Equipment and personnel shortages add to health system woes

CMA News 2000;10(7): 3

A CIHI publication, Health Personnel in Canada, 1988 to 1997, compiled data from 400 different sources, including professional organizations, provincial and territorial governments, its own data, educational institutions and Statistics Canada. The report found that even though the number of health professionals grew from 499 603 to 547 580 over the 10-year period, the number of professionals per 10 000 population declined by 1.7%, from 185 to 182.

The Yukon/Northwest Territories, Newfoundland and New Brunswick had higher rates of growth in the number of health professionals than population and saw the highest increase in the number of health professionals per 10 000 population (43.8%, 22.4%, and 15.5%, respectively).

Ontario, Alberta and British Columbia experienced moderate growth in the number of health professionals and a more significant increase in population, resulting in a decrease in the number of health professionals per 10 000 population (7.6%, 11.3% and 6.5%, respectively).

"There is a serious shortage of many kinds of physicians right now, not only in rural and remote areas, but increasingly in urban areas," said Dr. Hugh Scully, the CMA president. "Both family physicians, specialists and, of course, nurses and other health professionals are in short supply as well."

From 1988 to 1997, occupational groups that experienced decreases in the number of professionals per 10 000 population included nursing services (8.2%), administrative services (6.9%) and laboratory and therapeutic technological services (5.4%). Within these groups, the greatest decreases were seen in two professions, medical laboratory technologists (20%) and licensed practical nurses (17.1%).

CIHI reports that nursing services accounted for more than 60% of health personnel in Canada in 1997, a number that has held steady over the past 10 years. The second largest occupational group, medical and treatment services, represented 15.7% of health professionals in 1997, and included physicians, chiropractors, optometrists and pharmacists.

The health occupational groups that increased their proportions relative to the population included: rehabilitation services (up 52.6%), dental services (up 26.1%) and psychological and social services (up 22%). Within these groups, occupational therapists and dental hygienists saw the greatest increases of 104% and 64.1%, respectively.

Medical imaging situation critical

Just before CIHI released its figures, Scully joined with the Canadian Association of Radiologists (CAR) in their call for an immediate federal investment for much needed medical imaging equipment and to increase the number of radiology residency positions in Canada. CAR predicts that in addition to an expected shortfall of 500 radiologists in Canada by the year 2004, the equipment itself is dire need of updating.

"The existing [medical imaging] equipment is obsolete, slow and unreliable," said Normand Laberge, chief executive officer of CAR. "If we don't invest now, Canadians will suffer from increasingly long waiting lists for a radiological examination, thus putting their health at risk."

The CMA and CAR asked the federal government to address the equipment shortage during pre-budget meetings , where they pointed out that Canada now ranks 12th out of a list of 15 countries studied in the availability of computerized tomography (CT) scanners. More CT scanners per capita are available in countries such as Spain, Korea and Portugal than in Canada.

The CMA has called on the federal government to put $1.74 billion into a medical technology fund from which provinces could draw money to purchase equipment such as MRI machines and CT scanners. Recently Monique Bégin, a former federal health minister, recommended the same plan in an appearance before a Senate committee studying the future of medicare. Reports out of Ottawa say that support for the fund is growing among both federal and provincial politicians.

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© 2000 Canadian Medical Association