A path to improved health workforce planning, policy & management in Canada: The critical coordinating and convening roles for the federal government to play in addressing 8% of its GDP
DOI:
https://doi.org/10.11575/sppp.v14i1.74064Abstract
The goals of a health workforce system are to develop, deploy and sustain an integrated and collaborative network of health workers that is equipped with the necessary skills, supports, incentives, and resources to provide quality care that meets all population health needs in an acceptable, equitable and cost-effective manner. This requires robust data and evidence. A key problem in Canada is that it lags behind comparable OECD countries in terms of health workforce data and digital analytics. As a result, health workforce planning here is ad hoc, sporadic, and siloed by profession or jurisdiction, generating significant costs and inefficiencies for all involved. Health workers in Canada account for more than 10% of all employed Canadians and over 2/3 of all health care spending which amounted to $175 billion in 2019, or nearly 8% of Canada’s total GDP.[i]Recognizing these facts, supporting strategic health workforce planning, policy and management ought to be key priorities for federal and provincial/territorial governments and other health care organizations.
Across all the different stakeholders that make up the complex adaptive health workforce system in Canada, we lack a centralized and coordinated health workforce data, analytics, and strategic planning infrastructure, a neglect that has been readily acknowledged for over a decade. The significant gaps in our knowledge about the health workforce have been exposed during the COVID-19 pandemic causing critical risks for planners to manage during a health crisis. The time is ripe for the federal government to take on a coordinating leadership role to enhance the data infrastructure that provinces, territories, regions, and training programs need to better plan for and support the health workforce.
Efforts should centre on three key elements that will improve data infrastructure, bolster knowledge creation, and inform decision-making activities:
- A new data standard and enhanced health workforce data collection across all stakeholders
- More timely, accessible, interactive, and fit-for-purpose decision support tools
- Capacity building in health workforce data analytics, digital tool design, policy analysis and management science.
This vision requires an enhanced federal government role to contribute resources to coordinate the collection of accurate, standardized, and more complete health workforce data to support analysis across occupations, sectors, and jurisdictions, with links to relevant patient information, healthcare utilization and outcome data, for more strategic fit-for-purpose planning at the provincial, territorial, regional, and training program levels.
In this paper, a proposed vision for enhanced federal support to data-driven and evidence informed health workforce planning, policy and management is presented. First, two data infrastructure and capacity building recommendations include:
- the federal government should create through a specially earmarked contribution agreement with the Canadian Institute for Health Information a Canadian Health Workforce Initiative dedicated to the necessary enhancement of standardized health workforce data purpose built for strategic planning purposes and associated decision-making tools for targeted planning.
- In addition to the need to build better data, digital tools, and decision-support infrastructure, there is a parallel need to build the human resources capacity for health workforce analytics. Through a special CIHR-administered fund to build health workforce research capacity, this could include a Strategic Training Investment in Health Workforce Research and a complementary Signature initiative to fund integrated research projects that cut across the existing Scientific Institutes.
Building on these two necessary but insufficient building blocks, three options for a coordinating pan Canadian health workforce organization could include one of the following:
- The federal government could create a dedicated Health Workforce Agency of Canada with an explicit mandate to enhance existing health workforce data infrastructure and decision-support tools for strategic planning, policy, and management across Canada.
- The federal government could support through a contribution agreement the creation of an arm’s length, not-for-profit organization, Canadian Partnership for Health Workforce, as a steward of a renewed health workforce strategy and to provide health labour market information, training, and management of human resources in the health sector, including support for recruitment and retention.
- The federal government could support the creation of a more robust, transparent, and accessible secretariate for a Council on Health Workforce, Canada to improve data and decision-making infrastructures, bolster knowledge creation through dedicated funding and policy to inform decision-making and collaborate on topics of mutual interest.
Because of the importance of the health workforce to Canada’s economy and pandemic recovery, a sizeable and sustained investment over the course of at least 10 years is needed to build the necessary infrastructure for better decision-making.
In addition to building a more robust health system for Canada’s post pandemic recovery, these actions would align with the World Health Organization’s Global Strategy on Human Resources for Health (2016) which encourages all countries (including Canada) by 2030 to have institutional mechanisms in place to effectively steer and coordinate an inter-sectoral health workforce agenda and established mechanisms for HRH data sharing through national health workforce accounts.
[i] In 2019, healthcare constituted 11.5% of GDP. Although the data are not readily available for the full costs of the health workforce, it is generally accepted that approximately 70% of health care costs are the costs of labour; 70% of 11.5 is 8.05.
Downloads
Published
Issue
Section
License
The following is the copyright statement of SPPP.
Copyright © <Author name> <year>. This is an open-access paper distributed under the terms of the Creative Commons license CC BY-NC 4.0, which allows non-commercial sharing and redistribution so long as the original author and publisher are credited.
Publication Copyright and Licensing
The following guidelines and information, provided in six sections, are intended for authors (the “Author”) who are invited to write a paper (the “Work”) for The School of Public Policy Publications (the “Publisher”). The rights and responsibilities conveyed in the SPP Author Agreement will only apply once your paper is accepted for publication. At that point in the publication process, you will be asked to download the form and return a signed copy via e-mail to spppublications@ucalgary.ca. Please review the below information to ensure agreement with SPPP policies.
Section 1: Author’s Grant of Rights
In consideration of the Publisher’s agreeing to publish the Work in The School of Public Policy Publications, the Author hereby grants to the Publisher the following:
1.1 The irrevocable, royalty-free right to publish, reproduce, publicly display, publicly perform and distribute the Work in perpetuity throughout the world in all means of expression by any method or media now known or hereafter developed, including electronic format;
1.2 The irrevocable, royalty-free right to use the Author’s name and likeness in association with the Work in published form and in advertising and promotional materials related to the Work; and
1.3 The irrevocable, royalty-free right to license others to do any or all of the above.
Section 2: Prior Publication & Publication by Others
2.1 The Author agrees not to publish the Work, or authorize any third party to publish the Work, either in print or electronically, prior to publication of the Work by the Publisher.
2.2 The Author agrees not to publish the Work in any publication outlet which is substantially similar to The School of Public Policy Publications for a period of six (6) months after publication of the Work in The School of Public Policy Publications. Substantially similar is defined as a non-subscription, open-access publication outlet with a similar mandate/vision and intended audience.
2.3 Should the Author publish or distribute the Work elsewhere at any time or in any alternate format, the Author agrees to contact The School of Public Policy Publications to inform them of the subsequent publication.
2.4 Should the Author publish or distribute the Work elsewhere at any time or in any alternate format, the Author agrees to make reasonable efforts to ensure that any such additional publication cites the publication in The School of Public Policy Publications by author, title, and publisher, through a tagline, author bibliography, or similar means. A sample acknowledgement would be:
“Reprinted with permission from the author. Originally published in the The School of Public Policy Publications, http://www.policyschool.ca/publications/.”
Section 3: Editing and Formatting
The Author authorizes the Publisher to edit the Work and to make such modifications as are technically necessary or desirable to exercise the rights in Section 1 in differing media and formats. The Publisher will make no material modification to the content of the Work without the Author’s consent.
Section 4: Author’s Ownership of Copyright and Reservation of Rights
4.1 Nothing in this agreement constitutes a transfer of the copyright by the Author, and the copyright in the Work is subject to the rights granted by this agreement.
4.2 The Author retains the following rights, including but not limited to, the right:
4.2.1 To reproduce and distribute the Work, and to authorize others to reproduce and distribute the Work, in any format;
4.2.2 To post a version of the Work in an institutional repository or the Author’s personal or departmental web page so long as The School of Public Policy Publications is cited as the source of first publication of the Work (see sample acknowledgement above).
4.2.3 To include the Work, in whole or in part, in another work, subject to Section 2 above and provided that The School of Public Policy Publications is cited as the source of first publication of the Work (see sample acknowledgement above).
4.3 The Editors and Editorial Board of The School of Public Policy Publications requires authors to publish the Work under a Creative Commons Attribution-NonCommercial 4.0 International licence (CC BY-NC 4.0). This license allows others to distribute, remix, tweak, and build upon the Work for noncommercial purposes, and ensures the Author is credited for the original creation. This onward licensing is subject to section 2.4 of this agreement, which further ensures that the original publisher is credited.
Section 5: Author’s Warranties and Undertakings
The Author warrants that:
5.1 The Author is the sole author of the Work, or if a joint author, the Author has identified within the Work the other authors, and holds the copyright, either solely or jointly, and has the power to convey the rights granted in this agreement.
5.2 The Work has not previously been published, in whole or in part, except as follows:
5.3 Any textual, graphic or multimedia material included in the Work that is the property or work of another is either explicitly identified by source and cited in the Work or is otherwise identified as follows:
5.4 To the best of the Author’s knowledge, the Work does not contain matter that is obscene, libelous, or defamatory; it does not violate another’s civil right, right of privacy, right of publicity, or other legal right; and it is otherwise not unlawful.
5.5 To the best of the Author’s knowledge, the Work does not infringe the copyright or other intellectual property or literary rights of another.
5.6 The Author will indemnify and hold Publisher harmless against loss, damages, expenses, awards, and judgments arising from breach of any such warranties.
Section 6: The Reuse of Third-Party Works
The Publisher requires that the Author determine, prior to publication, whether it is necessary to obtain permissions from any third party who holds rights with respect to any photographs, illustrations, drawings, text, or any other material (“third-party work”) to be published with or in connection with your Work. Copyright permission will not be necessary if the use is determined to be fair dealing, if the work is in the public domain, or if the rights-holder has granted a Creative Commons or other licence. If either the Author or Publisher determines for any reason that permission is required to include any thirdparty work, the Author will obtain written permission from the rightsholder.