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Tuesday, June 5, 2012

Progress on HHR issues?

Ivy Lynn Bourgeault, PhD, is a Professor in the Interdisciplinary School of Health Sciences at the University of Ottawa and the Canadian Institutes of Health Research Chair in Health Human Resource Policy. She is also the Scientific Director of the pan-Ontario Population Health Improvement Research Network and the Ontario Health Human Resource Research Network both housed at the University of Ottawa. Dr. Bourgeault also leads the pan Canadian Health Human Resources Network. Dr. Bourgeault has garnered an international reputation for her research on health professions, health policy and women’s health.

Can our progress towards more effective and efficient use of health human resources (HHR) be seen as a case of a glass half full or half empty – or is it that any progress should be seen as only a drop in the bucket of what is actually possible?  The conclusions that the Health Council of Canada has reached in regards to HHR issues in its Progress Report are correct.  We in Canada have ‘succeeded’ in increasing the supply of HHR (indeed to the point where we are hearing calls of surpluses and underemployment of some medical specialists [see]), but we have done so while neglecting to attend to the appropriate mix of HHR and other measures to ensure that existing, highly trained health professionals are working to their full scope of practice. 

The issue of scope of practice is increasingly being highlighted at important policy tables, the Council of the Federation being just one [see]. Being able to work to full scope is not only important for the productivity of the health workforce, it is a critical element in efforts to retain highly qualified staff (yet another neglected issue). We have also improved collaborative practice and education initiatives – through the investment and successful efforts of the CIHC,  which is no longer being funded – but there has been little interprofessional planning of HHR supply and distribution. That is, any improvements in planning models are still limited by geographic and professional isolation. So we’ve done much less than we could in strengthening the evidence base for national planning and even less to foster closer collaboration across sectors critical in the planning process. 

We are disappointed that repeated calls to establish a pan-Canadian HHR observatory – echoed by all stakeholders and members of the Parliamentary Committee on Health in 2010 – has not been heeded 
[see]. Such an observatory would, as described by the WHO, collect, analyze and translate data and information on the health workforce, facilitate a dialogue among HHR stakeholders, and contribute to policy development and a broader understanding of HHR issues.  It is in this vacuum that we have been attempting to create some much needed research and knowledge exchange tools at the pan-Canadian HHR Network, with pilot funds received from Health Canada and the CIHR.  It is our intention to make evidence more accessible to those making critically important HHR decisions and to help sustain our publicly funded health system.

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