewan | HRD | cbc | ctv | leaderpost

General Support Services workers accept new agreement with Alberta Health Services 

Members of AUPE working for Alberta Health Services (AHS) General Support Services have voted to ratify a new four-year collective agreement expiring on March 31, 2024.  The 32,000 support services workers that the union represents have positions that range from housekeepers to maintenance staff to clerical and administrative duties as well as jobs in food services.

The wage settlement provides 0% on April 1, 2020; 0% on April 1, 2021; 1.25% on September 1, 2022; and 2% on April 1, 2023.  The AHS has also offered the following lump sum payments in recognition of members’ outstanding work throughout the COVID-19 pandemic:  1% Lump Sum (for 2021);  $1400 Lump Sum (within 90 days of signing). 

The parties agreed that AHS will stop contracting out jobs until March 31, 2024.  AHS also dropped proposals on red-circling, rollbacks to shift and weekend differential, and an attempt to hire temporary staff for longer periods of time. 

AUPE | GlobalNews 

[2022-10-31] An inside look at Ontario’s nursing nightmare:  Why turnover and vacancy rates are only getting worse

According to the annual Ontario Hospital Association’s (OHA) Health Human Resources Workforce Survey, the Ontario-wide hospital vacancy rate for RNs rose from 4.85% in March 2020 to 12.63% in March 2022. The province’s vacancy rate is rising despite the addition of more than 8,000 nurses since the start of the pandemic, a 3.6% increase in the number of nurses registered by the College of Nurses in the past year, and new measures announced by the province to allow internationally educated nurses to practice. The OHA survey also shows that, as of February 2022, the hospital turnover rate for nurses was 14.47%, constituting a 72% increase since 2020. Turnover is largely driven by resignations of RNs which have doubled in the past five years. Similar trends are prevalent in other health-care professions as well and, given the growing demands placed on the province’s health-care system by an ageing and growing population, CUPE estimates that approximately 47,000 workers will need to be added to the system in order to maintain current service levels.
torontostar

[2022-10-31] Recommendations released to address physician shortage in rural and Northern Manitoba

Faced with one of the biggest physician shortages in Canada, the Manitoba Chambers of Commerce and Doctors Manitoba have released a joint report to attract and retain more physicians to rural and Northern Manitoba. The report makes five recommendations to help the province recruit and retain staff:

• Attract more physicians by expanding training, streamlining recruitment efforts, and identifying financial incentives to smooth out-of-province candidates’ transition to practice in Manitoba 
• Find efficiencies to free up physicians’ time for more patient care and seek care guidance with other doctors
• Address burnout by reducing administrative burden, reviewing on-call expectations, and improving engagement
• Retain physicians by offering better peer support and mentorship, assisting with physician infrastructure costs, and enhancing the physician retention program
• Support the role of local communities and chambers of commerce in recruiting and retaining physicians and their families

The report has been submitted to the Minister of Health for the government’s consideration.
Doctors Manitoba | Report & Recommendations | winnipegfreepress | cbc | globalnews | winnipegsun | winnipeg.ctvnews

[2022-10-28] Nurses leaving Canada doubled in the last five years amid health-care crisis

The number of Canadian nurses transferring their credentials to work in the United States has more than doubled in the last five years and is now at an “all-time high.” CTV reports that many nurses, some of whom are frustrated with the wage cap imposed by Bill 124 in Ontario, are lured to the U.S. with higher wages, perks, and bonuses. Data from the Commission on Graduates of Foreign Nursing Schools (CGFNS) reveals that 801 Canadian nurses applied to transfer their credentials to the U.S. in 2018, and more than 1,300 applied in 2019. While the numbers dropped during the pandemic, they have already risen to 1,700 in 2022. This migration has exacerbated a nursing shortage that contributes significantly to emergency room and hospital ward closures across the country.
toronto.ctvnews | kitchener.ctvnews (video) | ottawa.ctvnews

[2022-10-28] Ontario nursing college now allowed to temporarily register international nurses

The Ministry of Health has made changes to support recruitment efforts by expediting the registration of health care professionals trained in Ontario, in other provinces, and internationally. The College of Nurses of Ontario (CNO) can now allow internationally educated nurses to practise while they work toward full registration. Also effective immediately, the CNO will have more flexibility in allowing retired or non-practicing nurses to return to the field. In addition, a new temporary independent practice registration class will be created for physicians from other provinces and territories, making it easier for them to work for up to three months in Ontario.
news release | toronto.ctvnews

[2022-10-28] Manitoba lags in physician recruitment and retention, new report says

A new report called Physicians in Manitoba reveals a significant shortage of doctors in the province, with projections suggesting that shortages are likely to worsen. Although Manitoba has had a 46% increase in the number of practicing physicians over the last 20 years, this amounts to only 19% when considered on a per capita basis. Manitoba’s per capita increase in physicians is lower than the Canadian average of 29% and it is also the lowest among the provinces. Today, Manitoba has the lowest number of family physicians per capita in Canada with 108 for every 100,000 residents, and the third lowest number of specialists per capita with the same ratio. Rural and northern regions in Manitoba also have below-average physician resources compared to peer regions across Canada. The Physicians in Manitoba report estimates that the province would need 359 more physicians to meet the Canadian per capita average.
Doctors Manitoba | Report | cbc | winnipeg.ctvnews | global-news

[2022-10-27] Newfoundland and New Brunswick nurses unions launch media campaigns this week

The Registered Nurses’ Union of Newfoundland and Labrador (RNUNL) is holding its 28th biennial convention this week with approximately 230 nurses in attendance. A rally was held in St. John’s on Wednesday to launch the union’s new media campaign, “Beyond Broken,” which depicts the “dire state” of health-care in the province and underscores the “urgent need for change.” In the union’s accompanying press release, RNUNL President Yvette Coffey explains that the situation for nurses is critical, noting that hospitals are over-capacity, patients are not receiving critical care, long-term care beds are sitting empty because of a lack of staff, and the backlog of surgeries is continuing to build. Coffey stresses that the government must take immediate action to stabilize nursing and protect patient care by retaining RNs, creating safer and healthier working conditions, improving access to leave, and recruiting RNs into full-time jobs.
news release | vocm | saltwire | cbc | beyondbroken

In parallel with RNUNL’s campaign, the New Brunswick Nurses Union (NBNU) also launched their own new media campaign this week, ‘Picking Up the Pieces’, to raise awareness about burnout among nurses.
nbmediacoop | globalnews | pickingupthepieces 

[2022-10-27] Opinion:  Six steps to help save Ontario’s health-care system

In this opinion piece, Raywat Deonandan, Epidemiologist and Associate Professor at the University of Ottawa, explains that the human resources shortage is at the heart of Ontario’s health care system crisis. He argues that while long-term strategies must be found, there are a number of actions that the provincial government could take immediately to alleviate the crisis. In order to keep ERs open across the province, Deonandan suggests increasing the pay for nurses, recruiting medical professionals from other jurisdictions, and giving ER physicians the option to move away from fee-for-service to a generous salary or capitation model. He also recommends negotiating an immediate pathway for foreign-trained but unlicensed medical professionals in the province to practice, and encourages increasing medical service capacity by expanding telemedicine services and removing administrative barriers to their use. Finally, Deonandan argues that we need strong public messaging to inform people of the severity of the crisis, encourage them to reconsider personal decisions that might heighten their chances of needing emergency medical care, and impart home triage skills so they know better when not to come to ER.
ottawacitizen

[2022-10-26] B.C. reaches temporary deal with paramedics aimed at boosting rural staffing

In an effort to address acute paramedic shortages, the B.C. Emergency Health Services (BCEHS) has reached an interim agreement with the Ambulance Paramedics of B.C. (APBC) for new staffing measures. Rural areas often rely on on-call paramedics to backfill a second ambulance when the main ambulance is responding to a call in another community. Under the new agreement, on-call paramedics will now receive a “pager pay” of $12 per hour, an increase from the previous compensation of $2 per hour.* In addition, all overtime and recall shifts worked by paramedics during evenings and weekends will be paid at the double overtime rate. These measures are in effect until December 31 or until the parties reach a new collective agreement. The APBC is looking for more competitive wages to recruit staff and fill vacancies.
globalnews | bc.ctvnews | cbc | vancouversun | APBC news release

*For additional background information, please consult our October 21, 2022 issue.

[2022-10-26] Manitoba investing $12.5 million for new training centre at Red River College Polytechnic 

The Manitoba government announced on Tuesday that it has pledged $12.5 million for a new interdisciplinary health and community services simulation centre at Red River College Polytechnic (RRCP). The aim of the simulation centre is to train a range of health-care professionals and, through this additional capacity, to strengthen Manitoba’s health-care system. This centre will include equipment and technology that reflects current health-care settings and simulates realistic care situations in order to enhance learning and prepare students for clinical placements and further employment. Last year, the province committed to 400 new nursing education seats over the next few years, of which 289 have already been created. The RRCP simulation centre, whose completion is anticipated in the next two years, will provide an additional 115 seats.
globalnews | news release

[2022-10-25] 320 protection services officers will support safer workplaces for health-care workers

Last month, the province of British Columbia identified workplace safety as one of the “key actions” in the province’s health human resources plan. To that end, it is introducing a new security model, which includes hiring 320 in-house protection services officers and 14 violence prevention leads at 26 hospitals across the province. The new model ensures that all security personnel will have an acute awareness of patients and their surroundings and be equipped to anticipate, de-escalate, and ultimately prevent aggression based on trauma-informed practice. The province will also provide $2 million to SWITCH B.C., the organization leading the province’s violence-prevention model. In Monday’s press release, Minister of Health Adrian Dix said, “Ensuring our health-care facilities are free of violence will not only help us recruit and retain health-care workers, but it will also improve patient care and continuity.”
news release | globalnews | bc.ctvnews | thestar | cbc 

[2022-10-25] New Brunswick hospitals hiring travel nurses from private temp agencies

New Brunswick’s Vitalité and Horizon Health Networks are currently relying on travel nurses from temp agencies in order to address the current nursing shortage. The New Brunswick Nurses Union (NBNU) opposes this practice on account of the higher wages that travel nurses earn in comparison to hospitals’ employees. Paula Doucet, President of the NBNU, notes that the union has “been sounding the alarm bell for a number of years” about the inevitability of the staffing shortage and stresses the importance of nursing retention and recruitment. Health Minister Bruce Fitch responds that hiring travel nurses at this point in time is “a necessary stop-gap measure” and highlights the importance of continuing to provide healthcare services to New Brunswick residents.
globalnews

[2022-10-24] Quebec will appeal decision on how COVID-19 bonuses were paid to nurses

In August 2022, Quebec’s Tribunal administratif du travail (TAT) found that the province should have consulted health care unions to determine the amount paid as bonuses to nurses working during the pandemic. The TAT found that the province’s unilateral decision with respect to these bonuses violated the provincial Labour Code by obstructing union activity and engaging in bad faith negotiations. The Quebec government is now challenging that decision to the Superior Court, arguing that the Public Health Act superseded the provincial Labour Code. In particular, the province contends that the pandemic was a health emergency and that the Public Health Act gave the government the power to order any measure to protect the public, notwithstanding existing legislation, and to do so “without formality or delay.”
montrealgazette | montreal.ctvnews

[2022-10-24] OPINION | Ontario must improve wages for nurses to compete with U.S.

Cathryn Hoy, the President of the Ontario Nurses’ Association (ONA), contrasts wage increases and bonuses provided by new labour contracts for nurses in Michigan with Ontario nurses’ current working conditions. Given that wage increases in the province have remained below the rate of inflation, Hoy explains, Michigan-based contracts may serve as a catalyst for some Ontario nurses to leave the province. She stresses that the result of an exodus of Ontario nurses would be closed emergency departments, delayed surgeries, long wait times, and less access to timely care. Hoy adds that, in the context of the current labour shortage, unions should be able to negotiate higher wages to retain overworked staff, and that they ought not to have their bargaining power restricted by laws like Bill 124.
windsorstar

[2022-10-21] ‘It’s a broken system that needs fixing,’ say emergency responders about B.C.’s rural paramedic shortages

Many rural communities in British Columbia are facing acute paramedic shortages. The union representing paramedics, the Ambulance Paramedics of B.C. (APBC), argues that serious gaps in ambulance service will likely continue in these communities if the province maintains its scheduled on-call (SOC) staffing model. Under this model, paramedics are scheduled to work an eight-hour shift, but are on call for the remaining 16 hours during their three-day rotation. While on call, paramedics receive $2 an hour unless they are actively responding to an emergency. In the union’s view, the SOC model makes it “extremely difficult” to attract staff as they receive full wages for only one third of their time. The province justifies its use of the SOC model in rural communities because of lower call volumes. In the current round of bargining with the province, the union demands that the current SOC model be phased out in favour of a new compensation-based model that “meets the needs of [rural] communities.”
nationalobserver

[2022-10-21] OPINION | Change health-care education to solve staff shortages

In this opinion piece, former health policy analyst Steven Lewis discusses the current “rigid” system of health science education in Canada. He points to the cost of medical education and the time it takes to graduate, which discourage potential students from pursuing careers in healthcare. Lewis argues that the structure of healthcare education must change in order to address current staffing shortages by becoming more “creative and agile.” One option, he suggests, would be a generic two-year, college-based program that would combine basic and highly practical health science education with rotating work experiences in institutions and in the community.
leaderpost

[2022-10-20] Registered Nurses Union Newfoundland and Labrador entering collective bargaining process as new survey says nursing situation “dire”

The Registered Nurses’ Union of Newfoundland and Labrador (RNUNL) and the provincial government have begun the collective bargaining process in the midst of a healthcare crisis. According to a recent survey commissioned by the RNUNL and conducted by MQO Research, the state of nursing in the province is “dire.” Survey results reveal that 88% of registered nurses and nurse practitioners believe that understaffing has resulted in unsafe conditions for patients. 92% of members surveyed indicated that their workload was increasing their risk of burnout and fatigue, while 88% agreed that it is contributing to high levels of sick leave. Yvette Coffey, President of the RNUNL, explains that the new findings “sound the alarm bells on the critical need to reach a fair collective agreement that stabilizes nursing and protects patient care.”
vocm | rnunl

[2022-10-20] British Columbia tables Health Professions and Occupations Act 

On Wednesday, the government of British Columbia tabled the Health Professions and Occupations Act to replace its predecessor, the Health Professions Act. The legislation enables a streamlined path to reduce the number of regulatory colleges from 15 to 6 through amalgamation. The regulation of counsellors and psychotherapists will be prioritized, followed by diagnostic and therapeutic professionals. The legislation institutes a new oversight body, which will perform routine audits of the colleges, and establish a disciplinary process that separates the investigative and disciplinary stages in order to improve transparency. All disciplinary agreements concerning health professionals will be publically available. The colleges will also fund counselling for victims of sexual abuse and sexual misconduct, and victims will be able to cover costs from the professionals who have harmed them. Finally, the proposed Act requires colleges to implement anti-discrimination measures and will consider discrimination as a form of professional misconduct. 
cbc | press release

[2022-10-19] Saskatchewan to hire hundreds of healthcare workers from Philippines

On Tuesday, Saskatchewan announced a plan to hire hundreds of healthcare workers from the Philippines over the next two years. The move is part of Saskatchewan’s Health Human Resources Action Plan, which aims to recruit, train, incentivize, and retain more workers to boost the province’s healthcare system. Saskatchewan is the first province in Canada to pilot an accelerated training and assessment pathway for eligible nursing recruits from the Philippines. Participants would remain in the Philippines to fulfil the online components of the educational program, then complete final clinical and practicum components in Saskatchewan. Successful applicants who commit to a “return for service” agreement will have costs covered for language and education assessments, bridging/training, accreditation fees, and travel for clinical placement.
gmanetwork | mb | canadianinquirer

[2022-10-19] Why Ontario is reducing doctors’ payments for one-off virtual appointments

The provincial government and the Ontario Medical Association have agreed to decrease payments to doctors for “one-off virtual appointments” to discourage virtual-only clinics and incentivize doctors to provide comprehensive ongoing care to patients. According to the Physician Services Agreement, the visits will be paid at a reduced rate of $15-$20 when the “physician renders a service to a patient where there is not an existing patient-physician relationship.” Physicians who see their patients on an ongoing basis will continue to get paid the same amount for a virtual visit as an in-person one, as will specialists who see referred patients. Critics say the province’s new approach to the virtual fees is a disincentive for physicians who are adding capacity to the system by offering in-person care in addition to providing virtual appointments to new patients.
thestar

[2022-10-18] Province of PEI announces $8-million retention incentive program

In addition to filling key vacant positions throughout the system, the Government of PEI has announced over $8 million in financial incentives to encourage health care providers to continue their work. The Retention Incentive Program will provide bonuses to health care professionals in exchange for a “one-year return in service agreement.” The incentives include $3,500 for registered nurses and nurse practitioners, $3,000 for licensed practical nurses and paramedics, and $2,500 for residential care workers, home support workers, and patient care workers. The province will also launch a Retirement Retention Program providing $5,000 to retain healthcare workers who are eligible for retirement in exchange for working another year. Finally, a Priority Vacancy Program will be implemented providing a further $3,000 incentive aimed at filling about 190 key vacant positions throughout the health care system. 
cbc | news release

[2022-10-18] Expanding the role of pharmacists in Newfoundland

Last month, the Government of Newfoundland and Labrador announced a number of measures to address healthcare issues in the province. One such measure was to expand services offered by pharmacists, but the province has yet to institute this measure. A recent Newfoundland-based report projects that allowing pharmacists full scope in managing high blood pressure alone would save the province $335 million over 30 years. Another 2018 report shows that pharmacists in other provinces who treated urinary tract infections had 88.9% success rate in achieving a clinical cure. Last week, British Columbia announced an expanded role for pharmacists, including issuing prescriptions for minor ailments, prescription renewal, and the ability to administer more vaccines.
saltwire | cbc 

[2022-10-18] B.C. hospital staff being trained for active attacker scenarios

British Columbia is implementing a new hospital code—“code silver”—in the coming months to prepare staff to respond to an active attacker situation. The province will implement a two-phase training programme, the first of which will take place online beginning this month, while the second will be conducted in person and will commence in January 2023. In the event that staff identify an armed person, they must call the emergency switchboard, which will, in turn, notify emergency services and announce “code silver” on the hospital’s paging system. The response strategy is based on three tenets: “run, hide, fight.” The training will explore possible attack scenarios and will consider staff’s ethical obligations towards their patients.
abbynews

[2022-10-17] Wait time trackers not the solution to overcrowded emergency rooms

Lakeridge Health in Durham Region, Ontario, has launched a wait time tracker for emergency room waits, but acknowledges that the online tracker does not address the root causes of the wait times. Natalie Mehra, Executive Director of the Ontario Health Coalition, suggests the current wait times are linked to the “staffing crisis.” While Ontario’s Plan to Stay Open will add up to 6,000 more health care workers, advocates say that the province will be “50,000 staff short.”  One solution, Mehra suggests, is to launch a recruitment strategy with financial incentives to bring back retired staff for four or five years in order to train new staff to replace them; another is to repeal wage restraint legislation Bill 124.
toronto.citynews (video) | toronto.citynews (article) | cbc

[2022-10-17] Saskatchewan Health Authority posts 175 full-time health care positions to address rural and remote staffing challenges 

The Saskatchewan Health Authority has posted 125 new, full-time, front-line healthcare positions in rural and remote communities to address staffing shortages. Over 50 existing part-time positions have also been enhanced to full-time. The province said creating and enhancing the positions is a “key pillar” in its Health Human Resources Action Plan. The positions span 49 communities across the province and include registered nurses, registered psychiatric nurses, licensed practical nurses, continuing care aids, medical radiation technologists, medical lab assistants, and combined lab and x-ray technicians. The Saskatchewan Union of Nurses said recruitment is just one step the province needs to take to solve the issue in health care fully. SUN president Tracy Zambori also notes that “retention is an issue” and that work must be done to “find out why people are leaving the system.”
regina.ctvnews | globalnews | news release | thestarphoenix

[2022-10-14] British Columbia health care workers ratify provincial collective agreement

On September 1, following 65 days of bargaining, a group of nine unions representing more than 60,000 hospital and long-term care workers, reached a tentative agreement with the Health Employers Association of British Columbia. The new three-year collective agreement, effective April 1, 2022 to March 31, 2025, has now been ratified by a vote of 64%. The agreement includes general wage increases (an initial $0.25/hour; a further 3.24% in year one; a minimum 5.55% in year two; and a minimum 2% in year 3), cost of living adjustments, new and improved premiums and allowances, and additional resources to address the impact of wage cuts on pay equity. There are also provisions to address serious staffing shortages and turnover in the sector, including a commitment to add an additional 9.25 million hours of staffing. Finally, there will be more access to training and education, improvements to safety in the workplace, and new language to foster greater inclusion and diversity in the workplace.
HEU press release | Details of Agreement | HEABC press release | nationalpost

[2022-10-14] Charges laid in Ottawa under new crime of harassing a health worker

Bill C-3, An Act to amend the Criminal Code and the Canada Labour Code, was passed in December 2021, making it a crime to intimidate health workers in delivering care. New charges under this legislation were made yesterday when Ottawa police issued a warrant for the arrest of an individual in relation to multiple threatening phone calls made to an Ottawa-based physician. The physician says that she was threatened after appearing on a national television show advocating for people to keep wearing masks. The individual in question is charged with “harassing communication, harassment by repeated communication, and mischief and intimidation of a health service.” According to criminal defence lawyer Michelle Johal, there are no reported decisions interpreting the charge. “This is a new amendment to the criminal code,” she says, “so if there were a conviction,” it could constitute “a precedent.”
nationalpost  | cbc | ottawacitizen | torontostar

[2022-10-13] Nova Scotia makes new investments to retain doctors, improve primary care

The Nova Scotia Government is investing $6.3 million over the next four years to increase access to primary health care in the province. The funding will help new medical school graduates and doctors willing to move to the province establish new practices at Dalhousie University Family Medicine Clinics. The funding also provides new doctors with mentorship opportunities and administrative support. After a period of one year, “doctors will be supported in transitioning to their own practice and will maintain their roster of patients.” The province will also launch a new collaborative care model, which involves a team of physiotherapists, pharmacists, nurses, and occupational therapists to care for patients with chronic diseases, allowing doctors and nurse practitioners to dedicate more time to new patients. 
press release | globalnews | thestar | globalnews (video) | halifaxexaminer | halifax.citynews

[2022-10-13] Manitoba Nurses Union issues ‘S.O.S.’ for Winnipeg hospital’s ICU

According to the Manitoba Nurses Union (MNU), a wave of resignations has left Winnipeg’s Grace Hospital’s intensive care unit “chronically short” with one nurse for every three patients. Normally, the level of care is one nurse for every ICU patient. Thirteen nurses have left the hospital since the beginning of the summer. The MNU said shortages are widespread in Manitoba, leaving nurses overworked and stressed out. “We are seeing nurses leave facilities, leave the province or leave the profession,” explains Darlene Jackson, the President of the MNU, and “there are not enough nurses in the system to go around anymore.”
winnipegfreepress | globalnews

[2022-10-12] How to fix Canada’s nursing crisis

The National Post provides a comprehensive assessment of the current state of nursing in Canada and offers suggestions for addressing these issues. It also provides valuable historical context by noting that the nursing crisis did not originate in the pandemic, but that it is a result of the “devastating nursing layoff[s]” and the restructuring practices of the 1990s that forced hospitals to operate at capacity. The article explains that the additional demand placed on nurses during the pandemic, coupled with poor working conditions, inflexible policies, and the lack of incentive embodied in legislation such as Bill 124 have led to further attrition and to the current nursing crisis. 
nationalpost

[2022-10-12] Interest Arbitration Award between the Participating Nursing Homes and SEIU

On October 2, 2022, Arbitrator John Stout issued a central arbitration award between 92 long-term care home employers and 1 retirement home employer and the Service Employees International Union, Local 1 (SEIU), renewing the parties’ collective agreements from 2022 to 2024. The award between SEIU and the Participating Homes is recognized as a “pattern setting” award and is referred to as the “SEIU Master.” The SEIU represents approximately 14,000 employees, the majority of whom are RPNs, PSWs and Nurse’s Aides. Employees belonging to the nine not-for-profit homes are subject to the 1% general wage increase specified by Bill 124. The remaining employees at for-profit homes were awarded 3% wage increases in each of the two years. The award also increased shift and weekend premiums for all employees, included new provisions for self-isolation, made adjustments to mental health, vision, and paramedical benefits, and added a new letter of understanding regarding diversity and inclusion.
canlii 

[2022-10-11] Exploring the critical gaps in Canada’s health workforce planning

Dr. Ivy Bourgeault, director of the Canadian Health Workforce Network, was recently interviewed on KevinMD regarding her 2021 article “The pandemic exposes critical gaps in Canada’s health workforce planning.” Dr. Bourgeault explains that health worker burnout and workforce attrition are two significant effects of the pandemic. She notes that the solutions should be based on “timely and relevant health workforce data,” and that they should be both reactive and proactive, addressing issues of retention and recruitment. Dr. Bourgeault proposes that registry data from regulatory authorities be mapped to more “nimble survey data,” such as Canada’s Labour Force Survey, to create a standardized body of information that can guide “interprofessional and inter-jurisdictional planning.”
KevinMD – Podcast  | KevinMD – Article

[2022-10-11] Emergency room at Ontario hospital closing until December due to staff shortage

The South Bruce Grey Health Centre (SBGHC) has announced the closure of the Emergency Department at its Chesley site until December 2 due to a “critical shortage of nurses.” The shutdown follows a number of recent temporary emergency room closures at hospitals across Ontario due to lack of staff, which is affecting rural hospitals disproportionately. SBGHC notes that it is actively recruiting nurses, but that the pool is limited due to a province-wide nursing shortage. In a related press release, ONA responded that announcements of ER closures are becoming all too common and that they must not be accepted “so casually” by the government.
SBGHC news release | thestar | ONA’s press release

[2022-10-07] ‘We have to stop the bleeding’: Recruitment and retention must go hand in hand

On Wednesday, the government of Newfoundland and Labrador announced a series of one-time financial incentives to expatriate doctors, nurses, and paramedics who are willing to return to and take up their practice in the province. Yvette Coffey, the president of the Registered Nurses’ Union, responded that one of the main challenges of the province’s health care system is retention, and that Newfoundland and Labrador needs to invest “in the people who are holding the system together.” Coffey adds that while the Come Home Year 2022 Incentive “is a positive signal,” it does not address the issues health care workers currently face regarding compensation and working conditions.
saltwire | halifax.citynews

[2022-10-07] Alberta, Philippines reach agreement to recruit more nurses to the province

The Alberta government announced that it has signed a memorandum of understanding with the Philippines to bring more registered and licensed practical nurses to the province in response to the current staffing crisis. As a result of this agreement, the Alberta government will provide financial and educational assistance to incoming nurses, as well as streamlining assessment and licensing programs. It is also considering the establishment of an Alberta-accredited nursing program in the Philippines.
cbc

[2022-10-06] BC Nurses’ Union holds demonstration in downtown Vancouver to sound alarm over system in crisis

Hundreds of members of the British Columbia Nurses’ Union (BCNU) took part in a Vancouver rally on Wednesday to raise awareness about the health care crisis in the province. The union’s collective agreement with the province expired in March and the timing of the rally coincides with its bargaining conference. Aman Grewal, President of the BCNU, told Global News that “nurses are working short staffed constantly” and that “they have extremely high nurse-patient ratios.” The BCNU is asking the government to include them in the province’s health human resources plan, noting that more needs to be done to address the nursing shortage.

bcnu | globalnews | dailyhive

[2022-10-06] Ontario hiring 225 nurse practitioners in the long-term care sector 

The Ontario Government has announced that it is investing $57.6 million over the next three years to recruit and retain 225 Nurse Practitioners (NPs) in the long-term care sector. As part of the program, long-term care homes can request funding for eligible employment expenses, including salary, benefits, and overhead costs, for newly hired NPs. The funding also provides up to $5,000 in relocation support for NPs who are hired to work full-time in rural communities for a minimum of 12 months of service. The Ontario Nurses’ Association responded that, “while [the program] is a start,” the timelines for its implementation “can and should be accelerated” and that there are “far too few [NPs] to meet the needs of Ontario’s 627 long-term care homes.”

ottawa.citytv | press release | ona

[2022-10-05] Nurses’ unions bring concerns of frontline nurses to the Prime Minister

The CFNU, along with eight leaders from provincial nurses’ unions, met on Monday with Prime Minister Justin Trudeau, Minister of Health Jean-Yves Duclos, and Minister of Seniors Kamal Khera to address nursing shortages. The purpose of the meeting, which took place at the Prime Minister’s office, was to seek “federal leadership on a pan-Canadian action plan,” with a specific focus on “retention, return and recruitment” based on long-term funding and accountability.
cfnu

[2022-10-05] Grievor’s termination for neglect upheld by Arbitrator

The grievor was employed as an RN at a long-term care home in Ontario. His employment was terminated in connection with two incidents, both of which were deemed to be neglect of residents in violation of the employer’s policies. A grievance alleged that the termination was without just cause. The Arbitrator found that the grievor’s misconduct warranted significant discipline and that his failure to provide the necessary care to the two residents met the standard of neglect. The Arbitrator dismissed the grievance, finding that the employer had just cause for termination.  
canlii

[2022-10-04] Female doctors in Ontario earn 34% less on average, even in fields they dominate

According to a Globe and Mail analysis of 2020-2021 OHIP physician billing, female doctors in Ontario made less on average than their male counterparts in 35 medical specialties, even where female practitioners outnumbered male practitioners. The analysis also shows that among the 35 specialties, those male-dominated were paid the highest, while female-dominated specialties were among the least lucrative. The overall gender wage gap, regardless of speciality, was 34%, with male doctors earning an average of $405,814 and women earning $265,983.

globeandmail

[2022-10-04] Ontario needs more primary-care practitioners, province’s COVID-19 advisory table says

The Ontario COVID-19 Science Advisory Table has released its final three briefs. The briefs include the roles of Ontario family doctors in the first two years of the pandemic; the factors affecting primary care capacity for pandemic response and recovery; and the lessons policy-makers should heed to strengthen primary care as the pandemic evolves. Findings conclude that people who had a formal relationship with a primary care provider or team of providers “had a better experience of care all through this pandemic” and that, in general, “teams [of practitioners] were better able to respond than people working as solo practitioners.” The Table suggests primary care teams be expanded to include pharmacists, physician assistants, social workers, and community health worker.

cbc | sciencetablepart1 | sciencetablepart2 | sciencetablepart3 

[2022-10-03] Some sectors in Canada are seeing a wave of retirements. Burnout might be why

A recent analysis by the Canadian Centre for Policy Alternatives reveals the unusual rise in retirements in Canada’s health care industry. In April 2022, Canada had 19,000 excess retirements in health care than in April 2021, with the number of retirees almost doubling from 28,000 to 47,000. This spike “likely means there is a wave of highly skilled nurses leaving the profession, perhaps due to burnout.” Another feature of the Canadian retirement wave is that a surprising number of relatively younger workers (55-59) are choosing to leave the workforce, hinting at “other reasons for retirement—like burnout or frustration with provincial government policies that make good jobs, such as teaching and nursing, impossible jobs.” Approximately 66% of the total excess retirements were in Ontario, which is relevant against the backdrop of Bill 124.
globalnews | monitormag

[2022-10-03] Inside ERs at a breaking point, staff provide care while juggling shortages and closures

According to the CBC, “an unparalleled wave of staff shortages” in health care is reaching a breaking point in Ontario, with 18 hospitals in the province experiencing ER interruptions since June due to a lack of nurses. OCHU/CUPE states that 46,000 hospital staff need to be hired in Ontario just to deal with staff turnover, hospital job vacancies, the impact of the pandemic, and the increased needs of an aging population. Staffing challenges affect large acute-care academic hospitals, such as the Kingston Health Sciences Centre, but are even more pronounced in rural Ontario. Organizations such as the Ontario Medical Association and Canadian Medical Association are calling for systemic solutions to reduce the strain. These solutions would include increasing the number of health-care workers through strategies such as licensing more foreign-trained physicians and the creation of a national physician licence.
cbc