OTTAWA Integrated Local
Labour Market Plan
HEALTH CARE &
SOCIAL ASSISTANCE Sector Overview
Updated December 2011
2010 - 2012
2012
HEALTH CARE & SOCIAL ASSISTANCE Sector 1
The Ottawa Story: Health Care & Social Assistance
ISSUES & CHALLENGES: A 2006 report1 on the 10-year outlook for the Canadian labour market
stated that the largest number of occupations showing signs of shortages at the national level is found in
the health sector. Pressures are particularly acute for physicians, therapy and assessment professionals
(e.g., physiotherapists), head nurses and nurse aides. Other health occupations, such as registered
nursing assistants, audiology technicians, physiotherapy technicians and medical radiation technologists,
are also under pressure.
On the other hand, supply growth in many of these occupations has been relatively weak. Canadian
health professionals are ageing, particularly physicians and nurses. There is a 3 to 10 year time lag
between the labour market entries of health professionals into the labour market. Immigrants make up
a significant share of the Canadian health workforce, with more than 37% of all physicians and about
20% of all registered nurses being foreign-born. However, the rate of integration of foreign-trained
health professionals has decreased tremendously (e.g., foreign-trained physicians made up 30.5% of
Canadian physicians in 1980. In 2005, they made up 9%). With a large immigrant population in Ottawa
that is ageing, practitioners with multilingual skills are going to be in even more demand.
Technology is changing the way we deliver health, particularly electronic health informatics and
distribution. The top labour issues in e-health are: not enough candidates/qualified applicants;
candidates do not have the required competencies; and the compensation offered for the e-Health
position was not attractive enough. There is also a growing market for entrepreneurship in the health
sector. With an ageing population, there is immense scope for ageing products such as assistive devices,
personal support and nursing, long-term and short-term care facilities.
POTENTIAL SOLUTIONS: Exploring ways to increase access to healthcare jobs by
internationally-educated health professionals is a key strategy. Entry-to-practice rates need to be
increased substantially – and a combination of training solutions and engaging with stakeholders to
review licensing processes may be an option. Bridging programs have been set up for foreign-trained
healthcare professionals; however, licensure and employment rates have to be verified. Anecdotal
evidence suggests that although bridging programs may increase licensure rates, they do not tend to
increase employment post-licensure, thus not affecting the labour supply positively.
Considering that Ottawa is a technology hub, the city could consider playing a more strategic role in
attracting health technology businesses to the region. However, the appropriate training has to be
available, to train the next generation of e-health and health technology workers. Further,
entrepreneurship training and multilingual skill / cultural competence training has to be made available.
1 Human Resources and Skills Development Canada (2010) Looking Ahead: A 10-year Outlook for the Canadian Labour Market
(2006-2015). http://www.hrsdc.gc.ca/eng/publications_resources/research/categories/labour_market_e
/sp_615_10_06/sp_615_10_06e.pdf accessed September 20 , 2011.
HEALTH CARE & SOCIAL ASSISTANCE Sector 2
Sector Summary: Health Care and Social Assistance
The Sector Summary: Health Care and Social Assistance was further developed in October 2011 to
provide in-depth analysis of labour market issues.
Sector Highlights & Potential Actions
SECTOR OVERVIEW Over the past decade, Ottawa-Gatineau’s health
and social assistance sector has been on a steady
incline. Between 2008 and 2010, the sector added
5,100 jobs. It also fared reasonably well during and
since the recessionary period, employing 80,700
persons in March 2011. About 5.3% of the city
residents are health professionals; there are 2.65
doctors for every 1,000 people living in Ottawa
(national average is 2.2).
Ontario Job Generation/Loss Ratio
141.3 Ambulatory Health Care Services
339.0 Hospitals
265.7 Nursing and Residential Care Facilities
Ease of Labour Market Entry
Very easy entrance into labour market,
especially for hospital jobs.
KEY CHALLENGES The healthcare worker population is ageing. Between
2001 and 2006, the proportion of health
professionals in Ontario aged 55+ increased from
11.12% to 14.41% and it is expected to rise as the
population ages.
Due to long training requirements, labour supply
cannot be increased quickly; takes a longer transition
time. Skills shortages highest for Audiologists, Dental
Hygienists, Physicians, Medical Radiation Technologist,
Occupational Therapists, Pharmacists,
Physiotherapists, Registered Nurses and Respiratory
Therapists. Having French-language workers,
especially nurses, is important.
POTENTIAL ACTIONS Investigate the need for enhanced
multilingual and cross-cultural skills in the
health sector. Develop appropriate training.
Investigate the need for administrative skills
in the health sector (e.g., data entry and
note-taking skills).
Explore development of cross-disciplinary
training for emerging health technology/e-
health sector.
Explore development of ICT skills training in
health technology.
Explore development of entrepreneurial skills
for health professionals.
Explore advanced training for Personal
Support Workers.
Explore ways to increase access to
healthcare jobs by internationally-educated
health professionals. Verify the employment
rate for graduates of health bridging
programs in the Ottawa region..
KEY OPPORTUNITIES Considering Ottawa’s position as a knowledge-based
hub, e-health and health technology are emerging
professions worth exploring (roles that involve the
planning, implementation, analysis, use, and
sustainability of technologies and systems).
HEALTH CARE & SOCIAL ASSISTANCE Sector 3
Sector Overview
The Health Care and Social Assistance industry in Canada includes establishments and services such as:
Hospitals, nursing and residential care facilities and out-patient care centres;
Offices of health practitioners (i.e., dentists, doctors, optometrists and chiropractors);
Medical and diagnostic laboratories;
Home health care services;
Ambulance services;
Social assistance services (i.e., for children, youth, the elderly, families);
Community food, housing, emergency and relief services;
Vocational rehabilitation services; and
Daycare services.
Hospitals employ the largest share of employees in the health care and social assistance sector, followed
by ambulatory health care services and nursing and residential care facilities.
Figure H1: Employees in Healthcare and Social Assistance, Canada, 2007
Source: Statistics Canada, Survey of Employment, Payroll and Hours, CANSIM table 281-00242.
2 Statistics Canada (2009) The Canadian Labour Market at a Glance, 2007. http://www.statcan.gc.ca/bsolc/olc-cel/olc-
cel?catno=71-222-X&CHROPG=1&lang=eng accessed September 23, 2011.
0 50 100 150 200 250 300 350 400 450 500 550 600
Social assistance
Nursing and residential care facilities
Ambulatory health care services
Hospitals
thousands
HEALTH CARE & SOCIAL ASSISTANCE Sector 4
How easy is it for new labour to enter the health care industry?
It’s much easier than entering other industries. The Ontario job generation/loss ratio for Health Care and
Social Assistance categories are very high – between 141.3 for ambulatory health care services to 339.0
for hospital jobs3. Workers can enter this marketplace very easily as there is high demand for health
care workers.
Table H1: Health Care Job Generation Ratio, Ontario, 2001 to 2006
3-Digit NAICS Job Generation
Job Loss Generation/ Loss Ratio
621 – Ambulatory Health Care Services 37.2 26.3 141.3
622 – Hospitals 17.8 5.2 339.0
623 – Nursing and Residential Care Facilities 36.7 13.8 265.7
624 – Social Assistance 30.2 13.4 226.0
Source: Ontario Labour Market Adjustment Dynamics by Industry Sub-Sector, LEAP Data, 2001 to 2006
Ottawa’s Health Care and Social Assistance Sector
The Census 2006 classifies healthcare as the third largest sector by employment in Ottawa at 9.9%.
Employment in the healthcare and social assistance sector has increased 5.1% since 2008, compared to
a 2.8% increase in the overall services category.
Table H2: Employment (persons x 1,000) Changes, Ottawa Census Division (CD)
2008 2009 2010 Δ 2008-10
Health care and social assistance [62] 73.1 75.2 78.2 5.1
Goods-producing sector 103.8 100.9 98.6 -5.2
Services-producing sector (13) 577.1 568.5 579.9 2.8
Total employed, all industries 680.8 669.3 678.5 -2.3
Source: Statistics Canada, CANSIM Table 282-0061, Custom Tabulation.4
The Ottawa-Gatineau region is part of the Champlain Local Health Integration Network (LHIN), one of 14
LHINs across the province5. Over the past decade, Ottawa-Gatineau’s health and social assistance sector
has been on a steady incline. Between 2008 and 2010, the Health Care and Social Assistance sector
added 5,100 jobs. More recent reports show it also fared reasonably well during and since the
3 Source: Ontario Labour Market Adjustment Dynamics by Industry Sub-Sector, LEAP Data, 2001 to 2006
4 Extracted from Table 2 (section I).
5 Toward Transformation in Health: Creating an Integrated Health Service Plan in the Champlain Region (2008)
http://www.champlainlhin.on.ca accessed September 22, 2011.
HEALTH CARE & SOCIAL ASSISTANCE Sector 5
recessionary period, employing 80,700 persons in March 2011. About 5.3% of city residents are health
professionals, and there are 2.65 doctors for every 1,000 people living in Ottawa, compared to the
national average of 2.26.
Figure H2: Employment (x1000), Ottawa-Gatineau, 2000-2010
Source: Statistics Canada, Labour Force Survey, Custom Tabulation (3-month moving average,
unadjusted for seasonality, monthly x 1000 persons).
Figure H3: Employment (x1000), Ottawa-Gatineau, 2008-2011
Source: Statistics Canada, Labour Force Survey, Custom Tabulation (3-month moving average,
unadjusted for seasonality, monthly x 1000 persons).
6 http://www.moneysense.ca/2011/03/13/best-place-to-live-ottawa-gatineau/ottawageneralhospital440/
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Healthcare and Social Assistance
HEALTH CARE & SOCIAL ASSISTANCE Sector 6
Labour Demand & Supply
Ontario's 23 self-regulated health professions have governing bodies called colleges that set the
standards for skills, knowledge and behaviour for their members. These professionals make up the
labour supply or health human resources, in the province. Ottawa has a higher proportion of
professionals in the health professions, but a slightly lower than average proportion of nurses, technical
and support professions.
Table H3: Occupational Share of Labour Force
Ottawa Labour Force
Ottawa
Distribution %
Ontario Labour Force
Ontario
Distribution %
D0 Professional occupations in health 6210 1.36 71,645 1.09
D1 Nurse supervisors and registered nurses 6925 1.52 102,325 1.55
D2 Technical and related occupations in health 5145 1.13 76,580 1.16
D3 Assisting occupations in support of health services
5830 1.28 90,130 1.37
Source: Statistics Canada, 2006 Census
The Health sector is predominantly small business; however, there are some very large institutions
(hospitals for example) that are also represented. Canadian Business Patterns (Table H4) data shows
that of non-indeterminate businesses, 66% of Ambulatory Health Care Services and 33% of Nursing and
Residential Care Facilities have 1-4 employees.
Table H4: Number of Employers by Employee Size Range and 3-Digit Industry, Ottawa 2011
3-Digit NAICS
To
tal
Ind
ete
rm.
Su
bto
tal
1
-4
5
-9
1
0-1
9
2
0-4
9
5
0-9
9
1
00
-19
9
2
00
-49
9
5
00
+
621 – Ambulatory Health
Care Services 2884 845 2039 1344 437 173 58 12 9 4 2
622 – Hospitals 21 4 17 2 1 1 3 0 0 0 10
623 – Nursing and
Residential Care Facilities 259 12 247 30 52 81 39 22 13 9 1
624 – Social Assistance 538 151 387 103 86 91 73 19 12 3 0
Source: Canadian Business Patterns, June 2011.
HEALTH CARE & SOCIAL ASSISTANCE Sector 7
Table H5: Distribution of Total Employers by 3-Digit Industry, Ottawa and Ontario, 2011
3-Digit NAICS Ottawa Total
Distribution %
Ontario Total
Distribution %
621 – Ambulatory Health Care Services 2,884 5.04 36,327 4.07
622 – Hospitals 21 0.04 323 0.04
623 – Nursing and Residential Care Facilities 259 0.45 4,272 0.48
624 – Social Assistance 538 0.94 6,323 0.71
Source: Canadian Business Patterns, June 2011.
Ottawa has a higher share of ambulatory healthcare services and social assistance employers compared
to Ontario. All healthcare categories have seen an increase in the number of employers since 2008, with
nursing and residential care facilities growing over 44%. Ottawa is well-served by healthcare facilities in
relation to Ontario, and healthcare is a growing sector of Ottawa’s economy.
Table H6: Change in the Total Number of Employers, Ottawa, 2011
3-Digit NAICS Total Employers
2008
Total Employers
2011
Absolute Change
Absolute %
621 – Ambulatory Health Care Services 2,370 2,884 514 21.69
622 – Hospitals 19 21 2 10.53
623 – Nursing and Residential Care Facilities 179 259 80 44.69
624 – Social Assistance 483 538 55 11.39
Source: Canadian Business Patterns, June 2011.
Ottawa’s share of health professionals in Ontario exceeds its 6.6% share of Ontario’s population in 21 of
the 23 regulated health professions; of these, nine have good prospects for employment. This seems to
demonstrate a relatively adequate supply of professionals to the Ottawa area at the moment. The nine
professions that have good job futures include: Audiologists, Dental Hygienists, Physicians, Medical
Radiation Technologist, Occupational Therapists, Pharmacists, Physiotherapists, Registered Nurses and
Respiratory Therapists. Considering, though, the advanced age of many health professionals, it is likely
that labour supply will be under pressure in coming years.
HEALTH CARE & SOCIAL ASSISTANCE Sector 8
Table H7: Job Prospects, Share Analysis and Main Industry of Employment, Ottawa 2006-2011
Occupation (NAICS Code) Prospects 2006-2011
Ottawa %
Main Industry of Employment #1
% Main Industry of Employment #2 (>2%)
%
Specialist Physicians (3111) Good 13% Health Care and Social Assistance
99%
Medical Sonographers (3216) Good 12% Health Care and Social Assistance
96%
Respiratory Therapists, Clinical Perfusionists and Cardio-Pulmonary Technologists (3214)
Good 12% Health Care and Social Assistance
93% Retail Trade 2%
Audiologists and Speech-Language Pathologists (3141)
Good 11% Health Care and Social Assistance
75% Educational Services
25%
Dental Hygienists and Dental Therapists (3222)
Good 11% Health Care and Social Assistance
98%
General Practitioners and Family Physicians (3112)
Good 11% Health Care and Social Assistance
100%
Medical Laboratory Technologists and Pathologists' Assistants (3211)
Average 11% Health Care and Social Assistance
91% Other Professional Services
3%
Nurse Aides, Orderlies and Patient Service Associates (3413)
Average 11% Health Care and Social Assistance
96%
Physiotherapists (3142) Good 11% Health Care and Social Assistance
100%
Dieticians and Nutritionists (3132)
Average 10% Health Care and Social Assistance
75% Retail Trade 6%
Licensed Practical Nurses (3233)
Average 10% Health Care and Social Assistance
97%
Medical Laboratory Technicians (3212)
Average 10% Health Care and Social Assistance
89% Other Professional Services
4%
Optometrists (3121) Average 10% Health Care and Social Assistance
98% Retail Trade 2%
Registered Nurses (3152) Good 10% Health Care and Social Assistance
94% Public Administration
2%
Veterinarians (3114) Average 10% Other Professional Services
100% Public Administration
4%
Dental Assistants (3411) Average 9% Health Care and Social Assistance
98%
Dentists (3113) Average 9% Health Care and Social Assistance
99%
Medical Radiation Technologists (3215)
Good 9% Health Care and Social Assistance
94%
HEALTH CARE & SOCIAL ASSISTANCE Sector 9
Occupation (NAICS Code) Prospects 2006-2011
Ottawa %
Main Industry of Employment #1
% Main Industry of Employment #2 (>2%)
%
Pharmacists (3131) Good 9% Retail Trade 83% Health Care and Social Assistance
17%
Ambulance Attendants and Other Paramedical Occupations (3234)
Average 8% Health Care and Social Assistance
79% Public Administration
17%
Occupational Therapists (3143)
Good 8% Health Care and Social Assistance
98% Educational Services
2%
Chiropractors (3122) Average 6% Health Care and Social Assistance
99%
Opticians (3231) Average 6% Retail Trade 85% Health Care and Social Assistance
15%
Source: Ontario Job Futures, Ontario Ministry of Training, Colleges and Universities.
Figure H4: Trends in Health-Workers-to-Population Ratio (per 100,000 Pop), 1997 to 2006
Sources: Health Personnel Database, Canadian Institute for Health Information;
1997 to 2006 population estimates, Statistics Canada.
Some professions have been growing more rapidly than others. For example, the dietitian-to-population
ratio grew by 18.4% between 1997 and 2006, compared with a 1.3% increase for medical laboratory
technologists. The ratio of social workers to population almost doubled in the decade from 1997 to 2006
as several provinces legislated social work as a regulated health profession.
20
30
40
50
60
70
80
90
100
1997 1998 1999 2000 2001 2002 2003 2004 2005 2006
He
alth
-Wo
rke
r-to
-Po
pu
lati
on
Rat
io
(per
10
0,0
00
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on
)
Dentist Dietitian
Medical Laboratory Technologist Radiation Technologist
Pharmacist Social Worker
HEALTH CARE & SOCIAL ASSISTANCE Sector 10
Figure H5: Health Professionals by Age
Source: Health Human Resources Databases Development Project, Canadian Institute for Health Information.
Canada – and Ontario’s – healthcare workers are ageing. Over one in five Canadian physicians is over the
age of 60, and almost 30% of physicians and nurses are between the ages of 50-59 years. Occupational
therapists and physiotherapists are amongst the youngest.
Between 2001 and 2006, the proportion of health professionals in Ontario aged 55+ increased from
11.12% to 14.41% and it is expected to rise as the population ages. The median age of persons
employed in the sector also rose by almost 1.5 years during the same time period. This is predicted to
put significant stress on the healthcare sector in coming years.
Table H8 and Table H9 outline the supply of physicians and nurses to the City of Ottawa. The rate of
growth of physician supply hovers between 1 and 2% as per 2008 to 2010 changes. The City of Ottawa
also seems well-supplied with nurses relative to Eastern Ontario.
Table H8: Employment Distribution in the Health Sector by Age, Ottawa-Gatineau,
2001 & 2006
Ottawa-Gatineau Total Population 15+ yrs.
15-24 25-54 55+ Median Age yrs.
Census 2006 60,115 5,755 45,690 8,665 42.1
Percentage 100% 9.57% 76.00% 14.41%
Census 2001 52,120 4,640 41,680 5,795 40.5
Percentage 100% 8.90% 79.97% 11.12%
Source: Statistics Canada, Census 2006 and 2001, Custom Tabulation.
Percent Percent Percent Percent Percent
<30 years 30-39 years 40-49 years 50-59 years 60+ years
RN 11.2 20.9 28.4 29.8 9.7
Physicians 1.6 20.3 28.3 28.4 21.2
OT 21.9 36.1 25.5 14.0 2.4
PT 15.0 32.0 27.0 20.1 6.1
Pharm 12.6 28.5 27.2 21.6 10.0
0.0
5.0
10.0
15.0
20.0
25.0
30.0
35.0
40.0
HEALTH CARE & SOCIAL ASSISTANCE Sector 11
Table H9: Physicians, Ottawa, 2005 to 2010
Ottawa Family Physicians Specialists Total % Annual Δ
2010 1,059 1,536 2,595 1.37%
2009 1,064 1,496 2,560 2.07%
2008 1,053 1,455 2,508 - -
2005 969 1,381 2,350 - -
Source: Ontario Physician Human Resources Data Centre7.
Table H10: Regulated Nursing Workforce, by Health Region, Canada, 2009
Health Region
Population Estimate
Registered Nurses Licensed Practical Nurses
All Regulated Nurses
Direct Care
Count
Per 100,000
population
Direct Care
Count
Per 100,000
population
Direct Care
Count
Per 100,000
population
City of Ottawa 882,477 7,559 857 1,963 222 9,522 1,079
Eastern Ontario 199,061 921 463 492 247 1,413 710
Source: Canadian Institute for Health Information (2009).
Between 2005 and 2009, Canada gained just over 27,000 nurses, bringing the total regulated nursing
workforce to approximately 348,5008, an increase of 9% in the number of working nurses over five
years. In comparison, the Canadian population grew by 5% over the same period. However, when
examining the workforce of registered nurses, for which longer-term data is available, CIHI figures show
there are actually fewer registered nurses today relative to the size of the population than there were
20 years ago. In 1992, there were 824 RNs for every 100,000 Canadians, compared to 789 per 100,000 in
2009.
7Ontario Physician Human Resources Data Centre, https://www.ophrdc.org/Public/Report.aspx, accessed September 22, 2011.
8 Canadian Institute for Health Information (2010) Regulated Nurses: Canadian Trends, 2005 to 2009,
https://secure.cihi.ca/estore/productFamily.htm?pf=PFC1565&locale=en&lang=EN&mediatype=0 accessed September 23,
2011.
HEALTH CARE & SOCIAL ASSISTANCE Sector 12
Challenges & Opportunities
A 2006 report9 on the 10-year outlook for the Canadian labour market stated that the largest number of
occupations showing signs of shortages at the national level is found in the health sector. Pressures are
particularly acute for physicians, therapy and assessment professionals (e.g., physiotherapists), head
nurses and nurse aides. Other health occupations, such as registered nursing assistants, audiology
technicians, physiotherapy technicians and medical radiation technologists, are also under pressure.
Growth in demand for those occupations has been strong, due to the rising needs associated with
population ageing, increases in government funding for health care, and a high number of retirements.
On the other hand, supply growth in many of these occupations has been relatively weak. In some
areas, the lack of supply may reflect the effects of earlier deficit control decisions (including accelerated
retirements), declines in enrolments in related training programs or delays in graduation due to
lengthening course requirements. There is a 3 to 10 year time lag between the labour market entries of
health professionals into the labour market.
Table H11: Time in Post-Secondary Education to Prepare Healthcare Providers10
Provider Training Time
Family physician 9-10 years
Specialist physician 12+ years
Sub-specialist physician 13+ years
Registered nurse 4 years
Advanced practice nurse (including primary care NPs) 6 years
Registered practical nurse 2 years
Physiotherapist 4 to 6 years
Medical imaging technologist 3 to 4 years
Medical laboratory technologist 3 to 4 years
Source: Human Resources and Skills Development Data.
Further, as noted in the introduction, Ottawa is in a unique position in the province since in 2006, 37.2%
of residents were able to converse in both official languages. The 2006 Census data also revealed that
11.1% of Ottawa’s population primarily speak a non-official language at home, up from 9.5% in 1996.
The number of people facing linguistic barriers to access (non-official languages) is between 10,300 and
88,660 people in Ottawa. This impacts most sectors, but perhaps healthcare is the most critical one.
9 Human Resources and Skills Development Canada (2010) Looking Ahead: A 10-year Outlook for the Canadian Labour Market
(2006-2015). http://www.hrsdc.gc.ca/eng/publications_resources/research/categories/labour_market_e
/sp_615_10_06/sp_615_10_06e.pdf accessed September 20 , 2011. 10
Government of Ontario (2005) Laying the Foundation for Change: A Progress Report on Ontario’s Health Human Resources
Initiatives http://www.health.gov.on.ca/english/public/pub/ministry_reports/hhr_05/hhr_05.pdf accessed October 28, 2011.
HEALTH CARE & SOCIAL ASSISTANCE Sector 13
How many doctors, nurses, physiotherapists, medical laboratory technologists, mental health
workers, and other regulated and unregulated health care providers does Ottawa need now?
How many will we need in the future?
Because of the length of time it takes to educate health care providers, planners must be able to
anticipate changing population health needs and changing treatments, and forecast into the future11.
Increasing the labour supply – both by attracting and graduating more health care workers and
increasing the registration rates of immigrant health professionals – will be critical in meeting the needs
of Ottawa’s population in coming years.
Figure H6: Migrants as a Percentage of the Total Population, Canada, 2001
Source: Canadian institute for Health Information, 2008
Note: General Canadian Workforce and Selected Health Care Occupational Groups (Based on Place of Residence 5 yrs Earlier)
11
Laying the Foundation for Change: A Progress Report on Ontario’s Health Human Resources Initiatives (2005)
http://www.health.gov.on.ca/english/public/pub/ministry_reports/hhr_05/hhr_05.html accessed September 23, 2011.
0% 5% 10% 15% 20% 25% 30% 35% 40% 45%
Physicians
Pharmacists
Dental Assistants
Dental Hygienists/Dental Therapists
Dentists
Occupational Therapists
Physiotherapists
Audiologists/Speech-Language Pathologists
Medical Sonographers
Medical Radiation Technologist
Respiratory Therapists
Medical Laboratory Technicians
Medical Laboratory Technologists
Licensed Practical Nurses
Registered Nurses
General Canadian Workforce
Total Population
Intraprovincial Migrants Interprovincial Migrants
HEALTH CARE & SOCIAL ASSISTANCE Sector 14
Immigrants make up a significant share of the Canadian health workforce, with more than 37% of all
physicians and about 20% of all registered nurses being foreign-born. Figures vary significantly between
health occupations, but large contributions of foreign-born professionals are also witnessed, for
instance, for dentists and pharmacists. However, certain professions seem to be excluding foreign-
trained professionals such as such as nurses – and increasingly physicians – as the rate of integration of
foreign-trained physicians has decreased tremendously from 30.5% in 1980 to a low of 9% in 2005
(Figure H7).
Figure H7: Share of Foreign-trained Physicians in Canada, 1968-2005
Source: Canadian Institute for Health Information and OCED Data, 2008.
Note: Percentages are computed as follows: The number of foreign-trained physicians (including US trained physicians) / the
number of total "active" physicians (including physicians whose country is unknown). Data refer together to family medicine and
specialist physicians, registered on a full and temporary basis. Data exclude residents and physicians working abroad.
Entry-to-practice rates are fairly low for foreign-trained graduates and will need to be increased
substantially – and a combination of training solutions and engaging with stakeholders (to making the
process easier and more transparent, while maintaining the quality of professionals) to review licensing
processes may be an option. Bridging programs have been set-up for foreign-trained healthcare
professionals; however, licensure and employment rates have to be verified. Anecdotal evidence
suggests although bridging programs may increase licensure rates, they do not tend to increase
employment post-licensure, thus not affecting the labour supply positively. Ottawa’s population is
increasingly multicultural, and an ageing multicultural population will require healthcare workers to
have multilingual skills. Culturally competent medical care services will be important and multilingual
skills will be important for Ottawa’s healthcare workers
1965 1970 1975 1980 1985 1990 1995 2000 2005 2010
0%
5%
10%
15%
20%
25%
30%
35%
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04
Physicians Registered nurses
HEALTH CARE & SOCIAL ASSISTANCE Sector 15
Figure H8: Share of Foreign-born and Foreign-trained Health Professionals in Main Health
Occupations, Canada, 2006
Source: Statistics Canada 2006 Census, Citizenship and Immigration
12.
Note 1: Place of training refers to the place where the person obtained its most advanced degree (University degree at bachelor
level or higher). The share of foreign-trained could not be calculated for nurses because most of them do not hold a University
degree at bachelor level (more than 50% of head nurses and registered nurses and about 95% of licensed practical nurses are in
this case).
Note 2: Foreign-born data include all persons born abroad independently of their place of training and citizenship. Few foreign-
born health professionals were born abroad with the Canadian citizenship (about 270 specialists and general practitioners,
about 670 licensed practical nurses and less than 100 in other identified occupations). A non-negligible number of foreign-
trained health professionals were born in Canada (about 770 specialists, 840 general practitioners, 1500 licensed practical
nurses, 1000 dentists and 600 pharmacists).
Private Sector Innovation & E-Health
Stakeholder consultations outlined key trends that may have a significant impact healthcare. The first is
private sector innovation and service delivery. With an ageing population, there is immense scope for
ageing products such as assistive devices, personal support and nursing, long-term and short-term care
facilities. Considering that Ottawa is a technology hub, the city could consider playing a more strategic
role in attracting such health technology businesses to the region.
The second trend is electronic health informatics and distribution. Technology is changing the way we
deliver health. A Labour Market Survey e-Health Supplement13 gathered baseline data on e-Health
professions across Ontario’s hospitals.
12
World Health Organization (2008) International Mobility of Health Professionals and Health Workforce Management in
Canada: Myths and Realities http://www.oecd.org/dataoecd/7/59/41590427.pdf accessed November 30, 2011.
0%
5%
10%
15%
20%
25%
30%
35%
40%
Specialist physicians
Genreal practitioners
and family physicians
Dentists Pharmacists Head nurses and
supervisors
Registered nurses
Licensed practical nurses
Foreign-born Foreign-trained
HEALTH CARE & SOCIAL ASSISTANCE Sector 16
E-Health professions are defined as roles that involve the planning, implementation, analysis, use, and
sustainability of e-Health technologies and systems with the goal of improving health service delivery.
The use of ICT/technical skills – whether in health technology or health informatics – will be critical.
Table H12: Number of e-Health Employees by Profession
e-Health Profession FT PT
FT Casual
PT Casual
Job Sharing
Total HC
% of Employees Reported
Applications Analyst/Specialist 257 9 12 1 0 279 18.62%
Change Management Expert 5 1 0 0 0 6 0.40%
Chief Information Officer 29 2 0 0 0 31 2.07%
Chief Medical Information Officer 1 3 0 1 0 5 0.33%
Chief Technology Officer 4 0 0 0 0 4 0.27%
Clinical Information Specialist 98 10 9 0 2 119 7.94%
Clinical Systems Instructor 23 4 0 1 0 28 1.87%
Computer Support Technician 228 32 10 4 2 276 18.42%
Database Analyst 26 2 0 0 0 28 1.87%
Decision Support Analyst 96 4 2 2 0 104 6.94%
Departmental-IS Liaison 44 5 0 1 0 50 3.34%
Director of Clinical Informatics 20 0 0 0 0 20 1.34%
Director of Information Systems 38 1 0 0 0 39 2.60%
Enterprise Architect 22 0 0 0 0 22 1.47%
Help Desk Manager 14 2 1 0 0 17 1.13%
Interface/Reporting Analyst 20 0 1 0 1 22 1.47%
Manager of Applications Development 36 1 0 0 0 37 2.47%
Manager of Systems Development 10 0 0 0 0 10 0.67%
Manager of System Support 27 1 0 0 1 29 1.94%
Network Manager 29 1 0 0 0 30 2.00%
Network Technician 95 8 1 0 1 105 7.01%
Process Analyst/Re-engineering Specialist
4 0 0 0 0 4 0.27%
Program/Analyst 76 6 1 1 0 84 5.61%
Project Analyst 42 0 1 0 0 43 2.87%
Project Manager 35 2 4 1 0 42 2.80%
Other Administrative 5 0 1 0 2 8 0.53%
Other Business/Clinical 15 1 1 0 0 17 1.13%
Other Technical 37 1 1 0 0 39 2.60%
Grand Total 1336 96 45 12 9 1498 100.00%
Source: Ontario Hospitals Association, 2009.
13
Ontario Hospitals Association (OHA) (2009) 2008 Ontario Hospital Labour Market Survey: e-Health Supplement - Findings
Report http://www.oha.com/KnowledgeCentre/Library/Documents/eHealthSupplement_FINAL.pdf accessed September 27,
2011.
HEALTH CARE & SOCIAL ASSISTANCE Sector 17
Some key findings the e-Health Supplement were:
Across the 86 hospitals that answered this survey, 1498 employees were working in an e-Health role. The Champlain LHIN (Ottawa region) had the second highest proportion of employees (13.02%) working in e-Health after Toronto Central (15.69%).
Most of the reported e-Health professions are those considered to be founded in a technical discipline (65.29%). This suggests that Ontario hospitals are currently focusing on the ‘build’ of e-Health, ensuring that the hardware, software, and connections are in place to facilitate e-Health adoption.
The majority of staff members in an e-Health role are full-time regular employees (1336). It was also found that these full-time workers dedicate 1317.63 FTE hours to e-Health. The gap between head count and FTE may mean that some full-time workers have responsibilities outside of e-Health at the hospital.
For the fiscal year 2007-08, the top three pools of applicants that represented the primary sources for external hires into e-Health were:
Employees from other hospitals/health care organizations
Employees from the private sector, and
New graduates from a post-secondary educational institution.
Students who were on a co-op placement/internship/fellowship were also high on the list.
In terms of internal transfers into e-Health, the top three sources were:
Nursing,
Information technology, and
Administrative/operational support.
Allied health also ranked fairly high as a source for internal transfers.
The three most commonly cited issues that influenced the ability to find suitable human resources in the e-health sector were:
Not enough candidates/qualified applicants;
Candidates did not have the required competencies; and
The compensation offered for the e-Health position was not attractive enough.
Finally, not all healthcare jobs will be within the public health sector. As per stakeholder consultation,
private health services and independent contracting in healthcare are likely to rise. This will necessitate
training in entrepreneurship for healthcare workers.
HEALTH CARE & SOCIAL ASSISTANCE Sector 18
Potential Actions
Investigate the need for enhanced multilingual and cross-cultural skills in the health sector.
Develop appropriate training.
Investigate the need for administrative skills in the health sector (e.g., data entry and note-
taking skills).
Explore development of cross-disciplinary training for emerging health technology/e-health
sector.
Explore development of ICT skills training in health technology.
Explore development of entrepreneurial skills for health professionals.
Explore advanced training for Personal Support Workers.
Explore ways to increase access to healthcare jobs by internationally-educated health
professionals. Verify the employment rate for graduates of health bridging programs in the
Ottawa region.