Summary

Canada’s healthcare system, long revered for its universal access and quality of care, is now at risk of collapse due to a critical shortage of Nurses and Personal Support Workers (PSWs). This staffing crisis, exacerbated by an aging population and chronic underinvestment, threatens the well-being of millions of Canadians, particularly seniors. If urgent action is not taken, the country’s healthcare infrastructure may buckle under the weight of unmet demand.

The Canadian Association of Retired Persons (CARP) demands immediate and decisive action from all levels of government. This post outlines the depth of the crisis, the root causes, and CARP’s policy recommendations for solving it. The time for half-measures has passed. We must ensure that every senior in Canada receives the quality of care they deserve, both now and in the future.

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I. The Scope of the Crisis

Canada’s shortage of nurses and PSWs is not just an issue of understaffing; it is a systemic failure that threatens the very viability of the nation’s healthcare system. As of 2023, more than 34,000 nursing positions remain unfilled, with a projected shortfall of nearly 60,000 nurses by 2028 if current trends persist . This crisis is mirrored by a critical lack of PSWs, who form the backbone of long-term care facilities and home care services, especially for seniors.

The situation is most acute in provinces like Ontario, where more than 38,000 seniors are on waiting lists for long-term care beds . Meanwhile, PSWs are increasingly exiting the workforce due to low wages, poor working conditions, and overwhelming workloads. This shortage has led to longer wait times, rationing of care, and, in some cases, the closure of beds in long-term care homes.

Impact of the COVID-19 Pandemic

The COVID-19 pandemic exacerbated pre-existing challenges in the healthcare system, leading to unprecedented burnout among nurses and PSWs. A survey by the Registered Nurses’ Association of Ontario (RNAO) found that 87% of nurses reported experiencing severe burnout, with many considering leaving the profession . The virus also exposed significant gaps in infection control in long-term care homes, where staff shortages led to insufficient care, particularly for seniors, the demographic hardest hit by the pandemic.

A study by the Royal Society of Canada found that the mortality rate in Canadian long-term care homes was among the highest in the world during the pandemic, with poor staffing levels being a key factor. This tragic outcome underscores the importance of addressing staffing shortages not just as a workforce issue but as a matter of life and death.

II. The Aging Population: A Growing Demand

Canada’s demographic landscape is shifting dramatically. By 2030, seniors will account for 23% of the population—up from 18% in 2020. Those numbers are much higher in regions of Atlantic Canada, Ontario and BC. This rapid aging of the population is significantly increasing the demand for healthcare services, especially for chronic conditions like heart disease, diabetes, dementia, and arthritis, which are more prevalent among older adults.

The Canadian Medical Association (CMA) estimates that healthcare spending on seniors will more than double over the next decade, increasing from $93 billion in 2021 to over $200 billion by 2031 . This surge in demand is occurring at the same time that the healthcare workforce is shrinking, making the shortage of nurses and PSWs even more critical.

Long-Term Care and Home Care

The pressures on long-term care facilities and home care services are particularly acute. According to the Ontario Long-Term Care Association (OLTCA), 90% of long-term care residents live with cognitive impairments or other complex medical needs . These conditions require a high level of skilled nursing and personal care—services that cannot be adequately provided without a sufficient workforce. Yet, as of 2023, 40% of long-term care homes in Ontario reported vacancies for PSW positions .

Home care services, a key component of the healthcare system that allows seniors to age in place, are also severely under-resourced. A 2022 report by Home Care Ontario found that 90% of seniors prefer to remain in their homes as long as possible . However, without adequate PSWs to support them, these seniors often end up in hospitals or long-term care homes, further straining the system. It is estimated that every $1 spent on home care saves the healthcare system $2 by preventing hospitalizations .

III. Lack of Workforce Planning and Government Investment

The shortage of nurses and PSWs is not merely the result of bad luck or global trends; it is a direct consequence of poor workforce planning and underinvestment by both federal and provincial governments. Successive governments have consistently failed to invest in long-term strategies to recruit, train, and retain healthcare workers.

According to the Canadian Federation of Nurses Unions (CFNU), while the federal government has made commitments to increase healthcare funding, these investments have largely focused on infrastructure, such as new hospital beds and facilities . What has been lacking is a parallel investment in the human resources needed to staff these facilities. Without enough nurses and PSWs, new infrastructure will remain underutilized or will worsen existing care deficits.

Provincial Variations in Funding

The patchwork nature of healthcare funding across provinces further complicates the issue. Provinces like British Columbia and Ontario have made some progress in increasing wages for PSWs, but these efforts have been inconsistent and insufficient. In many cases, PSWs still earn less than $20 an hour, leading to high turnover rates and chronic understaffing.

A 2022 report by the Conference Board of Canada found that the average wage for PSWs needs to increase by 30% to ensure retention and reduce turnover. Despite this, the federal government’s 2023 budget allocated only modest increases in funding for long-term care worker wages, falling far short of the necessary levels.

IV. CARP’s Policy Recommendations

CARP believes that solving the nurse and PSW shortage requires bold and immediate action. The following policy recommendations are crucial to ensuring that seniors receive the care they need:

1. Federal Investment in Nurse and PSW Training: The federal government must significantly increase funding for nursing and PSW education programs. This should include targeted scholarships, bursaries, and loan forgiveness programs for students willing to work in underserved areas, including rural and Indigenous communities.
   A 2021 report by the Council of Canadian Academies suggests that increasing access to education for healthcare workers could reduce the workforce shortage by as much as 25% within five years .
2. Retention Bonuses and Mental Health Support: Retention strategies must include competitive wages, retention bonuses, and access to mental health support for nurses and PSWs experiencing burnout. A 2023 study by the RNAO found that 50% of nurses experiencing burnout were considering leaving the profession , making this issue a priority.
3. Immigration Policy Reform: Streamlining the credential recognition process for foreign-trained nurses and PSWs is essential to filling the immediate shortfall. According to Immigration, Refugees and Citizenship Canada (IRCC), the current backlog for credential recognition for healthcare workers averages 18 months. Reducing this wait time could immediately boost the number of healthcare professionals available to work in Canada.
4. National Healthcare Workforce Strategy: Canada needs a coordinated, national approach to healthcare workforce planning. This strategy should include regular assessments of staffing needs, demographic projections, and coordinated recruitment efforts across provinces. The CFNU has called for a “national healthcare workforce task force” to ensure Canada can meet future demands .
5. Increased Investment in Home Care Services: Governments must prioritize investment in home care services to enable seniors to age in place and reduce strain on hospitals and long-term care facilities. According to Home Care Ontario, a 20% increase in home care funding would allow 50,000 more seniors to receive care at home, reducing hospitalization rates by 15% .

V. Conclusion: It’s Time to Act

The shortage of nurses and PSWs is a crisis that threatens the quality of care for seniors and the sustainability of Canada’s healthcare system. Without immediate action, the system will collapse under the weight of unmet demand. CARP urges all levels of government to act now by investing in the training, retention, and recruitment of healthcare workers.

Seniors deserve better, and Canadians cannot afford to wait any longer. The health and dignity of our aging population are at stake.

Call to Action: Join CARP and Help Fix Canada’s Healthcare Crisis

Canada’s healthcare system is on the brink of collapse, and our seniors are paying the price. CARP is fighting to solve the critical shortage of nurses and Personal Support Workers (PSWs), but we can’t do it alone. We need your voice to hold governments accountable and demand urgent action. Join CARP today and be part of a powerful movement advocating for better care, more healthcare workers, and a stronger system for all Canadians. Together, we can make a difference.

References:

1. Statistics Canada, Population Projections, 2023.
2. Canadian Institute for Health Information (CIHI), 2023 Report on Nursing Shortages.
3. Ontario Long-Term Care Association, 2022 Annual Report.
4. Canadian Medical Association, 2021 Health Spending Report.
5. Canadian Federation of Nurses Unions, 2023.
6. Royal Society of Canada, “The COVID-19 Impact on Long-Term Care in Canada,” 2021.
7. Canadian Home Care Association, 2022 Report.
8. Registered Nurses’ Association of Ontario (RNAO), 2023 Burnout Study.
9. Dr. Stephen Gordon, Healthcare Crisis in The Globe and Mail, May 2024.
10. Conference Board of Canada, “Who Will Care for Us? Addressing Canada’s Caregiver Crisis,” 2022 Report