We need more than just money when it comes to our care economy, Armine Yalnizyan writes. We need a Canada-wide strategy.
Just over a year ago I told you about the curse of agency nursing. It began as an emergency response to labour shortages in health care but morphed into the long-term “solution.” Without a strategy to reverse and prevent the growing burnout of nurses, I warned that agency nursing would doom you and I to pay more and get less. Look what’s happened since.
According to a recent arbitration decision between the Ontario Hospital Association and the Ontario Nurses’ Association, the use of agency nursing has exploded. In 2020, the first year of the pandemic, 31 hospitals purchased 450,000 hours from agencies. Last year, 77 hospitals purchased 1.2 million hours. Costs to the public purse more than quadrupled, to $174 million from $38 million.
The story is not unique to Ontario. Canada’s health care and social assistance sector is huge and growing, employing more than 2.25 million people. Across Canada, 53,000 more workers were added to the mix in the past year alone. But the number of vacancies keeps rising too, with almost 150,000 jobs vacancies at last count. How we fill those vacancies matters.
What was bad last year is worse this year. That’s because there’s still no plan to tackle the root causes of burnout and turnover. Hospitals are still so short-staffed, nurses are simply thrown at the labour crisis of the day, some not even able to take pre-scheduled vacations, know when or how long they are going to work on any given day, or what kind of work they will be asked to do.
Shift the lens to child care, long-term care and other forms of health care, and the same story emerges.
The care economy is especially labour intensive and not prone to automation. Demand for paid care is soaring due to population aging and the tightest labour market in half a century. We are paying more through public funding and getting less care because we keep squandering the skills of the people we already have by treating them poorly. We need to address the underlying symptoms that generate burnout, high turnover, low morale and reliance on for-profit care.
It’s a big problem, requiring a big fix. We need a Canada-wide workforce strategy for the care economy, one that insures we have enough people and focuses on the conditions of work. As my colleague Pat Armstrong would say: “The conditions of work are the conditions of care.”
Armstrong and Laurell Ritchie recently wrote on these pages about how one long-term care facility tackled the issues through weekly union-management sessions to address the needs of both residents and workers. The result: more full-time jobs, six-week schedule planning, and every second weekend off. That reduced turnover, and boosted morale and continuity of care. It also reduced the employer’s expenditures on temporary help agencies.
A few weeks ago, federal minister of families, children and social development Karina Gould showed us what could happen when we all row in the same direction. Gould is responsible for delivering $10 a day early learning and child-care plans across the country. She announced she and her provincial and territorial partners are now working on a multilateral Canada-wide workforce strategy to address labour shortages.
With the goal of adding 250,000 additional spaces for preschoolers by March 2026, every jurisdiction acknowledges they need to focus now on “recruitment, retention and recognition.” They’re talking about improved working conditions and compensation that reflects workers’ professional education, experience and responsibilities.
That strategy can and should be extended to the entire care economy — child care, health care and long-term care. The problems are the same everywhere. The economic choke point is not enough care workers. They do the work that lets all the other work get done.
Money counts of course. Ask registered early childhood educators or personal support workers in long-term care homes, many still earning the same as pet groomers in Ontario. Or Ontario’s nurses, only recently awarded a wage increase of 11 per cent over two years, overturning the Ford government’s 2019 attempt to cap their wages at one per cent a year, right through a pandemic and a wave of scorching inflation.
But working conditions are just as important. More control over working time requires staffing levels that allow workers a choice of full- or part-time hours and predictable shifts, access to paid sick days and opportunities to upgrade skills.
It costs to care. But it costs more when we don’t care.
Every year the number of Canadians googling the term “self-care” keeps rising. Too often it feels like the only type of care that’s left, given the long wait-lists for health care, long-term care and child care. But it’s no substitute for care from trained professionals.
Every year the Standing Committee on Finance invites submissions from the public for the next federal budget. The Care Economy collective, of which I am part, just submitted our two-pager for its consideration. We know housing is important. We believe a Canada-wide care economy workforce strategy is just as important, not just as a way to spend money but as a way to save it and to improve care.
You have until Aug. 4 to put in your two cents on how we can better spend our $500 billion together. The staff of the committee will read every single submission. It’s your chance to be heard by those who are paid to care about you.
Raising your voice to demand a care economy workforce plan is the real self-care this summer. It’s the only way we’ll all have quality health care, child care and eldercare when we need it.
Armine Yalnizyan is a leading voice in Canada’s economic scene and Atkinson Fellow on the Future of Workers. She is a freelance contributing columnist for the Star’s Business section. Follow her on Twitter: @ArmineYalnizyan. You can write to her at email@example.com. This column was prepared with files from Pat Armstrong, Marjorie Griffin Cohen, and Laurell Ritchie.