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International Mobility of Health Professionals and Health Workforce Management in Canada: MYTHS AND REALITIES

Auteur : Dumont Jean-Christophe, Zurn Pascal, Church Jody ...[et al.]
Date de publication : 16/10/2008
Type : Etude
Thème : Santé
Couverture : Canada

Résumé/Sommaire :

This report examines the role played by immigrant health workers in the Canadian health workforce but also the interactions between migration policies and education and health workforce management policies.

Migrant health worker makes a significant contribution to the Canadian health workforce. Around 2005-06, more than 22% of the doctors were foreign-trained and 37% were foreign-born. The corresponding figures for nurses are close to 7.7% and 20%, respectively. Foreign-trained doctors play an important role in rural areas as they contribute to filling the gaps. In most rural areas, on average, 30% of the physicians were foreign-trained in 2004.

Over past decades the evolution of the health workforce in Canada has been characterised notably by a sharp decline in the density of nurses and a stable density of doctors, which is in contrast with the trends observed in other OECD countries. This evolution is largely the result of measures were adopted at the end of the 1980s and early 1990s in order to address a perceived health workforce surplus. During that time, substantial public spending cuts in the health sector, anticipated cuts in medical and nursing school enrolments, and large layoffs of nurses also took place. In addition more restrictive immigration policies were adopted for doctors and nurses between 1986 and 2002 and more stringent registration procedures were introduced for foreign-trained health professionals.

More recently, concerns about health workforce shortages arose and various measures were adopted to expand and strengthen health workforce supply. This includes larger investment in nursing and medical education, the development of new models of care, a set of policies to improve retention, particularly for nurses, increases in the number of residency positions in family medicine, and the development of the Pan- Canadian Health Human Resources Strategy. Also, migration policies for doctors and nurses became more favourable. Between 2002 and 2006, permanent migration of doctors tripled and temporary migration increased by more than 10%, while for nurses, permanent migration increased by almost 40% and temporary migration decreased by 35%. In addition, significant efforts have been devoted at both the federal and the provincial level to address the barriers and facilitate the licensure process of internationally educated health professionals. Over time the origin countries of migrant health workers changed considerably. The United Kingdom has become less important and source countries like South Africa for doctors and the Philippines for nurses have gained importance.

While, a growing consensus is emerging for achieving greater health workforce self-sufficiency, this objective should be interpreted in the light of the role that migration plays in building Canadian society. Building a sustainable health workforce requires long term financial commitments, continuous monitoring of the health labour market, and coordination between all stakeholders and paying particular attention to policy response processes.

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