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Pre-Budget Submission August 2011 Presented to: House of Commons Standing Committee on Finance Presented by: The Canadian Society for Medical Laboratory Science Executive Summary 2011 Federal Pre-Budget
Submission from the The Canadian Society for Medical Laboratory Science (CSMLS) is the national certifying body for medical laboratory technologists and medical laboratory assistants, and the national professional society for Canada's medical laboratory professionals. Incorporated in 1937 as the Canadian Society of Laboratory Technologists, the society has over 14,000 members in Canada and in countries around the world. Medical Laboratory Technologists (MLTs) conduct the tests used by physicians to evaluate and make informed decisions about their patients’ health and possible treatment, and to help further advances in medical research. They are a crucial link between doctors and required laboratory tests, as approximately 85 per cent of physicians’ decisions are based on such test results. Recently, a number of commissions and investigations have taken place, and have focused attention on the critical role that medical laboratory professionals play in patient safety. In this context, and as part of the Finance Committee’s pre-budget consultations, CSMLS thanks the Government of Canada for the opportunity to provide the following recommendations: 2011 Budget Recommendations:
About CSMLS The Canadian Society for Medical Laboratory Science (CSMLS) is the national certifying body for medical laboratory technologists and medical laboratory assistants, and the national professional society for Canada's medical laboratory professionals. Incorporated in 1937 as the Canadian Society of Laboratory Technologists, the society has over 14,000 members in Canada and in countries around the world. As a group, the medical laboratory profession is the third largest health care profession in Canada. Nation-Wide Shortage of Medical Laboratory Technologists Canada is presently facing a nation-wide shortage of medical laboratory technologists. Our organization predicts that by 2016, half of Canada's MLTs will be eligible to retire. Since 1998, CSMLS has been alerting decision-makers that the number of seats in medical laboratory technology education programs is not sufficient to produce enough new graduates to replace those who will leave the workforce. Domestic supply is simply too low. Since 2000, governments have taken steps to address the shortage by opening new education programs, and increasing capacity in others. Data collection for the Canadian Institute for Health Information’s (CIHI) human resource database for medical laboratory technologists is now complete, and will help provide a solid foundation for human resource planning on the supply side, but CIHI does not collect data on the demand side. These are all positive developments; however, we still estimate a shortage of about 100 seats annually. Positive steps must be taken to help combat this shortage. Medical Laboratory Technologists in Rural Areas It is clear, as demonstrated throughout the most recent federal election campaign, that health care has surfaced as a top priority issue for Canadians. In fact, a public opinion poll released during the campaign demonstrated that health care remains the most important concern for Canadian voters. A key concern for the medical laboratory profession remains having medical laboratory technologist (MLT) graduates moving to rural areas, without receiving enough financial support to help them succeed. It was promising to note in the most recent Budget that the Government of Canada remains committed to strengthening health care in Canada's rural and remote communities. The Budget states that in order to further combat the shortage of health care professionals in these communities, it will forgive a portion of Canada Student Loans for new family physicians (up to $8,000 per year to a maximum of $40,000) and nurse practitioners and nurses (up to $4,000 per year to a maximum of $20,000). Canada's health care system is not comprised of doctors and nurses alone. Medical laboratory physicians (up to $8,000 per year to a maximum of $40,000) and nurse practitioners and nurses (up to $4,000 per year to a maximum of $20,000). Canada’s health care system is not comprised of doctors and nurses alone. Medical laboratory professionals play an important role in the maintenance of Canadians’ health. They work in many settings including hospitals, private laboratories, universities, research facilities, public health laboratories, and veterinary clinics. Whether it is a blood test, a throat swab or a biopsy, tests performed by medical laboratory professionals provide vital information about an individual’s health. Doctors depend on laboratory test results to accurately diagnose and treat illness, and monitor patient health. In fact, up to 85 per cent of decisions about diagnosis and treatment are based on laboratory test results. This lack of understanding of the key role medical laboratory professionals play in providing Canadians with quality health care leads to a lack of focus and investment to resolve critical health human resource challenges related to the profession. To maximize the impact of this rural communities health care commitment, and to ensure that Canada’s health care system is not compromised, it is absolutely vital to address the medical laboratory profession as a key component of this plan and ensure that loan forgiveness is also granted for medical laboratory technologists. The Integration of Internationally Educated Medical Laboratory Professionals The integration of internationally educated professionals into the Canadian workforce is a significant challenge for all professions, including medical laboratory technology. CSMLS is committed to ensuring that their credentials are assessed fairly and efficiently while at the same time safeguarding the integrity of the national certification process. The CSMLS recognizes and applauds the federal government for its continued work on this front; however, there is much more that can be done. The practice of medical laboratory science varies across the globe, and it is a requirement that all practitioners in Canada meet the rigorous entry to practice requirement, putting patient safety first at all times. A system that allows for additional training or practice in the Canadian context, that is accessible, affordable and reliable is imperative. In 1999, the Council on National Certification approved a new process to determine the eligibility of internationally trained MLTs to the CSMLS certification examinations. The process, called a Prior Learning Assessment (PLA) has three steps. Once an individual has successfully completed all three steps, he/she is deemed eligible to write the CSMLS national certification examination. Only half of all PLA applicants are deemed eligible to write the CSMLS certification examination. Furthermore, the failure rate for internationally educated professionals who challenge the CSMLS national certification examinations is significantly higher than that of graduates of accredited Canadian training programs. A 2004 pilot research study found that internationally educated applicants who had completed a bridging program had a pass rate comparable to graduates of accredited Canadian training programs. In a most recent CSMLS report, “Bridging Programs for Internationally Educated Medical Laboratory Technologists: A Business Case,” it concluded that bridging programs shorten the time for IEMLTs to become certified in Canada, decrease their financial hardships and expedite their integration into the Canadian laboratory workplace. As a result, IEMLTs contribute to the Canadian economy much sooner with the support of a bridging program. The most recent budget outlined several commitments related to certification and international education. These include the proposal to make all occupational, trade and professional examination fees eligible for the Tuition Tax Credit, and $10 million over two years to develop and implement an international education strategy. Additionally, the Government of Canada highlighted that it remains committed to helping foreign trained workers pay for tuition and other training costs associated with the foreign credential recognition process. These are positive steps in the right direction; however, there is a vital need for further, sustainable investments. With tuition costs soaring, students in medical laboratory science programs are incurring significant debt. The Government of Canada should provide debt relief/tuition grants to students entering medical laboratory science programs, to cover the full costs of the program. The Government of Canada must also play a lead role to support Internationally Educated Medical Laboratory Technologists (IEMLTs) through the establishment of a bridging program, which would address both health care resource challenges and the need for equitable treatment of newcomer professionals to Canada with expectation of employment in their profession. Investing in the integration of internationally educated professionals will create more jobs, helping to stimulate the national economy. Recommendations In this context, and as part of the Finance Committee’s pre-budget consultations, CSMLS thanks the Government of Canada for the opportunity to provide the following recommendations:
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