Recommendation 1:

That the F/P/T Advisory Committee on Health Care Delivery and Human Resources to consider the feasibility and appropriateness of either expanding its membership to include a wider range of stakeholders and broadening its mandate to allow for the development of an inventory of data and research on best practices in addressing HHR challenges in Canada; or establishing a new arm’s length national observatory on health human resources with a broad-based membership that would promote research and data collection on HHR; serve as an effective knowledge translation mechanism; and identify key priorities for future research.

Recommendation 2:

The ACHDHR report on the implementation of A Framework for Collaborative Pan-Canadian Health Human Resources Planning, including progress towards its short, medium and long-term objectives.

Recommendation 3:

Health Canada seriously consider providing funding through its Pan-Canadian Health Human Resource Strategy to enable CIHI to:

• expand its data collection to include demographic and work information on all categories of health professionals;
• repeat national HHR surveys as necessary so that they remain up to date.

Recommendation 4:

Relevant federal government departments and agencies work closely with CIHI to establish a minimum data set for HHR planning for all federal client groups, including: First Nations and Inuit; RCMP; veterans; members of the Canadian Forces; immigrants and refugees; and federal inmates.

Recommendation 5:

The federal government seriously consider providing CIHR with funding to develop further mechanisms aimed at supporting clinical research in the area of HHR, recognizing it as a means of attracting and retaining health professionals in Canada.

Recommendation 6:

The federal government continue to provide the Health Council of Canada and CIHR with funding to determine the most appropriate mix of health professionals, both paid and unpaid, for different communities and population groups.

Recommendation 7:

The federal government identify and address systemic barriers to the implementation of interprofessional collaborative practice within its jurisdiction, including its responsibilities as the employer of the federal public service and the health benefits and services it offers to federal client groups, including: First Nations and Inuit; RCMP; veterans; immigrants and refugees; federal inmates; and members of the Canadian Forces.

Recommendation 8:

The federal government consider the possibility of establishing sustained funding mechanisms devoted to promoting interprofessional collaborative practice within the provinces and territories.

Recommendation 9:

That Health Canada continue to provide sustained funding to bridging, adaptation and transitional licence programs for IEHPs, as well as community-based preceptorship programs in which practicing physicians assess and mentor IMGs.

Recommendation 10:

That Health Canada work with relevant stakeholders to ensure that the federally funded bridging programs that offer supervised clinical training over an extended period of time be included as part of the assessment of an IEHP’s credentials and training.

Recommendation 11:

That the F/P/T Advisory Committee on Health Delivery and Human Resources consider conducting an in-depth study examining IMG access to postgraduate training positions in Canada, including issues such as: capacity and funding within the medical education system for positions, or alternative supervised clinical placements, an evaluation of the residency matching system for IMGs, and the position of visa residents within the system; and that the F/P/T Advisory Committee on Health Delivery and Human Resources report the findings of its study on postgraduate training positions for IMGs.

Recommendation 12:

Recognizing the pre-existing cultural competency of Canadian citizens that went abroad to study medicine, that the F/P/T Advisory Committee on Health Delivery and Human Resources work with relevant stakeholders to identify ways to improve the assessment and integration of these IMGs into postgraduate medical training in Canada.

Recommendation 13:

That the Government of Canada establish an initiative to repatriate Canadian physicians practicing abroad; an initiative that would bring back as many as 300 physicians.

Recommendation 14:

That the Government of Canada consider providing targeted funding to the provinces and territories to increase the capacity of medical schools and teaching hospitals to play a constructive role in integrating IMGs and other medical graduates into the health care system.

Recommendation 15:

That the Government of Canada keep its 2008 commitment to fund 50 new residencies per year over four years at a cost of $40 million.

Recommendation 16:

That the Government of Canada consider a requirement that physicians seeking to immigrate to Canada include the results of the MCC Evaluation Exam as part of their immigration application to Canada so that the Government of Canada could use the exam results as part of their criteria in evaluating the candidate.

Recommendation 17:

That Health Canada provide secure and stable funding for Aboriginal Health Human Resources, including support for programs and initiatives such as: bridging, mentoring and outreach programs; scholarships; organizations providing leadership in this area; and initiatives supporting the recruitment and retention of a broad range of health professionals including: midwives, community health representatives, traditional healers, health promotion experts, and addiction counsellors.

Recommendation 18:

That Health Canada review its project-based funding model under the Aboriginal Health Human Resources Initiative to determine whether it is meeting the needs of stakeholders and on reserve First Nations and Inuit communities.

Recommendation 19:

That Health Canada continue to increase its focus on retention of health professionals in on reserve First Nations and Inuit communities, while respecting the institutions and initiatives already in place; and in particular, addressing issues related to cultural concerns and the pay scale of health professionals in those communities.

Recommendation 20:

That Health Canada consider enhancing its collaboration with Indian and Northern Affairs Canada, other relevant departments, and organizations such as: Indigenous Physicians Association of Canada, the Aboriginal Nurses Association of Canada and the National Aboriginal Health Organization, to promote careers in health sciences at all education levels, including: primary, secondary and post-secondary education.

Recommendation 21:

That the Federal Health Care Partnership ensure that its Mental Health Working Group has sufficient funds to undertake collaboration in addressing common health human resource issues related to the provision of mental health care treatment and support, including: case management, the recruitment and retention of mental health professionals, and tools for mental health assessment.

Recommendation 22:

That the RCMP continue to enhance the following components of its workplace development and wellness strategy: case management and data collection, training of health care professionals in the experiences of members of the RCMP, development of mental health assessment tools, the recruitment and retention of mental health professionals with expertise in trauma.

Recommendation 23:

That Health Canada host a national conference on rural health to bring together stakeholders to discuss best practices and develop recommendations in rural health, education and the recruitment of health human resources.

Recommendation 24:

That Health Canada provide targeted funding to support initiatives aimed at increasing the number of students pursuing careers in rural health, such as: scholarships and bursaries for students of rural background that would like to pursue health careers in rural areas.

Recommendation 25:

That the F/P/T Advisory Committee on Health Delivery and Human Resources consider establishing a working group dedicated to examining and responding to best practices in the recruitment and retention of HHR in rural and remote areas, including: the guidelines and recommendations presented by the WHO’s expert panel at the World Health Assembly in May 2010.

Recommendation 26:

That Health Canada, Indian and Northern Affairs Canada, and the Public Health Agency of Canada utilize health professionals and program officers with expertise in food security and recreation as part of their programming in Nunavut.

Recommendation 27:

That the Government of Canada consider sustaining its funding of the Territorial Health System Sustainability Initiative and the Medical Travel Fund beyond 2012.

Recommendation 28:

That the Government of Canada continue to take into account the differences between the challenges faced by the Inuit living in the North and First nations populations living in the South in its funding decisions.

Recommendation 29:

Over the course of its fact-finding mission in Nunavut, the Committee heard of the difficulties faced by Inuit living in Nunavut in gaining access to spots in provincial faculties of medicine, the Committee therefore would like to bring this to attention of the Association of Faculties of Medicine Canada and requests their feedback on this issue.