Canada - World Health Organization Regional Office for Europe

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