HEALTHCARE

The Canadian healthcare system consists of all organizations, institutions and resources that focus their activity on maintaining and improving the health of Canadians.  This activity includes services provided in hospitals, nursing homes, residential care, out-patient care centres, medical and diagnostic laboratories, the offices of health practitioners such as dentists, doctors, optometrists and chiropractors, and public health services; disease prevention and health promotion services offered in community health centres and homecare services.

Healthcare in Canada is a shared responsibility between the federal and provincial/territorial governments.  The federal government sets standards and principles and assists in financing provincial/territorial health care services.  The provinces/territories are responsible for the administration and delivery of services.  In Alberta, the healthcare system is organized and administered by the provincial ministry of health, Alberta Health and Wellness.  All Albertans are eligible to receive medically necessary services without paying the facility or physician fees through the Alberta Health Care Insurance Plan (http://www.health.gov.ab.ca/ahcip/Ahcip.html).

The health services delivery system in Alberta is based on nine regional health authorities (RHAs) and the Alberta Cancer Board (http://www.cancerboard.ab.ca/).  The regional health authorities are responsible for all hospitals, continuing care facilities, community health services and public health programs in their region (to access the map of the RHA’s and respective links, go to http://www.health.gov.ab.ca/regions/Rha_map.html).

For a comprehensive overview of facilities and services available in each RHA’s, please access the Alberta Regional Health Authorities Directory 2005 http://www.erc.calgary.ab.ca/Web%20Directory.pdf)

Private clinics may also provide publicly-funded health services either within the parameters of the Alberta Health Care Insurance Plan or through contracts with RHA’s.

The College of Physicians and Surgeons of Alberta regulates private medical clinics that offer insured surgical services, such as cataract and general surgery.  Private health care clinics are also accountable to the Minister of Health and Wellness and to RHA’s, through the contracts they sign to cover the facility costs of insured services.  The Minister of Health and Wellness must approve any contract between a health authority and a private medical clinic.

In Calgary, healthcare services fall under the jurisdiction of the Calgary Regional Health Authority. For a complete listing of programs, services and departments, please go to: http://www.calgaryhealthregion.ca/programs/index.html.

Healthcare embraces a wide range of occupations, from the basic ones including physicians and registered nurses to so-called “allied” occupations, such as physical therapists, speech language pathologists, diagnostic medical sonographers, and pharmacists.  For a comprehensive listing of the occupations specific to Alberta’s healthcare, please access the occupational database of the Alberta Learning Information Service at http://www.alis.gov.ab.ca/occinfo.  

Naturally, remuneration, or salary/wages, is a very important element of any occupational description and can influence individual decision-making in gathering the current labour market information for the purpose of a career choice.  The following are a few examples of current salary/wage statistics for the healthcare industry in Alberta:

To access salary/wage data on other healthcare occupations, please go to: http://www.alis.gov.ab.ca/wageinfo.

As to Alberta’s physicians, they are most likely to use the traditional fee-for-service billing system rather than salaries and other payment systems.  Currently, only 9% of Alberta doctors are on salaries.  Average billing of family physicians stands at $238,182 per year and reaches $322,204 for specialists (note: billing payments to physicians do not equal income.  Billings for work completed exclude overhead costs, which are about 50% for family physicians and 75% for specialists and taxes.)  For more information about physicians’ fees and income, please go to:

http://www.albertadoctors.org → “Fees and Negotiations.”

Most of the healthcare occupations are “regulated” in Alberta, which means they are controlled by provincial law and governed by professional organizations or regulatory bodies.  The regulatory body governing the profession has the authority to set entry requirements and standards of practice, to assess applicants' qualifications and credentials, to certify, register or license qualified applicants and to discipline members of the profession.  Requirements for entry, which may vary from one province to another, usually consist of such components as examinations, a specified period of supervised work experience, language competency, etc.  To be eligible to work in a regulated occupation, a licence, certificate or registration with the regulatory body is required.  Physicians, nurses, pharmacists and medical laboratory technologists belong to regulated occupations.  For in-depth explanations of certification and licensing requirements for regulated occupations in Alberta, please go to: http://www.alis.gov.ab.ca/certinfo.

"Non-regulated" occupations in Alberta’s healthcare, such as nursing aides, medical transcriptionists or medical office assistants, do not imply a legal requirement or restriction on practice with regard to licences, certificates or registration.

Healthcare is leading Alberta’s employment growth across industries.  Current employment growth, or the rate at which the number of people employed in healthcare is expected to grow each year, is estimated at 3.4 % (compared to the average rate of 2.1% across industries).  By 2010, it is projected that over 23,000 jobs will be introduced into the provincial healthcare and social services industry.

Alberta’s healthcare industry is experiencing one of the lowest unemployment rates in the province, that is, the percentage of the labour force that is not employed but currently seeking work – 1.5 % (general unemployment rate across industries has fallen to 3.4% which is the lowest unemployment rate seen in Alberta in the last 25 years).  Many healthcare occupations are faced with increasing labour shortages.  Apart from the impact of Alberta’s robust economy and the steady creation of new jobs, the factor of Canada’s aging population is contributing significantly to the widening gap between the demand and supply of the labour force, which is demonstrated by the following trends:

·         supply of available health professionals diminishes as a large number of workers, for example, physicians and nurses, reach potential retirement age (65);

·         demand by the elderly for both active treatment and long-term care increases, which, in its turn, drives the demand for a wide cross-section of healthcare providers, especially physicians, nurses and healthcare aides;

·         Alberta’s population is growing steadily, due to the increased influx of immigrants and residents of other provinces who are attracted by the province’s strong economy and a wide range of employment opportunities.

The following are some examples of current and projected labour shortages experienced by a number of healthcare occupations:

·         DOCTORS. Alberta is presently faced with the deficit of 500 family physicians, nearly 300 specialists and over 140 surgeons.  The shortages are reaching the levels of severity in rural and remote areas of the province, especially in the Northern Lights RHA.  Across Canada, only nine percent of all doctors work in small towns while trying to serve 21% of the nation’s population.  Many provinces have created programs to attract physicians to rural areas, offering incentives such as signing bonuses, loan forgiveness and differential pay structures.  Rural Physician Action Plan, a province-wide program established by Alberta Health and Wellness, is focusing on the education, recruitment and retention of physicians for rural practice.  To find out more please access http://www.rpap.ab.ca; information about rural practice opportunities under a special “restricted” license for international medical graduates can be found at: http://www.cpsa.ab.ca/physicianregistration/registration_part5.asp.

·         NURSES. Canada’s nursing shortage is progressing to a point where a shortfall of 78,000 registered nurses (RN’s) is projected by 2011.  Within 15 years, 50 percent of employed nurses will be retiring.  In Alberta, fully 28 per cent of RN’s are over the age of 50 and significant numbers of RN’s are expected to retire over the next few years.  It is forecasted that over 600 new positions will be created each year in addition to job openings created by employment turnover.

·         PHARMACISTS. With about 3,000 practicing pharmacists in the province, there are nearly 300 vacancies in retail and hospital settings, in urban and rural locations.  It is forecasted that 50 to 80 new positions will be created each year in addition to job openings created by employment turnover.

To recognize health-related needs of Alberta’s population and to improve access to healthcare across the province, the government has recently approved the injection of $1.4 billion in funding for capital projects.  The approval means that additional bed capacity will be provided in the form of new buildings and renovations and expansion of existing facilities.  A total of at least 657 new and upgraded acute-care beds and 85 new long-term care beds will be added across the province.  To find out more about the specific initiatives in different RHA’s, please go to: http://www.health.gov.ab.ca/resources/resources_nr2005.html  → “Government takes action on wait times…”

Calgary Health Region, in particular, will receive $662 million for six projects including the new Sheldon M. Chumir Health Centre and an expansion to add 140 new beds to the Peter Lougheed Centre.  To learn about the detailed plan for growth and expansion within the Calgary RHA, please go to: http://www.calgaryhealthregion.ca/capital/.  It is predicted that by 2010, the Region will need an additional 3,000 health workers to staff its south Calgary hospital and additional 7, 700 nursing personnel to keep up with Calgary’s growing population during the next 10 years.

Current trends in the healthcare labour market and the burgeoning demand present a potential in regards to career opportunities for internationally-trained health professionals.  While the restrictiveness of regulated occupations does not presently allow for easy, quick and direct transfer and utilization of international credentials and work experiences, the funding and program-planning initiatives in the past several years have demonstrated an increased interest from the government in meeting occupational demand through the integration of immigrant healthcare professionals.  Such initiatives include:

·         Increasing the number of residency seats for international medical graduates (IMG’s) by nearly 50%, to the maximum of 42, within the annual provincial IMG residency intake (http://www.aimg.ca)

·         Implementing a new program for IMG’s to provide them with gainful employment as clinical assistant within the Calgary RHA (http://www.calgaryhealthregion.ca/ccap)

·         Continuing to provide financial support to the bridging program for internationally-trained pharmacists offered at Bredin Institute - Centre for Learning (www.bredin.ab.ca)

·         Improving language assessment for internationally-trained nurses through the introduction of the Canadian English Language Benchmarks Assessment for Nurses which was specifically designed to test language skills within a healthcare context (http://www.celban.org)

·         Providing funding to Grant MacEwan College to implement a nurse credentialing program in several locations province-wide; the program has been designed to help internationally trained nurses meet the practicum requirement and better prepare for the licensure examination (http://www.macewan.ca/web/hcs/nursec/)

·         Introducing an accelerated bridging program for internationally trained medical laboratory technologists at Northern Alberta Institute of Technology (http://www.nait.ca/programs/MTA/)