Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
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<strong>Health</strong> systems in transition <strong>Canada</strong> 89<br />
4.2 Human resources<br />
4.2.1 <strong>Health</strong> work<strong>for</strong>ce trends<br />
During the past decade, P/T government decision-makers throughout <strong>Canada</strong><br />
have expressed concerns about health human resource shortages, in particular<br />
doctors and nurses. In response, these governments implemented policies to<br />
increase educational enrolments as well as recruit professionals from outside<br />
their respective jurisdictions and from other countries. This shift contrasts<br />
with the period in the early to mid-1990s when governments were concerned<br />
about surpluses and actively worked with the professions and postsecondary<br />
institutions to curtail the supply of both physicians and nurses as well as reduce<br />
the number of new entrants into these professions (Tuohy, 2002; Chan, 2002a;<br />
Evans & McGrail, 2008).<br />
At a minimum, these ef<strong>for</strong>ts have produced higher health sector remuneration<br />
and inflation (CIHI, 2011b). They are also increasing the per capita supply of<br />
nurses and doctors. However, it is important to note that while doctor density<br />
surpassed 1990 levels by 2009, nurse density continued to decline substantially<br />
after 2000, and had not recovered to 1990 levels even by 2009 (see Table 4.7).<br />
Table 4.7<br />
Practising health professionals in <strong>Canada</strong> per 1 000 population, selected years,<br />
1990–2009<br />
1990 1995 2000 2005 2009<br />
Nurses 11.10 10.89 10.13 8.71 9.39<br />
Primary care doctors 1.06 1.03 1.00 1.04 1.12<br />
Medical group of specialists 0.41 0.43 0.45 0.47 0.53<br />
Surgical group of specialists 0.34 0.33 0.34 0.33 0.36<br />
Psychiatrists 0.13 0.14 0.14 0.15 0.15<br />
Dentists 0.52 0.53 0.56 0.58 0.59<br />
Pharmacists 0.68 0.70 0.77 0.79 0.88<br />
Physiotherapists – – – 0.50 0.52<br />
Source: OECD (2011a).<br />
Other health professions were not affected by the budgetary constraints of<br />
F/P/T governments in the early to mid-1990s. Since dental care is largely private<br />
in <strong>Canada</strong>, dentists were not affected by public-sector expenditure cutting in the<br />
1990s. While prescription drugs are a mixed sector subject to both public and