High-Level Commission on Health Employment and Economic Growth
On 2 March 2016, the United Nations Secretary-General announced the appointment of a Commission on Health Employment and Economic Growth (the Commission), co-chaired by H.E. Mr. François Hollande, President of France, and H.E. Mr Jacob Zuma, President of South Africa. Dr Margaret Chan, Director-General of the World Health Organization (WHO) serve as the co-vice chair along with Mr Angel Gurría, Secretary-General of the Organization for Economic Co-operation and Development (OECD) and Mr Guy Ryder, Director-General of the International Labour Organization (ILO).
The Sustainable Development Goals(SDGs) set an ambitious agenda to improve the lives of all, including through improved health and prosperity. Recent outbreaks have additionally confirmed the urgency of building resilient health systems and strengthening global health security. Health workers and health employment reside at the heart of the SDG agenda.
The global economy is projected to create around 40 million new health sector jobs by 2030; mostly in middle- and high- income countries. Despite the anticipated growth in jobs there will be a projected shortage of 18 million health workers to achieve and sustain the Sustainable Development Goals primarily in low and lower-middle income countries.
The rising global demand and need for health workers, over the next fifteen years, presents significant challenges. Importantly, it also offers the opportunity to generate employment, in areas where decent jobs are most needed.
The Commission has been tasked with proposing actions to stimulate the creation of health and social sector jobs as a means to advance inclusive economic growth, paying specific attention to the needs of low- and lower middle income countries.
Physicians in Canada, 2015
Physicians in Canada, 2015 contains demographic information about the supply of physicians in Canada and information about the payments made to them that are administered through provincial and territorial medical care plans. Data includes the average cost per clinical service for family medicine physicians and other specialists at the national and provincial levels
Psychologists Practicing to Scope: The Role of Psychologists in Canada's Public Institutions
Within Canadian healthcare systems there is a misalignment between what regulated health providers can do by virtue of their licenses and what other legislation or regulation permits them to do within publicly funded health care systems. While current discussions around optimizing scope of practice are important in recognizing the skills and expertise of health care providers through regulationi, it is important first to create legislation and regulation that supports health care providers practicing to the scope that their licenses already permit.
For example, a psychologist in Ontario has the regulatory authority to diagnose mental illness but cannot initiate a period of mandatory supervision in the event of acute harm to self or other. Further, that same psychologist working within a publicly funded institution may not be able to initiate treatment for a mental illness they have diagnosed and have the regulatory authority to undertake.
The impact of this misalignment is not inconsiderable. Psychologists are Canada’s largest group of specialized and regulated mental health providers, outnumbering psychiatrists about 4:1. Only one-third of people in need seek and receive mental health careii; this because of stigma but also because mental health treatments provided by the public sector are in limited supply. Legislation and regulation within public health systems creates barriers and bottlenecks to accessing care; barriers which are not determined by the availability of suitably trained and regulated healthcare providers.
A great deal of attention has been paid to reducing wait times for assessment and treatment of common physical health conditions but not nearly sufficient attention has been paid to the same need when it comes to mental and behavioural health disorders. This lack of parity is especially significant in light of the facts that one in five persons will experience a mental health problem in a given yeariii and that depression will shortly become the second leading cause of disability adjusted life years worldwideiv. In Canada, mental illness costs the workplace 33 billion dollarsv and the economy over 50 billion dollars annuallyvi.
In order to understand the magnitude of the misalignment between scope and practice, the Canadian Psychological Association undertook a survey of psychology discipline chiefs and practice leaders in public institutions (hospitals, outpatient clinics and university clinics). Over forty respondents from departments across the country were asked a series of questions regarding practice privileges held by psychologists in their institutions. The intent was to assess the degree of alignment between the scope of practice of psychologists and what they are permitted to do in Canada’s public institutions.
Emergency Medicine Training & Practice in Canada: Celebrating the Past & Evolving for the Future
Postgraduate Emergency Medicine (EM) training and certification in Canada currently consists of two separate training pathways that are overseen by two autonomous national colleges. The Royal College of Physicians and Surgeons of Canada (Royal College) and the College of Family Physicians of Canada (CFPC) independently offer EM residency training programs with differing training requirements and objectives (FRCPC-EM and CCFP(EM), respectively). Each program was originally intended to fulfill differing societal and healthcare needs. In reality, the products of these training programs significantly overlap, and have evolved to meet population needs differently than their initially intended roles as outlined by the two colleges, leading to substantial debate within the Canadian EM community.
The prime objective shared by both the Royal College and the CFPC is to ensure that expert EM graduates provide high quality EM care for patients presenting to emergency departments (EDs) across Canada. The Collaborative Working Group on the Future of Emergency Medicine in Canada (CWG-EM) was constituted in 2013 to provide recommendations to the Canadian Association of Emergency Physicians (CAEP), the CFPC, and the Royal College and was composed of seven (7) members: a Chair, and two (2) members appointed by each of CAEP, the CFPC, and the Royal College. The Terms of Reference of the CWG-EM, including roles and responsibilities, membership, and decision making process, are provided in Appendix A of the final report. The following report describes the activities, findings, and recommendations of the CWG-EM, with the ultimate goal of outlining a path forward that enhances EM training and care in Canada. Informed by the past and present state of EM training and practice, the CWG-EM report is fundamentally focused on charting a course for the future of emergency medicine in Canada.
Regulated Nurses, 2015
This report highlights current trends in nursing practice in Canada across a variety of demographic, education, mobility and employment characteristics. The report highlights data from three groups of regulated nursing professions:
- registered nurses (RNs, including nurse practitioners or NPs)
- licensed practical nurses (LPNs) and
- registered psychiatric nurses (RPNs).