Don’t privatize our health professionals

“New doctors are passionately committed to working in, and preserving and enhancing, a universal one-tier accessible comprehensive public medicare system, one in which all Canadians have equal access to physician, hospital and other”

From: Canadian Association of Interns and Residents, Presentation to the Romanow Commission

By the Numbers

Doctor and nurse shortages: Privatization isn’t the answer

When you can’t find a family doctor in your community, or if you’re a hospital patient waiting for care from a desperately overworked nurse – then you understand the importance of finding solutions to Canada’s shortage of doctors and nurses. But allowing more private health care facilities and services won’t fix the shortage of health professionals. In fact, it will make it worse.
All private for-profit health services need nurses, doctors and other health professionals. They turn to the same nurses and doctors who work in the public health system and “poach” them to serve people who can afford to pay for private services. Because the private system charges more for its services, it often can pay more for health professionals.

This “poaching” of health professionals who have been trained by the public health system means that there are fewer doctors, nurses and other professionals available to rest of us. Wait times grow longer for family doctors and specialist; hospital nursing care is stretched by too few resources; and everyone suffers – except the wealthy who can afford to pay for expensive, private services.

Is there really a shortage?

When we think of health care professionals, we usually think first of doctors and nurses. But there are more than 1.5 million people who keep our health care system going. Doctors make up only about 8%; nurses make up about 35% – including registered nurses and licensed practical nurses. The rest is made up of physiotherapists, home care workers, chiropractors, lab employees, imaging technologists and a whole range of skilled people who help us to stay well or get better. Shortages in any of these areas have an impact on the whole health care system.

The most talked-about shortages are doctors and nurses.

By the year 2012, it is estimated that we will need 5,200 more family physicians to care for the 4.6 million more Canadians – including those who currently don’t have a family doctor - who will need care.

Within 10 years, we will be short more than 100,000 nurses to care for the demands of an aging population.

Why are there shortages?

Throughout the early 1990s, governments believed we were training too many nurses and doctors. So there were cutbacks in enrollment in medical and nursing schools, as well as federal cutbacks in funding for health care and post-secondary education.
Cutbacks also meant that we didn’t have enough money to hire the faculty to train incoming students, so even when there were places for students, there were no teachers to train them.

So we just didn’t train enough doctors and nurses to meet our needs. And we added extra demands to the work load of doctors and nurses already in the system. Our doctors and nurses are working longer and harder to meet the increasing demands of an aging population and more complex diseases and treatments. And our doctors and nurses are burning out. Three out of ten graduating nurses either leave Canada or leave nursing within five years. Almost half of all nurses retire before age 65. Those who stay face heavier work loads and more paperwork.

And they themselves are aging. The average age of our doctors now is 50; our nurses are on average 5 years older than most in the workforce.

The problems that created shortages in our nurses and doctors also created shortages in many other health professionals. Shortages are only part of the problem.

It’s not just that we have fewer health professionals, it’s also that we don’t have them where we need them. There are wide discrepancies between provinces and between rural or remote and urban communities.

It is harder for those living in rural or remote communities to be assured access to medical care than it is for those living in urban centres, where most doctors and nurses prefer to locate.

Why privatization won’t help

Privatizing health services and allowing more services offered through pro-profit companies won’t help the shortage of medical professionals.

In fact, it will make it worse.

Private services don’t train health professionals – they take them from the public system. Every doctor, nurse or other health care worker who leaves the public system for private for-profit clinics means one less for the public system that cares for most of us.
When health care professionals leave for private for-profit clinics:

• Shortages of professionals get worse
• Waiting lists get longer
• Fewer nurses in hospitals and medical centres
• Increased workload on those who stay in the public system
• Higher costs as public system tries to retain staff by competing with private salaries
• More reliance on internationally trained Professionals

This means that Canada is “poaching” doctors from countries that desperately need trained professionals to maintain their own health care systems.

Health care should be based on need, not on ability to pay – it’s one of the strongest beliefs of most Canadians. Our public health care reflects our Canadian values of equality and fairness. We want all Canadians to get access to quality and timely care – not just those who can afford to pay out of their own pockets.

Don’t privatize our health professionals [272 kb]