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HealthCareCAN‘s Election Imperative

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Paul-Émile Cloutier
President & CEO

The need to rebuild health in Canada

HealthCareCAN unites health organizations across Canada, networking their individual strengths to catalyze and capitalize on the disruptive innovation occurring in health.

There has been no greater disruptive force in health than COVID-19, and as Canada seeks to emerge stronger from the challenges thrown at us by the pandemic, a renewed healthcare and health research system will be the keys to our future success.

That is why HealthCareCAN and our member institutions from across the country believe that in this federal election Canadians want to hear from parties and candidates who are committed to charting the course forward for health.

We have some ideas, based on the frontline perspective and extensive experience of our membership. We are also ready to roll up our sleeves and help usher in a new era for Canadian health, one that acknowledges and learns from the difficult and sometimes tragic lessons learned during the pandemic.

Canada’s new era for health begins now.

We represent

  • Hospitals
  • Health research institutes
  • Health authorities
  • Canadian health sector associations

Our members by the numbers

  • 800,000 employees
  • 60,000 volunteers
  • 15,000 scientists
  • 60,000 highly skilled researchers, staff and students

Our Asks

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– 1 –

Ramp up Canadian health research and biosciences through consistent, long-term investment.

– 2 –

Build a national health workforce planning strategy.

– 3 –

Support the reimagining of older adult care with dedicated funding.

– 4 –

Better support health sector infrastructure, including for digital health and cybersecurity.

– 5 –

Act now to modernize Canada’s healthcare system.

1. Commit to consistent, long-term investments in health research and the biosciences.

The issue

Canada’s academic health sciences centres are independent, stand-alone entities and drivers of economic growth and merit being allowed to compete directly and on equal footing with other sectors for federal funding. Health research institutes are also currently unable to compete globally due to chronic underfunding by the federal government. This reduces Canada’s ability to attract and retain talent.

Both historically and during the pandemic, funding predominantly flowed to universities and private industry, not to academic healthcare organizations (AHOs) – namely healthcare delivery organizations and research institutes at the centre of the health and biosciences ecosystem.

Why it matters

  • The full potential of AHOs, and the economic benefits of the vital work they do, are not being fully realized.
  • If invested in appropriately, the health and biosciences sector will ensure a competitive advantage for Canada.
  • A robust health research ecosystem is vital to attracting and retaining top talent, securing global investments and building the knowledge-based economy of the future.

Our expectations

  • Allow academic healthcare organizations direct access to federal funding.
  • Increase investments to the level equivalent to 2 per cent of public federal spending on health ($3.7 billion)
  • Provide $103 million in funding over two years to support research initiatives and fill the gaps left by decreased charitable giving during the pandemic.
  • Provide enhanced funding to better support the national clinical trial network to advance health sciences discovery.

Lay of the land

Health research in Canada is both a major economic driver and foundational element to improved health outcomes, yet lacks a clear, coherent and strategic funding and investment plan to maximize the sector. The potential of Canada’s hospital-based research sector continues to be undermined by complex funding models and unequal access to federal innovation and funding opportunities.

Certain sources of research funding, like health charities, have seen a substantial reduction in donations due to COVID-19, forcing many charities to drastically reduce their investments in research. Canadian health research relies heavily on investment from the charitable sector, with this source of funding covering close to 40 per cent of indirect research costs for health research.

How Canada measures up in terms of % of federal health expenditures devoted to health research
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Sources: Tax Policy Centre, AAAS, AIHW, HM Treasury, CIHI, CIHR

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2. Build a national health workforce planning strategy.

The issue

Canada does not have enough healthcare workers to meet present and future demand on the health system. Factors that have contributed to this issue include a lack of training, subpar working conditions and inadequate pay.

Why it matters

  • At the end of 2020, job vacancy rates in healthcare reached a record high of 100,300, up 56.9% from 2019
  • The impacts of the pandemic, including increased stress and burnout, have led many healthcare workers to leave the sector, with many more saying they will leave once the pandemic ends.
  • Canada’s has struggled to address health workforce concerns, including shortages and high rates of mental health concerns among healthcare workers, for decades.

Our expectations

  • Create a national coordinating body to facilitate standardized data collection and strategic planning.
  • Develop and implement plans to train more healthcare workers in nursing, family practice and geriatrics.
  • Consider expanding health professionals’ scopes of practice to supplement services provided by other healthcare workers.
  • In emergency situations, work with licensing bodies to allow licensees in one Canadian jurisdiction to practice in another.

Lay of the land

In recent months, healthcare workers have been speaking out about the increased levels of stress, anxiety, depression and burnout they are dealing with. Studies from around the world, including here in Canada, back this up, showing that these issues were concerns prior to the pandemic and are being exacerbated by it.

According to Statistics Canada, more than two-thirds of the increase in job vacancies in Canada in the 4th quarter of 2020 was in health care and social assistance. While these increases were spread across all subsectors, they were led by hospitals (+15,700) and nursing and residential care facilities (+10,800).

Canadian job vacancies in the health care and social assistance sector
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Source: Statistics Canada

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3. Support the reimagining of older adult care with dedicated funding.

The issue

Canada has long struggled without a true, strategic approach to providing high-quality older adult care. Consequently, there are insufficient home care services to meet the level of need across the country, and long-term care homes were not ready for COVID-19 after years of being overlooked, underfunded and understaffed. With no care standards in place, the situation in long-term care deteriorated, leaving residents and staff vulnerable to the virus.

Why it matters

If Canada continues to turn a blind eye to the needs and challenges of providing timely access to high-quality older adult care where and when it is needed, we risk continuing to jeopardize the safety and security of Canada’s most vulnerable populations. This means:

  • Increased LTC deaths & poor health outcomes
  • Inability for seniors to receive care where and how they wish, ie. in their homes
  • Too many seniors languishing in hospital when home or long-term care would be more effective and efficient.

Our expectations

  • Fill the gaps that exist between home care and long-term care services, such as supportive housing.
  • Work with the provinces and territories to develop and implement evidence-based national standards for long-term care, with funding tied to outcomes.
  • Increase infrastructure funding so that healthcare facilities, like long-term care facilities, can be modernized and optimized for energy efficiency and climate and pandemic resiliency.
  • Support efforts to strengthen a community of practice model of care that mobilizes a connected system of providers that coalesce around the patient to provide the right services in the right setting for the right cost.

Lay of the land

Close to 70 per cent of Canada’s COVID-19 deaths have occurred in long-term care homes.

Governments failed to harness the lessons learned from the first wave of the pandemic to protect residents and staff in long-term care, resulting in an even more dire second wave for the long-term care system.

The second wave saw more homes experiencing outbreaks,
a 62% increase in the number of residents infected with COVID-19 and a higher number of resident deaths (compared with the first wave).

The pandemic has placed a heavy burden on front-line staff in LTC and retirement homes, with over 23,000 staff infected and 28 deaths since the start of the first wave.

COVID-19 deaths in LTC and retirement homes per 100,000 population during the first and second waves, by jurisdiction
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Source: CIHI

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4. Better support health sector infrastructure, including for digital health and cybersecurity.

The issue

Canada’s failure to maintain adequate capital investment in its healthcare facilities harms our environment, impacts patient care, and severely undermines our ability to sustain an innovative and technologically advanced healthcare system.

Why it matters

  • The pandemic showed how Canada’s outdated health infrastructure puts the health of Canadians at risk, including in long-term care where many facilities cannot even comply with infection prevention and control protocols.
  • In 2019, virtual care saved Canadians and the economy 11.5 million hours through people not having to take time off work to attend appointments in-person. It also resulted in a reduction of 120,000 metric tonnes of CO2 emissions.
  • Maintaining 50% of primary care visits virtual in Canada would result in projected annual savings of 103 million hours for Canadians and the economy and 325,000 metric tonnes of CO2 emissions.

Our expectations

  • Canada must expedite efforts to implement digital health infrastructure and strengthen cybersecurity to streamline the health system, support virtual care, improve access, and facilitate the safe sharing of health information.
  • With the increase of health sector cyber threats experienced during the pandemic, it is vital that cybersecurity be strengthened as part of the move toward increased digital infrastructure and virtual care
  • Federal support for healthcare infrastructure is needed to end the sacrificing of capital investments to fund operational expenses, a challenge that will grow as the healthcare needs of Canada’s growing and aging population require ongoing redirection of funds to the delivery of care.

Lay of the land

Since the November 1st, 2020, there has been an increase of over 45% in the number of attacks seen against healthcare organizations globally, compared to an average 22% increase in attacks against other industry sectors.

The average number of weekly attacks in the healthcare sector reached 626 per organization in November, compared with 430 in October.

Central Europe tops the list of regions impacted by the spike in attacks against healthcare organizations, with a 145% increase in November, followed by East Asia, which suffered a 137% increase, and Latin America with a 112% increase. Europe and North America saw  67% & 37% increases respectively.

Instances of weekly cyber attacks per Canadian healthcare organization (June 8, 2020 – July 12, 2020)
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Source: Check Point Research

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5. Act now to modernize Canada’s healthcare system.

The issue

COVID-19 exposed the fragility of our healthcare system and exacerbated long-standing system issues, like inadequate access to mental health services and the need to reimagine older adult care. The pandemic also demonstrated that all levels of government can move quickly and overcome bickering to work collaboratively to address pressing issues.

Why it matters

  • The COVID pandemic aggravated surgery and procedure backlogs, and there are likely other long-term impacts that will emerge in the coming months and years.
  • The overall performance of Canada’s health care system continues to lag internationally, ranking 10th out of 11 high-income countries in a 2021 Commonwealth Fund survey
  • The Canada Health Transfer has not kept pace with increasing healthcare costs caused by inflation, population growth, population aging, population health status, and health system improvements.
  • Provinces and territories cannot realistically shoulder increasing healthcare costs on their own.

Our expectations

  • Additional sustained federal funding for healthcare to address existing gaps and build a health system that meets the current and future needs of Canadians, especially as our population ages.
  • We need federal action, with clear commitments from candidates in all political parties standing for election, on how they intend to support innovation in our healthcare system to ensure Canada emerges stronger from the pandemic.
  • We need the next federal government to engage in constructive dialogue with provinces and territories so that the mistakes of the past waves are not repeated in the looming fourth COVID wave.

Lay of the land

Healthcare supports Canada’s a knowledge-based economy attracting top talent and global investments, and contributes $7.8 billion each year to our national economy.

As Canada moves out of the pandemic, it is vital that we use the lessons learned from COVID-19 to build a more efficient, effective and equitable health system. Canada can emerge stronger by capitalizing on our strengths in healthcare, health research and innovation, to build a more inclusive, equitable, green and resilient health system.

Canada also has a proud history of making groundbreaking healthcare discoveries that benefit the world, but we have rested on our laurels for too long. We need federal leadership and a national vision that supports innovation in healthcare to ensure that all Canadians can have timely access to high-quality healthcare when and where they need it.

Health Care System Performance Rankings 2021
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Source: The Commonwealth Fund

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