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37th PARLIAMENT, 3rd SESSION

Standing Committee on Citizenship and Immigration

EVIDENCE

CONTENTS

Tuesday, March 30, 2004

1105

The Chair (Mr. Sarkis Assadourian (Brampton Centre, Lib.))

Dr. Paul Cappon (Director General, Council of Ministers of Education (Canada))

1110

1115

The Chair

Mr. Art Hanger (Calgary Northeast, CPC)

Dr. Paul Cappon

Mr. Art Hanger

Dr. Paul Cappon

Mr. Yves Beaudin (National Coordinator, Canadian Information Centre for International Credentials, Council of Ministers of Education (Canada))

1120

Mr. Art Hanger

Mr. Yves Beaudin

Mr. Art Hanger

Mr. Yves Beaudin

The Chair

Hon. Jerry Pickard (Chatham—Kent Essex, Lib.)

Dr. Paul Cappon

1125

Hon. Jerry Pickard

Dr. Paul Cappon

Hon. Jerry Pickard

Dr. Paul Cappon

The Chair

Ms. Madeleine Dalphond-Guiral (Laval Centre, BQ)

1130

Dr. Paul Cappon

Ms. Madeleine Dalphond-Guiral

Dr. Paul Cappon

Mr. Yves Beaudin

1135

Ms. Madeleine Dalphond-Guiral

Mr. Yves Beaudin

Ms. Madeleine Dalphond-Guiral

Dr. Paul Cappon

The Chair

Mr. Pat Martin (Winnipeg Centre, NDP)

1140

The Chair

Mr. Pat Martin

Dr. Paul Cappon

Mr. Pat Martin

Dr. Paul Cappon

Mr. Pat Martin

Dr. Paul Cappon

Mr. Pat Martin

Dr. Paul Cappon

Mr. Pat Martin

1145

The Chair

Dr. Paul Cappon

Mr. Pat Martin

Dr. Paul Cappon

Mr. Pat Martin

The Chair

Hon. Hedy Fry (Vancouver Centre, Lib.)

1150

Dr. Paul Cappon

The Chair

Dr. Paul Cappon

Hon. Hedy Fry

Dr. Paul Cappon

Hon. Hedy Fry

Dr. Paul Cappon

Hon. Hedy Fry

Dr. Paul Cappon

The Chair

1155

Dr. Paul Cappon

The Chair

Dr. Paul Cappon

The Chair

Dr. Paul Cappon

The Chair

Dr. Paul Cappon

The Chair

Dr. Paul Cappon

The Chair

Mr. Art Hanger

1200

Dr. Paul Cappon

The Chair

Mrs. Louise Sweatman (Chair, Canadian Network of National Associations of Regulators (CNNAR))

1210

1215

1220

The Chair

Mrs. Lisa Little (Health Human Resources Consultant, Canadian Nurses Association)

1225

1230

The Chair

Mr. Art Hanger

Mrs. Louise Sweatman

Mr. Art Hanger

Mrs. Louise Sweatman

1235

Mr. Art Hanger

Mrs. Lisa Little

Mr. Art Hanger

The Chair

Mrs. Lisa Little

Mr. Art Hanger

Mrs. Lisa Little

Mr. Art Hanger

Mrs. Lisa Little

Mr. Art Hanger

Mrs. Lisa Little

1240

The Chair

Hon. Jerry Pickard

Mrs. Louise Sweatman

1245

Mrs. Lisa Little

The Chair

Hon. Jerry Pickard

Mrs. Lisa Little

1250

Hon. Jerry Pickard

The Chair

Mr. Pat Martin

Mrs. Louise Sweatman

Mr. Pat Martin

Mrs. Louise Sweatman

Mr. Pat Martin

Mrs. Louise Sweatman

Mr. Pat Martin

1255

Mrs. Louise Sweatman

Mr. Pat Martin

Mrs. Louise Sweatman

Mr. Pat Martin

Mrs. Louise Sweatman

Mr. Pat Martin

Mrs. Louise Sweatman

Mr. Pat Martin

Mrs. Louise Sweatman

Mr. Pat Martin

Mrs. Louise Sweatman

Mr. Pat Martin

Mrs. Louise Sweatman

Mr. Pat Martin

Mrs. Louise Sweatman

Mr. Pat Martin

Mrs. Lisa Little

Mr. Pat Martin

The Chair

Mrs. Lisa Little

1300

The Chair

Hon. Hedy Fry

1305

Mrs. Lisa Little

Hon. Hedy Fry

Mrs. Lisa Little

Hon. Hedy Fry

Mrs. Lisa Little

Hon. Hedy Fry

The Chair

Hon. Hedy Fry

The Chair

Mr. Art Hanger

Mrs. Lisa Little

Mr. Art Hanger

Mrs. Lisa Little

Mr. Art Hanger

Mrs. Lisa Little

Mr. Art Hanger

Mrs. Lisa Little

The Chair

Mrs. Lisa Little

Mr. Art Hanger

Mrs. Lisa Little

Mr. Art Hanger

1310

Mrs. Lisa Little

Mr. Art Hanger

Mrs. Lisa Little

Mr. Art Hanger

Mrs. Lisa Little

Mr. Art Hanger

Mrs. Louise Sweatman

Mr. Art Hanger

Mrs. Louise Sweatman

Mr. Art Hanger

Mrs. Louise Sweatman

Mr. Art Hanger

1315

Mrs. Louise Sweatman

Mr. Art Hanger

The Chair

Hon. Hedy Fry

The Chair

Mr. Art Hanger

1320

Mrs. Louise Sweatman

Mr. Art Hanger

Mrs. Louise Sweatman

Mr. Art Hanger

Mrs. Louise Sweatman

Mr. Art Hanger

Mrs. Louise Sweatman

Mr. Art Hanger

Mrs. Louise Sweatman

The Chair

Mrs. Louise Sweatman

Mrs. Lisa Little

The Chair

Mrs. Lisa Little

The Chair

1325

Mrs. Lisa Little

The Chair

Mrs. Lisa Little

The Chair

CANADA

Standing Committee on Citizenship and Immigration

NUMBER 005

3rd SESSION

37th PARLIAMENT

EVIDENCE

Tuesday, March 30, 2004

[Recorded by Electronic Apparatus]

Á (1105)

[English]

The Chair (Mr. Sarkis Assadourian (Brampton Centre, Lib.)): We are going to start now. The clerk tells me that the bag with all the secrets is not here yet, but as soon as we get it, we'll pass the secrets along to you.

We have today the Council of Ministers of Education of Canada, Mr. Paul Cappon, and Yves Beaudin, national director of the Canadian Information Centre for International Credentials.

Go ahead, please.

Dr. Paul Cappon (Director General, Council of Ministers of Education (Canada)): Thank you, Chair, and all members of the standing committee, for inviting us to appear before you to share our thoughts and concerns regarding the recognition of foreign credentials.

I am the director general and CEO of the Council of Ministers of Education of Canada, which acts as a national voice for education in Canada. The CMEC also represents the education interests of the provinces and territories internationally.

[Translation]

I am accompanied today by my colleague Mr. Yves Beaudin, who is the national director of CMEC's Canadian Information Centre for International Credentials, or CICIC.

In July 2002, the provincial and territorial ministers of education and labour market released a joint paper entitled Working Together to Strengthen Learning and Labour Market Training. It was a call to the federal government to cooperate closely with the provinces and territories in order to meet Canadians growing post secondary education and labour market training needs. One of the four key priorities identified for action in this paper was the willingness of all of the provinces and territories to work collaboratively in "encouraging full labour market participation of under-represented groups."

Acknowledging that many Canadians, including immigrants, are not participating fully in the labour market, the ministers called upon the federal government to support efforts to engage immigrants in the labour force by addressing the major barriers that immigrants face, by: first, ensuring academic credential assessment overseas—I will get back to that point later; second, ensuring that occupational regulatory requirements and credential assessment are available to skilled immigrants before they land in Canada; third, strengthening English and French-language training so that it is workplace relevant; selecting skilled immigrants who are most likely to contribute to the job market in areas where there are skill shortages; providing high-quality information on employment prospects and regulations to potential immigrants living overseas; providing sufficient support to immigrant settlement services; and working with professional and regulatory bodies in facilitating the recognition of foreign-earned professional and occupational credentials.

[English]

Taking these barriers into account, we want to stress the importance that we accord to establishing codes of good practice and common assessment principles within the processes for recognizing foreign credentials and occupational qualifications.

Since 1990, through our Canadian Information Centre for International Credentials, the CMEC has consolidated a wide range of information on the assessment of foreign academic credentials and professional qualifications. It encourages professional and educational organizations to abide by CICIC's general guiding principles for good practice in the assessment of foreign credentials, and by the recommendations on criteria and procedures for the assessment of foreign qualifications adopted under the Lisbon Recognition Convention. The CICIC website—and I have information on CICIC and CMEC here, for anybody who wishes to take it away with them—provides information on over 150 occupations and trades in Canada. These information fact sheets are an important source for the foreign-trained who want to obtain a licence to practise in a regulated occupation in Canada. We take this opportunity to thank Citizenship and Immigration Canada for the subsidy that permitted CICIC to prepare and update these fact sheets.

CICIC, the organization that works on providing information to potential immigrants and people who want to study in Canada, was established jointly by the Government of Canada and the provinces and territories following the ratification of something called the UNESCO Convention on the Recognition of Studies, Diplomas and Degrees concerning Higher Education in the States belonging to the European Region. In UNESCO terms, you may or may not know that Canada is actually part of the Europe region.

On April 1, 2003, however, following the decision by the federal government to discontinue its share of funding for the Canadian Information Centre for International Credentials, the ministers responsible for education unanimously expressed their disappointment over the federal decision and agreed to maintain our responsibility for Canada's obligations under the UNESCO convention. They felt that it was not helpful for the Government of Canada to withdraw from its obligations under an international convention, given the interests of all governments in finding solutions to the difficulties inherent in the assessment and recognition of foreign credentials and qualifications. Given the importance of providing information on this issue of credential and qualification recognition, the ministers at that time encouraged the federal government to reconsider its decision. I think that relevant departments of all levels of government want to find solutions to the problems inherent in the assessment and recognition of foreign credentials and qualifications.

CMEC considers that CICIC is an essential link between education, training, and employment organizations, when you consider what it does. It provides information on Canadian post-secondary studies, diplomas, and degrees needed to promote mobility and the recognition of Canadian qualifications abroad. It facilitates access to information on foreign credentials and foreign recognition activities to Canadian authorities and organizations. It establishes and coordinates an information network in Canada of individuals and agencies involved in the international recognition of foreign qualifications, which builds upon and enhances existing provincial and territorial professional and educational networks. CICIC gathers and disseminates information on domestic and international certification procedures and recognition systems, refers requests regarding the recognition of credentials to appropriate Canadian or international bodies, and establishes liaison with relevant international organizations.

I think it's apparent that CICIC's activities and the information that it consolidates, updates, and provides to a variety of audiences is an important source of information for potential immigrants.

Á (1110)

[Translation]

CICIC, in collaboration with provincially mandated credential evaluation services, therefore, has prepared a publication entitled “General Guiding Principles for Good Practice in the Assessment of Foreign Credentials”. It also acts as the Secretariat to the Alliance of Credential Evaluation Services of Canada.

Since education is primarily the concern of the provinces and territories and since the educational systems vary from one jurisdiction to another, the impetus and rationale for the guiding principles were provided by the following basic tenets: first, the need to promote fair, credible, and standardized methods in the assessment of foreign credentials; the need to promote consistency among the jurisdictions in the assessment of foreign credentials; the importance of the portability of educational evaluations from one jurisdiction to another; the importance of articulating a conceptual framework for the assessment of foreign credentials to promote consistency; the advantages of working collaboratively to address issues related to the assessment of foreign credentials.

Furthermore, all parties agreed with seven overarching principles. I will mention only four: assessments should be performed without any form of racial, religious, political or sexual discrimination; holders of foreign qualifications should have adequate access, upon request, to an assessment of their foreign qualifications; the procedures and criteria used in the assessment of foreign credentials should be clear, rational and reliable; and the same basic methodology should apply whether the statement is for general employment purposes, entry into secondary and post-secondary institutions, or entry into a regulated occupation.

Á (1115)

[English]

The Alliance of Credential Evaluation Services of Canada has elaborated, in conjunction with CICIC, a quality assurance framework that we believe could be used as a guide for regulatory bodies, higher-education institutions, and employers in the assessment of foreign credentials.

[Translation]

We've also been in communication with the Alliance of Sector Councils and we hope to work with their members as they develop tools to bring qualified and skilled workers into the country's workforce.

We are proud of our relationship with the Canadian Network of National Association of Regulators. We should also mention that the Canadian Council of Professional Engineers, a member of CNNAR, was the first to abide by CICIC's general guiding principles.

The Public Service Commission requires that all foreign-trained applicants present a Canadian evaluation of their credentials in order to qualify for work within the public service. It systematically refers these individuals to CICIC to obtain information about foreign credential evaluations. On all electronic job offers a note refers job applicants to the CICIC website for information.

CICIC has also been an active participant in the Federal-Provincial-Territorial Working Group on Access to Professions and Trades. This Working Group, originally co-chaired by Citizenship and Immigration Canada, seems to have suspended its operations.

[English]

In conclusion, Chair, as mentioned at the beginning of this presentation, we do believe that federal-provincial-territorial cooperation is essential in this file. We do believe that we should take advantage of existing cooperative arrangements and avoid duplication.

The document forwarded to us about the recognition of foreign experience and credentials—the one that was shown to you as well by staff—concludes by referring to the Australian experience. The model that Australia put in place is most certainly the result of an ongoing collaboration between all jurisdictions to facilitate the recognition of foreign credentials. Australia's National Office of Overseas Skills Recognition participates in some of the same activities as CICIC.

We do require a cooperative and focused effort by all levels of government, within the full range of their respective mandates, to ensure that future resources are invested where they are most needed.

I note specifically, and I think critically, from the paper prepared for this committee, that Australia requires that applicants' skills for their nominated occupations be assessed by the authorities before the applicants apply for permanent residence in Australia.

[Translation]

We are fully aware that foreign credential recognition requires an important partnership with the federal-provincial-territorial governments, as was the case in Australia. I'm convinced that the Australian model was developed over time, with the full participation of all jurisdictions. We can be just as creative. You can count on CMEC's support and the full participation of our Canadian Information Centre for International Credentials.

We again thank you, Mr. Chairman and members of the standing committee, for providing us with this opportunity to explain our views and our concerns regarding the recognition of foreign credentials.

Thank you.

[English]

The Chair: Thank you very much.

We have 40 minutes for questions and answers. I regret that we don't have a set agreed time on who's going to speak and for how long. At the last meeting, we agreed to give 10 minutes for each party, which means 10 minutes for the Conservatives, the Bloc, the NDP, and the Liberals.

If it's possible, perhaps you can be good enough to keep your questions short so we can have a second round.

Mr. Hanger.

Mr. Art Hanger (Calgary Northeast, CPC): Thank you, Mr. Chairman, and thank you, sir, for your presentation. I apologize for being late and walking in on your presentation.

We've certainly been following the issue of credentials recognition in this committee. It is a topic that has been around for some time. Obviously your organization has been a participant, as you say, both in federal and provincial programs. I'm curious as to why this working group collapsed or was suspended when you were active with it for some time. What was the cause of the breakdown?

Dr. Paul Cappon: Are you referring to the withdrawal of funding by the federal government from the centre, or are you referring to the citizenship and immigration committee?

Mr. Art Hanger: I am referring to the citizenship and immigration committee.

Dr. Paul Cappon: Okay. I'll ask my colleague Yves Beaudin if he has an explanation.

Mr. Yves Beaudin (National Coordinator, Canadian Information Centre for International Credentials, Council of Ministers of Education (Canada)): The access to professions and trades working group was co-chaired with the Department of Citizenship and Immigration approximately a year and a half ago, when there was an interest by the federal government to do some in-depth discussion around foreign credential recognition. That particular working group just drifted away, even though many people asked that it be activated so that the provinces and the territories as well as some national organizations could participate in and have input around the same table on foreign credential recognition in the discussions that are presently being held.

Á (1120)

Mr. Art Hanger: My thought is that if there is going to be some recognition, without the inclusion of both federal and provincial discussions and, in particular, the greatest input probably from the provincial side of things, if there isn't a substantial level of cooperation, it will never happen then. I see that the provinces, in particular, have a specific need to address skill level and credential acceptance.

Mr. Yves Beaudin: On the committee you had the provincially mandated credential evaluation services, which actively participated in this particular group. Of course, we found that very interesting, because the provinces could express their opinion around a responsibility that rests with the provinces and territories. And all were very interested, as Dr. Cappon said, to collaborate with the federal government on this issue.

Mr. Art Hanger: But it collapsed. Putting it bluntly, was there not a will within the government or the committee? Perhaps there was in the committee, but as far as the government was concerned, was there not the will there to follow through on this issue?

Mr. Yves Beaudin: I don't think it was a decision to close down that particular committee. I think it was simply the result of the efforts that were being made by various federal government departments to reassess the work that was being done at the access to professions and trades working group. And I am told that eventually a similar committee could be put in place, but for the time being it's suspended.

The Chair: Thank you.

Jerry, do you have a question?

Hon. Jerry Pickard (Chatham—Kent Essex, Lib.): Thank you.

You know, I've been really wondering how, in light of all of the professional people who can come to Canada, we can work visually with qualifications abroad. We can assess each person as they come down the line, and that certainly is admirable, but time-wise, I'm not sure we're able to meet those parameters.

Is there any way, in a situation abroad, such as New Delhi or wherever we're at, with universities that graduate certain kinds of professionals, we can assess or measure foreign universities to see if their qualifications are equal to the qualifications of professionals in Canada? And if they are equal, can those people who graduate from those programs be easily brought into the country?

I know there may be language problems associated with foreign university people coming in, but getting beyond that stripe, quality education, in our view, is very important, and if it's comparable to Canadian standards, why aren't we just checking language quality--that's part of our whole demean of serving people--and then bringing people in a lot easier and a lot quicker?

Dr. Paul Cappon: I think that's a very good question. It is the case that people generally are assessed on an individual level and not on the level of the institution from which they might graduate. There is actually no international system of accreditation of universities to which we could turn in order to establish whether there is a comparability between Canadian standards and international standards. To be quite blunt with you, we don't even have a national accreditation system in Canada of universities, let alone an international accreditation system.

The world is a long way away, despite online learning and all those kinds of things, from comparing quality of institutions. We're only at the point now, both internationally and within Canada, of looking at ways to review the kinds of processes put in place for a quality review of institutions. If you wanted to decide what institutions, for example in India, produce engineers or physicians at the level of Canadian universities, you wouldn't be able to do that in today's terms. There's a lack of a common system of accreditation or even quality review around the world. As I said, we don't even have that within our own country. Therefore, what happens is that people are reviewed on an individual basis, which I think for the foreseeable future is where perhaps a lot of effort is going to have to go.

I do see no reason why people's individual skills and talents, including prior learning, cannot be assessed where they are, before they come to this country. That was, I think, the thrust of the paper you received from researchers on what Australia does. I think that would be a very helpful step, and it is one of the steps that the provinces and territories described in the paper we did on collaboration with the federal government.

Á (1125)

Hon. Jerry Pickard: Maybe I could back this up just a little bit. I believe mobility is an absolute requirement of professional people today, and it will be in the future. It can be through tele-mobility or it can be through actual movement of people from one area to another. Corporations in Canada are hiring people in high-tech areas in India, through the Internet, to service all the customers they have in South America, Europe, and Asia. It seems to me we're not even catching up on this mobility. We're not even considering the huge, enormous opportunity we have.

Coming back to Canada, should we not start looking on a basis of what is consistently acceptable in the professions here in Canada so that we have a basic line we can work from? Then we can measure, with some reason, other people coming into Canada. Without that, I really think we're never going to use the potential that's required to do it. In the medical profession, where you have a client one-on-one, that's one kind of usage. But I can see engineers sitting in other countries who certainly can do the application of engineering work here in Canada, on the Internet or whatever. I see this as a huge opportunity for Canadians to be employed anywhere in the world.

The facility is there. We're a world community. But we're not even thinking in terms of getting our own country sorted around, let alone immigrants coming into the country and serving Canadian needs. We have to move eons, in my view, from where we're at right now.

Dr. Paul Cappon: I think that's a fair comment. I cannot but agree and perhaps elaborate with just two quick points.

One is that if we don't do this in a public way through governmental approaches or public approaches.... Of course, it's being done by the private sector. The private sector establishes its own kinds of qualification systems, which they will apply, then, in the use of--

Hon. Jerry Pickard: But there is a public requirement here as well as private.

Dr. Paul Cappon: Indeed.

The other point I wanted to make, in terms of recognition of people's learning, is that we don't have in Canada a national system of assessment and recognition of learning. Again, it's difficult for us to go international when we don't have a pan-Canadian system of prior learning assessment recognition. It's different from province to province and from occupation to occupation. This is one of the issues you're pointing out that I agree with.

The Chair: Thank you.

Madeleine, s'il vous plaît.

[Translation]

Ms. Madeleine Dalphond-Guiral (Laval Centre, BQ): Thank you, Mr. Chairman.

I was a nurse in my former life and I'm rather aware of the difficulty of integrating people in that profession into the labour market. This is true not only for nurses, and I think that they have made some progress in this area recently, but we all know full well that there are certain professional associations that can be qualified as closed shops.

We're living in a world where people can travel more and more easily. For instance, if I were to get sick in France, Belgium, Norway or Germany tomorrow, I would not be worried about the quality of the care I would receive. There are countries with a level of development comparable to our own where it is reasonable to think that training programs are certainly equivalent. I find it unthinkable that we wouldn't recognize that sooner or later.

On page 4 of your document, you allude to the fact that the federal government cut back funding for the Canadian Information Centre for International Credentials. I'd like to know what the consequences of that have been, because you can't get away from it: nothing can move forward without the necessary financial support. So I'd like to know what the consequences have been. You said that you've continued to operate, but there's certainly been an impact. We just had a new budget handed down and I imagine that if there had been something in that budget, you would have told us so. So here we are before a federal government that is willing to say things, but does not walk the talk.

Á (1130)

Dr. Paul Cappon: I'd like to address your first point, with your permission. Then I will answer the question.

With regard to the first point, the issue of nurses or doctors points to the fact that this is all very complex. We often read or hear that there is a shortage of doctors and nurses, that there are doctors who are driving taxis in Canada, but I haven't seen any studies about this. I've heard anecdotal evidence, but I don't know what the demographic reality is behind all this. We'd have to conduct studies that show that there are many people who have the same qualifications and the same opportunities as those trained in Canada.

With regard to the second question about the impact of the federal government decision to cease joint financing of CICIC in spite of the fact that Canada was a signatory of the Lisbon Convention with the provinces and territories, all this simply means that the resources that are allocated for this important activity are far less than what they could have been. I find this unfortunate because one can see the workload that this represents and the need to move forward, and we find ourselves in a situation where we are constrained by financial considerations, as are the provincial and federal governments. That is unfortunate.

Now as to why the federal government did this, you'd have to ask the Department of Human Resources, I believe. I think it's their intention to create another system for new immigrants, another website, but this system was not yet in place when the decision was made not to continue funding CICIC. But that's the decision they made. I couldn't say why, because I really have no idea why they made that decision.

Ms. Madeleine Dalphond-Guiral: I have another question. On page 5, when you refer to the document entitled “General Guiding Principles for Good Practice in the Assessment of Foreign Credentials” you talk about a number of basic principles and you mention four. I must admit that I find the second one interesting, but I'd like some clarification. The second guiding principle is:

2. Holders of foreign qualifications should have adequate access, upon request, to an assessment of their foreign qualifications.

When I hear that, it sounds like one of these days I could have on-demand service, but I'm sure that's not what is meant. What are the actual time frames faced by people who want to have their credentials assessed? Given the delay between applying for permanent residency and obtaining that residency, for example, we know that that's part of the problem.

Dr. Paul Cappon: I will ask my colleague Yves to answer that question on what is adequate.

Mr. Yves Beaudin: Here again, there's no easy answer, in the sense that most evaluation services that have a mandate from the provinces can perform an assessment within a reasonable time frame.

Á (1135)

Ms. Madeleine Dalphond-Guiral: What would that be?

Mr. Yves Beaudin: When we say a reasonable time frame, we're talking about anywhere from 10 days in some cases and that's actually true—to five or six weeks in other cases.

Very often, we hear people tell us that it takes a month or two or three. Yesterday one person told me it took 10 months, but when we analyze credentials, we also have to have the documentation that allows us to perform this assessment. But when everything has been provided to current evaluation services, it takes them between 10 days and 4, 5 or 6 weeks.

Ms. Madeleine Dalphond-Guiral: What were the other guiding principles that you set out? A fundamental principle is very important. Could you describe the other three that you didn't include? To my mind, you drafted your text knowing full well that we were going to ask you questions about this.

Dr. Paul Cappon: I don't have the document here with me, but on the whole, what is important is that an evaluation be done in a fair manner so that the person can be certain that the evaluation will be as similar as possible from one province to the next. This is why we coordinated the efforts of the Alliance of Credential Evaluation Services of Canada. All provincial services are members of the alliance precisely to have exchanges and come up with approaches that are as similar as possible, taking into account the differences in education systems among the provinces.

[English]

The Chair: Mr. Martin, NDP. Do you have a question? If you don't, we can go over to this side?

Mr. Pat Martin (Winnipeg Centre, NDP): No, I'd just as soon use my time.

Á (1140)

The Chair: Go ahead.

Mr. Pat Martin: Thank you, Mr. Chair. I've waited this long. I'm not going to give it away.

Thank you, Dr. Cappon. I think I agree with Mr. Jerry Pickard. This is a problem that's hounded us for so long, and Canadians are genuinely frustrated about this, those who advocate on behalf of immigrants and new Canadians and industry sectors that are facing serious skill shortages. It's useful for us to learn that there are proactive steps being taken, and I fully accept that both of you are fully seized of the issue and doing all you can, but the progress seems stalled, if you will.

It's certainly the public perception that there are all these irritating cases of doctors driving taxis. There was a guy on the national news last night, or two nights ago. I can't remember what his occupation was. He was working in a minimum wage job and was a highly-skilled scientist, and he was saying, “I can't go on like this any longer. Two or three or four years is about all you can live at the poverty line, and we didn't come to Canada for this”.

So we see this contradiction, as an immigration committee, that we welcome people into the country based on the point system and they qualify based on their credentials, their occupation, and their skills, and then once they're here we don't let them practise their craft. It's stupid. It's the only word a layperson can come up with.

I'm having trouble getting my mind around specifically how what you're doing is going to solve this problem in the immediate future. You point out yourself that we don't even have national standards within the country on a lot of these occupations.

I'm a carpenter by trade, and there are 14 different curricula for being a carpenter. And when I had to travel to do my job, as I did regularly...you go from Ontario to B.C. and it's a completely different skill set because they're taught different practices. So there is no standardization even among those basic blue collar trades, never mind the highly technical skills.

In a nutshell, is the problem because there is sandbagging and protectionism and closed shops among regulating associations? Is that what you're finding, that people like engineers are trying to protect their jobs for their domestic buddies because they don't want the foreign competition? Is that it?

Dr. Paul Cappon: I'd like to make four points in response, if I may.

That would be far too simple. I don't believe that's the case overall. I think that's the case for some professions. There are a great many bodies regulating professions and occupations and trades in Canada.

Mr. Pat Martin: Yes, we have a list of some here.

Dr. Paul Cappon: Yes, and that's because they have to be licensed at the provincial or territorial level, so there will be many. And of those, some will be protectionist, no doubt, but I think most of them are of good will.

You happen to be talking to somebody who is a physician by training. As a physician I would want to be sure that people practising on my family members really have the equivalent training, skills, and expertise that I think people trained in Canada would have. I'd want that assurance, and you would, too, when you come out of the abstract and you come into the actual practical and think about people you know who would come in for treatment.

I don't believe it's simply protection of skills and territorialism on behalf of most of the professions. What is the problem, then? One problem, and we've talked about it before, is that we have a difficulty doing things on a national basis--or a pan-Canadian basis, as we say at CMEC--and to be able to do things on a national basis is often the trampoline for going international. I mentioned the fact that we don't have a pan-Canadian system of recognition of skills, and you know that from carpentry. That's the case in almost all of the occupations and trades.

So it's very hard to go international when you haven't done things nationally. Most countries do have a national system of skills recognition, so we don't have the base from which to work.

The second thing is the deficiencies or the limits of the organization of which I've spoken today. This organization isn't proactive. In the sense of credential recognition, all this organization does is provide information to those who want credential recognition, and we direct them to the organizations that can do it.

This brings me to the third point. We would need a fairly important investment of time and resources--including human resources, but as well, money--involving both levels of government and the organizations themselves. And I would argue we have to do it, as I've said before, overseas. As the provinces and territories have said in their paper, we need to do it overseas, before people come to the country--as the Australians are wanting to do--as part of the system of bringing people into the country to ensure you bring people in who aren't going to fall into unemployment or underemployment when they get into the country. And I don't think we've done that as part of the assessment system. So I think it would take a lot of collaboration, but it takes resources as well.

Mr. Pat Martin: It's a much better answer than the question was. I appreciate that.

It seems to me that there is no human resources or labour market strategy in Canada in, really, an assessment of needs and demands. Inviting immigration to fill shortages, you have to know there are shortages, first of all. That's maybe a problem for HRDC more than Immigration, but now that it has fallen to Immigration....

I sit on so many committees. I just came from the aboriginal affairs committee, and they're furious that we don't look first to the hugely underemployed population of aboriginal youth when we find skill shortages in industry sectors. So we're working almost at cross-purposes here sometimes too.

I noticed in your brief that you were formed--or CICIC was formed, at least--in recognition of or due to our ratification of the UNESCO convention, and we're lumped in as part of Europe for the purposes of their carving up the planet. Why is that?

Dr. Paul Cappon: That's because, in part, the United States withdrew from UNESCO, and when they withdrew from UNESCO, it left us--

Mr. Pat Martin: There weren't enough left in our sector.

Dr. Paul Cappon: There weren't enough countries in this part of the world to form its own sector. So we were part of the Europe region, and we've just stayed part of the Europe region even though the United States has rejoined UNESCO.

Mr. Pat Martin: You know, you mentioned the medical profession as an example, and we have a terrible illustration in Winnipeg, where I come from, where the checking of credentials hasn't worked.

The director of our pediatric heart program was a Dr. Odim, who has had to flee the country because he literally butchered 12 babies because he was so underqualified. Somehow that guy got into the country and was allowed to practise medicine when he was clearly underqualified. Nurses at the operating table were so horrified that, if there had been whistle-blowing legislation in this country, they would have blown the whistle on him with the first baby he killed, never mind the other 11.

So there are holes in our current credential checking, I suppose.

Dr. Afifi is the other one, the orthopedic surgeon who just wreaked havoc throughout the whole medical system in Canada. Somehow these guys got into the country even with the current checks and balances.

So as much as we advocate to try to let more people practise their craft in the country, there seem to be shortfalls in the current checking of credentials. There are an awful lot of families in Winnipeg devastated by Dr. Odim. Were he here, he would probably be in prison for what he has done.

Is there any comment on the inverse? What is the shortfall of the current credential checking system?

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The Chair: A short answer.

Dr. Paul Cappon: Two short answers, then.

The first is that there are mistakes that happen in credentialing indeed, even under the scale on which we're working now. So when you imagine a much vaster scale, which is what we're talking about and which I think will be required, you have to be sure that it's rigorous, at least as rigorous if not more rigorous than we have now.

The other part of the answer is that if you're talking about the inverse, we do have to keep in mind that there are a lot of people already in the country who would wish training or upgraded training in their skill or profession or occupation, whatever it be, and we haven't done a very good job, I think, overall in apprenticeship, for example, for people who are already in the country, without even thinking about going abroad.

So when you think about resources, competing for scarce resources, that is a factor. You have to think about those who are already here, and not just those who are abroad.

One final point about that is that Canada, among other western countries, comes in for a great deal of criticism from the developing world for what they call “asset stripping”, taking the most qualified professionals--

Mr. Pat Martin: Yes, I know, harvesting the best and the brightest.

Dr. Paul Cappon: Yes, while we don't develop the people who were born in this country or raised in this country and are already residents here with adequate apprenticeship and other professional development programs.

Mr. Pat Martin: It's a contradiction.

The Chair: Thank you.

Ms. Fry.

Hon. Hedy Fry (Vancouver Centre, Lib.): You just touched on what I was going to ask you about. You haven't mentioned a great deal about apprenticeships and training and the resources required for that. I think that's a huge piece of the puzzle that we haven't resolved yet and that needs a lot of resources.

Let's take medicine as an example. If you're going to start apprenticeship programs, preceptorships, internships, or residency programs not only for those who are coming into the country but also for the current pool of people who are here and have not been able to practise either as physicians or nurses, where are you going to train them? The biggest problem right now is that we have only so many medical schools and hospitals. The average teaching hospital has at least eight people at the bedside trying to get training, including students; interns; and first-, second-, and third-year residents.

One of the things we have identified is that we have to find places for this training to occur because of the problem that Mr. Martin was speaking about. If you don't have adequate training, then you can have inadequate quality. Therefore, you run some risks, especially in something like medicine. You've hit on some of those things, and the one I would like to hear you make some comments on would be how we find that preceptorship.

I agree with you completely that the first thing we need to do is to get a pan-Canadian assessment model. I think that's important. When we went to the world conference against racism, one of the things Canada put on the table was an international set of standards. Of course, we could never talk about international standards when we didn't even have pan-Canadian ones here. I think there's a movement to start doing that.

There is a third piece I would like you to comment on, and that has to do with understanding the Canadian culture of work. If someone comes to Canada to work as a physician, for example, they're coming into a totally different type of medicare system. They need to understand how that system works and how to fit into the model of patient expectation of what a physician should provide.

A good example has been given to me by pharmacists. They are not involved with public employers. They are involved mostly with private employers, because pharmacists work for chains, a lot of them anyway. A pharmacist coming from another country may have excellent training on paper. But pharmacists here are beginning to provide primary care, advice and treatment to the person who walks in. A lot of these people have never worked outside of a plant or an institution, and therefore they're not able to cope with the Canadian culture, the model that is required. So that alone needs to have some experience within the system.

How do you think we can find the ability to create that Canadian experience and a preceptorship model in this country? Even if you have the resources, how can you find the places?

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Dr. Paul Cappon: How much time do I have, Mr. Chair?

The Chair: Two minutes.

Dr. Paul Cappon: On the third issue with regard to the culture of work, it's why I raised the example of the anecdotes about physicians who are driving taxis. It isn't just the technical requirements, although we could have concerns about those. It's also the cultural component of that. As I said, I haven't seen any studies about the actual numbers. I've heard these things repeated a number of times.

Hon. Hedy Fry: The Conference Board said 550,000, not physicians, but persons who have been here for 10 years and haven't been able to work or are underemployed.

Dr. Paul Cappon: That drives you to the issue about the difference between the abstract, when you're talking about these things, and the concrete, when it's to do with your house being built by a carpenter or your family member being seen by a physician. It looks a little different when you do it that way.

I think you've answered some of the questions yourself in terms of what we need to do. I think that, first, we need a pan-Canadian assessment model. We don't have one. That is a matter of federal-provincial cooperation of the kind we haven't had up to now and cooperation with all of the occupational groupings. People have been clamouring for that. We haven't done it the way it would need to be done.

In terms of preceptorships, one of the issues is a resource issue, not just for medicine but for the other areas as well. I remember that even in the 1970s when I was in medical school we were doing that. We'd have a gaggle of clerks, a flock of interns, and so on up the hierarchy in terms of getting access to that kind of experience. It's even worse now. Therefore, there's an understandable competition over that between people who are trained here and want spaces in residency or internship and people trained abroad. I think there is a huge resource issue that comes in there.

Finally, I think we need--I'm trying to go quickly here, Mr. Chair, in regard to what you said--far more coherence between international policy and national policy and between what we're trying to achieve in terms of international trade and international aid on the one hand and using foreigners to solve all of our problems on the other. We seem to turn to international solutions to solve our problems, because we're not investing locally as much as we should and because we don't have national programs. Even at CMEC, when we want to do something nationally, we tend to try to do it internationally first because it seems to be more acceptable to do it that way.

That's only a partial answer. I'd need more time to fill in the gaps.

Hon. Hedy Fry: Just quickly, it's my understanding from Statistics Canada that because of the falling birth rate and the increased number of people who are retiring in our country we are going to have to turn, within the next seven years, by 2011, to immigration for our net labour market needs. No matter how much we train the current cohort of people we have, we still don't have enough people coming up the pipe because of birth rates, etc. So this is a long-term problem that we need to face, and we need to look at how to address it in a proactive manner.

Have you any suggestions for how we address it in a proactive manner?

Dr. Paul Cappon: Yes, I do, and it's one that's in the provincial-territorial paper from the year before last. There are two suggestions that are very concrete, I think.

One I've made already, and that is to actually seek out immigrants that we need, who we know have the skills, in their home countries, rather than waiting until they come here and having--

Hon. Hedy Fry: But isn't that picking the pockets of those countries?

Dr. Paul Cappon: Yes, it is, and that raises the problem of coherence. I think you have to be consistent and you have to be transparent--if that's what you're doing, you say that's what you're doing. Nevertheless, you asked me how you'd do it practically.

The second thing you would do is what the Australians are proposing, which I've mentioned already, which is to do the assessment of skills over there, before they get here and are disappointed and underemployed or even unemployed, which we haven't done.

The Chair: Thank you.

Before we go to Mr. Hanger, I'd like to ask a short question, sir.

You mentioned the Australian experience a few times and that they'd been working for a long time. It occurs to me that Israel is one of the countries that take in the most immigration percentage-wise. They've had 600,000 or 700,000 immigrants come in from Russia--they even have their own political party.

I asked one person from Israel, who knows of the Israeli experience, how to become a physician in Israel. He said you have to speak Hebrew and you have to speak English; if you don't speak both, you can't be a doctor. Obviously, most people coming in from Russia don't speak English or Hebrew. But they have somehow managed the problem.

Do you have any knowledge of how they handle this problem in Israel, so we can learn from the experience of Israel, along with that of Australia and New Zealand?

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Dr. Paul Cappon: The problem of language, you mean?

The Chair: Yes, language and how to train them, too. Because in order to be trained in Israel, you have to speak Hebrew and English. If you speak only Russian, you can't even be trained.

Here we have people coming in who are fluent in English, but they cannot get a job.

Dr. Paul Cappon: I can't refer to the Israeli model. I don't know. I suspect that most of the people who go to Israel already speak Hebrew before they get there.

The Chair: They go there from Russia; they speak none.

Dr. Paul Cappon: They speak none?

The Chair: No. But somehow they manage. I don't know how.

Dr. Paul Cappon: Then I don't know.

I do know that in the Australian model, one of the advantages they have there is that they have a council for employment, education, and youth affairs. It's a combined council and involves the federal and state governments working closely together in terms of labour market arrangements and tying it to employment and education.

I don't know the Israeli model, but I would expect the models that we need to look at would be federal rather than unitary states because of the way we are organized.

The Chair: The different jurisdictions.

Dr. Paul Cappon: Yes. So I would look at the United States, Australia, Switzerland, Germany, those kinds of countries.

The Chair: Okay, thank you.

Mr. Hanger.

Mr. Art Hanger: Dr. Cappon, I was invited a short time ago to a reception put on by the Filipino community. In fact, it was very narrow in its invitation. It was directed to engineers who had graduated from a university in the Philippines that had been established by the Americans about 75 years ago. Some 450 of those engineers who came out of that school practised in Alberta in the oil and gas industry. They had no problem integrating into the needs of the country. Obviously the standards were such, in the overall picture, that they fitted into what the needs were here in this country, in particular in the oil and gas industry.

A university with those kinds of known credentials obviously would be attractive to a country such as ours, in particular to a province like Alberta, to fill a certain need. Now, if every university was assessed in this way, and you say there would be a tremendous cost involved in actually doing that—I would have to say that there probably would be—why not establish a protocol? We can send engineers to Australia, we can send engineers to basically Europe or the U.S. or Britain, and for the most part, they will be integrated quite easily into that framework. Perhaps some of the other countries in the world, the third world countries in particular, might not have the same assessments. But we would not be the only country, obviously, making these assessments. I would assume that England, the U.S., and others would be doing the same thing. So would it not be easier to establish that kind of a unified protocol than just to have our own level of assessment and be subjected to a substantial cost?

The other point I would like to make is this. In the oil patch there's a great need for workers of all levels—I don't care if it's on the supervisory side, all the way down. There are calls out everywhere to bring in experienced workers to work in the oil patch. There is such a lack of skilled individuals that you couldn't go to a foreign country and probably get those skills that are required in that very specific industry. So the efforts, I would have to say, would be more directed to local people to fill the need. I think over the years there has been slippage in that area of attracting skilled workers. I don't care if it's in the trades and occupations or even in the professions, whether it be medical or otherwise; this country could fulfill all our needs without having to look overseas. I don't buy this theory of saying we're going to have to draw on all areas of the world to fill our labour needs or to fill the professions. I think there's another issue that has to be addressed, and that is an internal one, and I think our needs could be filled just as much. I believe this is an alternative argument to that expressed by Madam Fry.

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Dr. Paul Cappon: On the second issue, I appeared in this very room last year in front the committee on human resources development on the issue of adult education. One of the points I made is a point that you're making here, I think, Mr. Hanger, which is that we could do a lot better in terms of workplace-based training in Canada and in terms of adult education.

When I look at our education system, for example, and how we compare with other systems around the world, I find that we do quite well in our formal education system--the K-to-12 education, post-secondary--but our adult literacy rate diminishes faster than that of most countries in the OECD once people get into the workplace. People need to be very literate to work in the oil patch or anywhere else where the skilled trades now are prominent. Why is that? The reason is that we don't have the kinds of activities and workplace-based training and the kinds of incentives, perhaps, and the kinds of programs that we would need. So a lot more effort could go in there.

On your first point, there actually are special arrangements made bilaterally or multilaterally among countries now that are similar in terms of economic or social development. I agree that they could be taken to a further step. I also have to say that there's a great danger in Canada that if we don't do accreditation nationally in Canada, which we don't do now, particularly at universities and colleges, we will then become accredited by foreign accrediting agencies. That is already the case for some of our universities that are accredited by American regional accrediting organizations because we don't have our own accrediting organization in Canada for universities and colleges. Programs are accredited, but not universities in Canada.

The Chair: Thank you very much.

That concludes our one-hour presentation. As you see, this is a very, very important subject, and we have just begun to scratch the surface.

We are going to have a five-minute break and then resume for a second session.

Thank you very much, again.

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The Chair: We are going to lead off with a 10-minute presentation from each witness, Ms. Louise Sweatman and Ms. Lisa Little. After the 10-minute presentation from each witness, we will go to questioning again.

I would suggest that we follow the old format this committee had, so we don't have a debate about timing after the intervention. We will follow the format we had in the previous committee. We have until 1:30, so please go ahead.

Mrs. Louise Sweatman (Chair, Canadian Network of National Associations of Regulators (CNNAR)): Thank you very much, and good morning.

CNNAR welcomes this opportunity to discuss with the standing committee the important issue of the recognition of international credentials.

My name is Louise Sweatman, and I'm the chair of CNNAR, the Canadian Network of National Associations of Regulators. It is a network of national associations composed of provincial and territorial organizations whose members are responsible for the self-regulation of a profession or occupation.

CNNAR members represented in this presentation include the Agriculture Institute of Canada, the Association of Canadian Occupational Therapy Regulatory Organizations, the Canadian Alliance of Physiotherapy Regulators, the Canadian Council of Practical Nurse Regulators, the Canadian Council of Professional Engineers, the Canadian Council of Technicians and Technologists, the Canadian Federation of Chiropractic Regulatory Boards, the Canadian Nurses Association, the Canadian Society for Medical Laboratory Science, the Canadian Veterinary Medical Association, the Federation of Medical Regulatory Authorities of Canada, and the National Association of Pharmacy Regulatory Authorities--a family somewhat like the federal government.

CNNAR's mandate is to support the understanding of self-regulation of professions and occupations. CNNAR facilitates this through collaborative projects and information exchanges among our members, with federal government agencies, and with other national and international groups. It also monitors and responds to proposed federal legislation and policy changes and serves as an information clearing house on these public policy initiatives. Importantly, CNNAR also develops and shares resources with respect to regulation, and it addresses regulation from a national perspective.

CNNAR members acknowledge the importance of recognizing the credentials, competencies, and experiences of internationally educated professionals. Regulators are charged, via the provincial and territorial governments, with the statutory responsibility of regulating professions and occupations. This responsibility is mandated through the lens of public protection.

Based on the collective experience of its members and with the objective of ensuring the safety of the public, CNNAR has identified six principles of foreign credential review. The six principles are focus, consistency, fairness and access, competencies and credentials, disclosure, and multiple responsibilities and collaboration. We will now describe each of these principles in more detail.

The first principle is focus. We respectfully submit that the primary objective for recognition of internationally educated professionals' qualifications should be to ensure that the needs of the Canadian public are met through a workforce with the appropriate knowledge and skills. Canada is relying more and more on immigrants to fill domestic work demands. As the global workforce becomes increasingly mobile, a greater number of skilled workers are seeking to work in Canada. This means qualifications must be fairly reviewed to promote the entry of safe, ethical, and competent workers.

The second principle is consistency. Recognition of immigrants' qualifications should be consistent across Canada for each professional or occupational group of workers. The development of a consistent approach and standards is necessary to ensure the stability of the workforce. Substantial consistency promotes the achievement of a unified approach to the mobility of immigrants to Canada. This principle of consistency allows for consideration of worldwide endeavours, for example, seeking guidance from and alignment with international standards and strategies.

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Third is fairness and access. The process of recognition should be fair, timely, predictable, and transparent. The processes must provide and must be seen to provide just treatment for those seeking recognition. Applicants are entitled to information on the status of their applications and the basis for decisions related to the qualifications in the immigration and regulatory/licensure process.

An honest and open process requires that objective measurements are used and that all applicants are fairly treated in a timely fashion. Methods of evaluation for eligibility for entry into a profession or occupation should be fair, transparent, and accessible. There ought to be encouragement of communication and an opportunity to appeal decisions.

Principle four is competencies and credentials. Recognition of internationally educated professionals' qualifications should include recognition of competencies and experience as well as educational credentials.

Assessment of educational training is one criterion to be used to determine entry into a regulated profession or occupation. There are other factors. One factor is the competencies of the applicant. Competencies reflect the knowledge, skills, judgment, and personal attributes of an individual. Canadian regulatory agencies prescribe the competencies required of a professional to practise safely, ethically, and competently in a designated role. The public must have confidence in the ability of each professional licensed to practise in Canada, whether they were educated in Canada or elsewhere, to perform work safely.

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Principle five is disclosure. Internationally educated professionals seeking work within Canada are entitled to information on Canada's employment and immigration policies and practices, as well as on applicable regulatory requirements they need to meet. This information should be available to them prior to their coming to Canada.

Under the Canadian Constitution Act, the provincial and territorial governments have the exclusive power to regulate professional groups. These governments in turn have, under statute, delegated this work to regulatory bodies. Under the Canadian Constitution Act, the federal government has the exclusive legislative power over immigration. The immigrating professional who is not trained in Canadian constitutional law and its distribution of powers must therefore meet two classes of entry standards, one designed by the federal government and one designed by the provincial-territorial regulatory authority.

Governments have expressed a commitment to bringing in immigrants. They must also ensure that individuals seeking to immigrate and work in a regulated profession are informed of the regulatory requirements, including costs and licensure processes in Canada. Potential immigrants need to be informed of what will be required for them to practise their profession or occupation before they come to Canada. CNNAR believes that governments and the regulated professions have roles to play in this. The question is, who should bear the cost?

Principle six is multiple responsibilities and collaboration. The successful integration of internationally educated workers into Canada requires collaboration amongst numerous parties. They include the immigrant; the federal, provincial, and territorial governments and their departments; employers; educators; regulatory bodies; and the public.

Regulators must have frameworks in place that maintain public protection. At the same time, internationally educated professionals must be provided with the best opportunity to achieve their full potential in practising their chosen profession in this country. That is why it is essential that new immigrants have access to tools and resources to assist them through the regulatory process and integration into the Canadian workforce. Governments, the public, regulators, employers, immigrants, and educators need to collaborate to provide the infrastructure necessary to facilitate this integration process.

We all need to make a sustained commitment to assist these individuals when they arrive in Canada. They will need support to attain professional and occupational recognition and to make a successful transition into the Canadian workforce.

Many of our member organizations are evaluating the processes and attempting to take a more pan-Canadian approach to regulation. The next speaker, from the Canadian Nurses Association, will be providing you with information about some initiatives that are occurring within the nursing profession. Over the coming days and weeks you will hear from other CNNAR members, such as the Canadian Council of Professional Engineers, the Canadian Council of Technicians and Technologists, and the Federation of Medical Regulatory Authorities of Canada. These organizations will provide information about their professions' initiatives

Provincial, territorial, and federal governments are encouraging regulators to carry out reviews of regulatory processes, and the federal government has provided financial support for this work for the larger professions, such as medicine, nursing, and engineering. Support for the smaller professions is also sought, as their needs are similar. CNNAR respectfully urges the federal government to continue to collaborate with regulators and provide ongoing support for ensuring a principled approach that is focused, consistent, fair, and accessible; and that considers competencies, discloses appropriate information, and respects the multiple responsibilities and need for collaboration.

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In conclusion, CNNAR is committed to supporting the self-regulation of professions and occupations. In doing so, we are also committed to identifying and promoting best practices with respect to the regulation of international applicants. We are pleased to see the standing committee's interest in this area, and we look forward to discussing this further with the committee during the question and answer period.

Thank you very much.

The Chair: Thank you very much, Ms. Sweatman.

Now we have the Canadian Nurses Association and Lisa Little. Please go ahead.

Mrs. Lisa Little (Health Human Resources Consultant, Canadian Nurses Association): CNA appreciates the opportunity to speak to the standing committee on the importance of foreign credential recognition.

To begin with, I would like to say that CNA supports the principles-based approach articulated by CNNAR in the previous presentation. The Canadian Nurses Association has defined these principles as, one, transparency; two, competency-based; three, fairness; four, national; and five, ethical. CNA recognizes that this principles-based approach will require leadership and investments by all levels of government and by other relevant stakeholders.

The CNA proposes that the federal government, one, fund the development and dissemination of electronic information targeted at internationally educated nurses; two, provide support for nursing and other health professional regulatory bodies to offset the increased demand to process international applicants; three, fund the development of infrastructure to achieve a national approach to the recognition of foreign workers' qualifications and to their integration into the workforce; and four, support a national health and human resource strategy that coordinates employment, education, social, health, and immigration policies to enhance the productivity of all nurses.

I would now like to review the five principles and provide more information on how they pertain to internationally educated nurses.

The first principle is transparency. Foreign workers seeking jobs within Canada are entitled to full disclosure and information on employment policies and practices, including applicable regulatory requirements. CNA receives numerous inquiries from nurses all over the world, including international recruiters, who are trying to determine what is required for nurses to work in Canada. Many do not understand that nursing is a regulated profession, let alone that it is regulated at the provincial level in this country. Information on the roles and responsibilities of a registered nurse, the health system, the licensure process and requirements, salaries, etc., should be available to them prior to their coming to Canada.

Once they apply to immigrate to Canada, they should also be able to access information related to the status of their application and any reasons for non-eligibility. It is for this reason CNA proposes that the federal government fund the development and dissemination of electronic information targeted at internationally educated nurses. This could be linked to the “Going to Canada” website.

The next principle is competency-based. CNA believes that recognition of foreign-educated workers' qualifications should include recognition of competencies and experience and not just educational credentials. Canada is a very attractive country, and immigrants will often utilize various measures to gain access, including purchasing educational credentials through the Internet. Also, the constant proliferation of nursing educational institutions around the world makes it increasingly difficult for regulatory bodies to validate transcripts and curriculum content.

Language proficiency is another key requirement for licensure. CNA believes that results from the research on prior learning assessment and recognition for nurses, funded through Human Resources and Skills Development, and from the Canadian language benchmark assessment for nurses should be incorporated into the overall assessment approach.

The third principle is fairness. The process of recognition should be fair. All nurses working in Canada must meet the same standards. They must all meet the same educational requirements, have the same language proficiency, and write and pass the Canadian registered nurse exam. These same criteria should apply to international applicants.

An internationally educated nurse must provide the same quality of care to a patient--for example, one with prostate cancer--as does a Canadian-educated nurse. They must be knowledgeable of chemotherapy drugs and their pharmacokinetics, be able to calculate the correct dosage for the patient, safely administer chemotherapy, and provide patient teaching with regard to potential side effects. Similarly, they must be able to communicate clearly to be able to instruct a patient on how to self-administer their insulin. Another example is that nurses, whether educated in or outside Canada, would be expected to provide culturally sensitive diet and exercise counselling to a family with an obese child.

Fairness must also be applied to the burden of the assessment process. Many provincial regulatory bodies in nursing are reporting double the number of applicants in less than one year. This increased volume has resulted in an extended timeframe for delivery of assessment. Currently applications can take up to 18 months to process. There is a component of user-pay for this service, but the bulk of the costs are borne by the regulatory body, which is funded by nurses licensed to practice in Canada. The increased focus on internationally educated nurse applicants is resource intensive and competes with other equally important priorities.

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It is for this reason CNA proposes that the federal government support nursing and other health professional regulatory bodies in a manner similar to that which they did for the medical regulatory bodies. It is our understanding that the medical regulatory bodies received $3 million to offset the increased demand to process international applicants.

I'll move on to the fourth principle, that of national. CNA supports a national approach to the recognition of foreign workers' qualifications. Provision of financial support would allow the development of products and services such as a national assessment centre to support the integration of international nurse applicants into Canada. This national approach would reduce duplication, create efficiencies, and streamline processes.

This infrastructure could also be expanded to support educational upgrading, language training, and social and cultural integration. It is our understanding that other professions, including the engineers and physicians, are also exploring a national approach. To this end, the CNA proposes the federal government fund the infrastructure to achieve a national approach to the recognition of foreign workers' qualifications.

The final principle is ethical. CNA recognizes the right of individual nurses to migrate and confirms the potential beneficial outcomes of multicultural practice and learning opportunities supported by migration. However, CNA acknowledges the adverse effects international migration may have on health care quality in countries seriously depleted of their nursing workforce. CNA does not support unethical recruitment of registered nurses from countries that are currently or will be experiencing a nursing shortage.

In conclusion, clearly the assessment of internationally educated nurses for licensure in Canada is complex. There are improvements to be made to ensure that each immigrant achieves their full potential. These improvements must be made within a framework of ensuring patient safety. CNA is committed to implementing a new approach, one that is based on the principles of transparency, competency-based, fairness, national, and ethical.

Thank you for your time.

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The Chair: Thank you very much.

We'll start with Mr. Hanger, please.

Mr. Art Hanger: Thank you for your presentations.

To be quite honest with you, I'm very impressed with your outline, especially as it relates to some very specific principles. I'm also in a sense reading between the lines in some areas here.

My first question would be to you, Ms. Sweatman, in reference to what your experiences are, again, with educated immigrants from foreign countries who've applied to Canada. They indicate they have a certain level of skills, and they believe they can apply those skills when they get here. When they do in fact arrive, they find there are a lot of barriers. Is that generally your impression with respect to skilled workers from foreign countries, that when they come here they find their skill level is not sufficient to practise what they did over in whatever country?

Mrs. Louise Sweatman: I think one of the differences is that in Canada we have a complex regulatory structure. In many other countries, once you've received your educational credential, you pretty much automatically get your licence. It's very much like how when you annually go to get your driver's licence renewed; you pay your fee, you get a piece of paper, and off you go. The expectation is that once you have your credential and you've received your immigration papers, you can come here and then go to get your licence to practise.

But there's a different structure here. It may not necessarily be of a higher standard, but it is complex, and that bit of information on the licensure requirements does not seem to be getting out to the potential immigrants. That's why one of our principles is about ensuring disclosure of information about what is required from the regulatory perspective. People should know about that so they can pursue their dream of being a pharmacist or a vet in their own country rather than coming here, thinking they might be able to pursue their dream but finding they're delivering pizzas or, when they're nurses, being nannies.

Mr. Art Hanger: I look at your one statement here on page 4, principle 5: “Potential immigrants need to be informed of what will be required for them to practise their profession or occupation before coming to Canada”. I've heard it said often from those who eventually immigrated to Canada, whether as doctors or some other profession, that they find it very difficult afterwards. They were of the belief that they could in fact almost step into professions when they get here. Consultants would inform them of such. Sometimes they paid vast sums of money to come. They were educated in their homelands, but then they run into this major barrier. It's years, for some, before they are able to practise, and some may never practise their professions.

I guess, in that sense, I'm looking at the statement that you recognize that these things in fact go on. It gives the immigrants, the professionals over there, a clearer understanding then of what's expected when they get here, or they may not even want to come here. Is that what you're suggesting with this statement?

Mrs. Louise Sweatman: Yes. We'd also submit that if more information was received by the immigrants before leaving their country in terms of the regulatory processes, there would presumably be less incorrect information.

On your reference to recruiters, sometimes they are not completely informed as to what the requirements are, and quite frankly, they're gouging immigrants. It's doing a disservice to a lot of people. We don't need that kind of middle person in there.

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Mr. Art Hanger: That's interesting. And I commend you on your research. I know that this is in fact happening.

Ms. Little, I have one question. How many nurses leave Canada every year? How many nurses have left over the last ten years?

Mrs. Lisa Little: We don't have an accurate number. We know the number of nurses who annually write—for example, the U.S. is one of the major migratory places where they go—the national licensing exam in the U.S. There are ways around that, where nurses can go down as a spouse, etc., and they don't actually go through that process. They're not captured through immigration papers. They're not captured through writing the national exam. Certain states in the U.S. take the Canadian exam at par, so they don't make you rewrite it.

It's a hard-to-capture number, but some of the numbers have been at around 1,500 per year in terms of writing the NCLEX exam in the U.S.

Mr. Art Hanger: It's 1,500 per year.

The Chair: How many come back?

Mrs. Lisa Little: Again, it's hard to know. If you were educated here, then left and worked in a different country, when you come back in, if you haven't kept up your licence, you have to rewrite it. There's a chance that we're getting duplicate numbers of people who were originally here.

We don't have accurate numbers, to put it frankly, because of the way we capture their licences. If people are down there less than five years, the thought is that many of them return, but if they're in another country beyond five years, they're pretty much there to stay.

Mr. Art Hanger: They may go down, as you point out, for various reasons. One may be because the family, as a whole, may migrate there. They may see an offer that they can't refuse, so to speak, with better opportunities maybe. Is there a way of retaining some of those people, in your opinion?

Mrs. Lisa Little: Certainly, I think there are ways of retaining them. We will never compete with the U.S. in terms of monetary incentives offered to nurses to work in the U.S., but I think there are other things that we have to promote, such as an environment of healthy workplaces in Canada. If we look at the sick time of nurses and absenteeism in some of the reports that have come out, we feel that a large percentage of that is due to unhealthy workplaces. That may be why we're losing a lot of nurses.

For example, being forced to work overtime, having no support for continuing education, having no visible leadership in their facility of work, those kinds of elements, and even safe practices around occupational health and those kinds of things, are some of the reasons that nurses are saying they've had enough. They're walking away and going to places that have better environments.

Mr. Art Hanger: On the first page of your presentation, you indicated that immigration is one recognized strategy to ensure sufficient numbers of knowledge workers in the health sciences. Are the others those that you just related to me?

Mrs. Lisa Little: That's one.

I think, as was referenced this morning, increasing the number of nurses who are Canadian educated is another. We've had a drastic cut over the last 10 years in the numbers of seats for Canadian nurses to enter into. We have seen some improvements in those over the last few years.

As well as recognizing, as Dr. Fry spoke of earlier, the immigration and net labour growth that we'll need, I think in parallel we still need to work on the Canadian side as well. We have, on average, three applicants for every one seat in nursing in this country. We are turning away Canadian students who are interested in nursing.

Mr. Art Hanger: Who regulates that?

Mrs. Lisa Little: It's just a matter of their applying to the educational institutions. They have only so many funded seats, so if a certain university receives 1,000 applicants for nursing and they have only 200 seats, they turn away those students. They may get in at other universities, but by the numbers we're seeing, we think there are still a large number who are not successful in receiving an educational spot.

Â (1240)

The Chair: Thank you.

We'll come back to you.

Jerry.

Hon. Jerry Pickard: Thank you very much, Mr. Chairman.

Ms. Sweatman, I apologize for having to run out and back, but it wasn't because Hedy and I weren't very interested in your presentation.

I think this is a critical issue, and we seem to be caught in a bind on jurisdiction and on how we can work together to resolve the problem. The federal government is being asked to put money in to help coordinate and bring things together, and we're talking about provincial administration of the programs and territorial administration across the board.

I really feel there is a professional side to this question that needs to be resolved as well. That professional side that I would see is bringing those professionals together in order to come up with strategies under which we can set minimum criteria and longer-range courses for resolving these problems on a more global setting.

When I say “global setting”, I guess we have to go to Canada first, and then expand more after that. Obviously our last witnesses made it very clear that you're not going to resolve it outside of Canada with immigrants before you resolve it internally in this country.

Are you, as professionals and as people very involved in the process, ready to start looking at criteria? I know you said, well, some people can get false criteria from abroad and come in. I think a very simple answer to that is that there are questions that only the professionals could answer, and you could go with a few questions and quickly identify those people who do not qualify for that profession. That's not a difficult task, in my mind.

As a matter of fact, I asked my son, when he was talking about recruiting internationally. He said, “We have a set of questions that we change and develop as we move on, and if you can't answer those questions, you're not going to be an employee of ours, because you're not at the level we want”.

I think you can do that with any profession. So I think that is one that could be done, identifying anybody with false criteria or forms.

But how do we get to the point internally in Canada where the professions are saying this is the minimum standard in Canada? How do we get the provinces on side, to come up with some basis, some form where we can put together a national effort and move it forward? I'm not just talking about nursing now, I'm talking about all professions and all areas of need.

I know that on the immigration side we have very special programs, the provincial nominee program, where supposedly we're able to bring people in with certain needs. That's so limited and so small in proportion to what our demands are that we'll never be able to resolve it. We can't put a ball and chain on nurses and keep them in Canada; that's just not the case either.

So we need to.... I hear so much about nurses working 60 hours a week--not a healthy environment--ready to go elsewhere, just fed up with a lot things that are happening.

We as a federal government have a responsibility. We don't have control over what's happening in each of the provinces and how these things happen, but I think we have to, as a public, come up with some solid basis--healthy, enough people, qualifications that will make opportunities for mobility there--and respect it. If a person qualifies as a nurse in Ontario, I would hope the mobility will very quickly come to nurse in every other province, or vice versa, those things.

How do we get there? Where are we going? What's the profession doing about that?

Mrs. Louise Sweatman: Those are very astute observations. I would say we have done some baby steps. Different professions and occupations are at different places.

For example, if I may speak about the nursing profession, they get together across the country and determine the competencies that are required to become a nurse, and those are national competencies. So that work is done collaboratively.

There's other work. For example, I know the federal government has provided funds for the engineers--and I believe, again, Lisa Little can speak to the nursing--in terms of doing exactly what you're suggesting, looking at what is going on across the country and then finding solutions to those differences.

Perhaps I can ask Lisa to provide a bit more detail.

Â (1245)

Mrs. Lisa Little: I think there's a model that's turning out to be fairly successful in its preliminary stages, and that's the work the federal government has been doing with the international medical graduate task force, as well as the project with the engineers.

The nurses are about to engage in that in the next few days, with funding from HRSD. We're looking at a current state analysis of how we're approaching international applicants, to a very detailed level, to determine where the inconsistencies are among provinces and what the barriers and enablers are to moving toward national standards.

We would hope that the next phase would then have a consensus on how we come to national standards and setting that minimum piece, and perhaps looking at the legislation, provincially and territorially, that may require amendments to facilitate it.

Then we would move, as we've talked about in the paper, to a national assessment kind of model, one that could be used by many health professionals so that there's a centralized point of information for people. It's a centralized and consistent approach in terms of assessment, but you can still leave the actual licensing in the hands of the regulatory body that has the mandate.

I think there's a good process in place. It has been slow. There's a need to keep moving on that, and for momentum as we finish each project, in terms of that goal of getting to the national assessment kind of approach.

The Chair: You have three minutes. Do you want to use it or give it to Hedy? You have three or four minutes.

Hon. Jerry Pickard: I guess, as a follow-up, what you're telling me is that your profession is ready, willing, and energetic about resolving that particular problem.

Let's take this one step further. We do have the capacity in our educational institutes to deal with the nursing demand in this country. Very obviously, there's a great deal of training going on, with the clear intent of those nurses going elsewhere to practise. The “elsewhere” that I'm talking about is the United States, in particular. I see it very much in some instances.

How do we look at our Canadian system and say...? We're training nurses, we're spending a huge amount of money on those training opportunities for Canadian people. Is there any way, within the system and within the structure, you could suggest reasons or ways that we can keep those nurses practising in Canada for a minimum time period before licensing? I believe there are huge tax dollars. You know, and I know, that states in the U.S. do that. We have protection for doctors, nurses, and others. It stops mobility, in the first couple of years, to make sure there's a partial payback of the state's cost in doing those kinds of things.

Is that something your profession would totally abhor, or is it something that you feel could work in order to facilitate our demands? We're going to put millions of dollars into extra training. Should we not reap some of that reward on an individual basis?

Mrs. Lisa Little: I have two responses.

There's a wonderful report out, the Canadian Nursing Advisory Committee report, that had 51 recommendations on how to improve healthy workplaces and retain nurses in Canada. There has been some action on that, but I'd say there hasn't been enough coordinated action on it to make a difference yet.

The number one, key thing for new graduates coming out of the educational system on why they don't stay in Canada is a lack of full-time jobs. There are a few studies that we have out. Our graduates report that they can only get part-time and casual positions. It's the more senior nurses who get the full-time positions when they become available.

It's also related to the unhealthy work environments that they are exposed to in the educational system and the clinical opportunities. They say that they don't want to work in that kind of unhealthy, very laborious place, with overtime and all that kind of work.

One of the things that CNA has proposed, in previous submissions to the finance committee, is the notion of forgivable loans. If you are willing to stay in Canada for x number of years of service, perhaps there's an agreement with funding to say that we'll support you in an educational program for x amount, but there's a commitment that you stay in Canada for those few years afterward.

I'm not saying that it would work for everyone. Everyone is free to migrate and go where they want to go. It may be a way, because financial burden is one of the big issues for students in education right now.

Â (1250)

Hon. Jerry Pickard: The healthy side of it--

The Chair: Jerry, I'm sorry.

Pat Martin.

Mr. Pat Martin: Thank you, Mr. Chairman.

Thank you for being here. I think it's very appropriate that both of you are here for our purposes, because you represent organizations that are seen as the gatekeepers by new Canadians who want to operate or practise within their fields of expertise.

There are those who say you or some of the organizations you represent are being too rigid and are actually acting as barriers. You're actually blocking immigrants from actively playing roles, in order to protect jobs for existing members. That's kind of a natural instinct, I would think, for the associations you represent. The accusation has been made that some new Canadians can't even get answers from your organizations. They write correspondence and seek to apply to practise within the crafts or professions you represent, but they're literally barred by being denied access.

I notice you cite that fairness in access as one of the key founding principles of your organization, but I can tell you I used to run into this. I used to run a union hall for carpenters. People would come to my union hall wanting to join the union and go to work. If I turned them away, there would have been human rights challenges. They had a right to....

Is this a problem? Are the organizations you represent being accused of this? Have there been cases where they've been challenged under human rights or some other tribunal for denying access?

Mrs. Louise Sweatman: I don't have specific examples to support what you're suggesting. I'd have to ask you to defer to your researcher. I know that in B.C. a human rights complaint has been filed by some foreign-trained physicians. But I'm afraid the details escape me.

Mr. Pat Martin: That wouldn't be an association represented by your organization anyway.

Mrs. Louise Sweatman: That's right. That would be at the provincial-level medical licensing authority in B.C.

We're suggesting that if these principles are adopted, the light bulb will go on and we'll be able to see exactly what is going on. If after the adoption of these principles there are still dark corners, we'll need to shine a light on them to find out what the problem is there.

Mr. Pat Martin: But isn't this the problem with self-regulating organizations? You have a duty to best represent the members of your association, not those who are outside your association and want to get in. Should this be self-regulated at all, or should it be regulated by some neutral, impartial third party like government?

Mrs. Louise Sweatman: If the government wanted to take over this function you'd have to think about the structures. You'd have to think about the experts you would need, and I submit that you already have those. You have the regulatory bodies.

Mr. Pat Martin: We'd hire you.

But there is self-interest associated with that. I know we used to get accused of that with the carpenters' union. I was the head of the carpenters' union, and those who didn't like unions would say we were just an old boys' club taking care of our existing union membership, that we didn't want any new members because we didn't want to share the work. We would have been subject to challenges if we hadn't had an open door policy for anybody who wanted to join our organization and practise their craft.

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Mrs. Louise Sweatman: To get back to your question, you're asking whether self-regulation promotes turf protection and income protection--

Mr. Pat Martin: Self-interest and sandbagging.

Mrs. Louise Sweatman: That's right, to put it colourfully.

As Dr. Cappon mentioned earlier this morning, we don't have a whole lot of hard evidence.

Mr. Pat Martin: There are lots of anecdotal complaints.

Mrs. Louise Sweatman: Exactly. That's why we're submitting that if these principles were adopted and enforced, we'd have a much better idea of what was going on. As to the allegation that there is a barrier and it's arbitrarily high, we would know more about that if these principles were actually in place.

Mr. Pat Martin: Why aren't they in place now? I mean, you'd think that would be the bare minimum for any association that had such power, frankly, and control over an industry sector. I'd be disappointed to learn that these six principles aren't currently your practice.

Mrs. Louise Sweatman: These are collaborative principles amongst not just the regulators but governments, employers, and educators. To be, I guess, frank about it, sometimes you have to think about what lens you're using. You can use the lens of the barrier, but there actually is a financial lens. I mean, you're perfectly correct in that the regulatory bodies at the provincial-territorial level are funded completely by their members and their job is to protect the public against their members.

Mr. Pat Martin: Well, to look after the best interests of their members.

Mrs. Louise Sweatman: Not the regulatory bodies.

Mr. Pat Martin: Oh, not the regulatory bodies. I'm sorry, I'm thinking of the association of--

Mrs. Louise Sweatman: Those are more advocacy.

Mr. Pat Martin: That's right.

Mrs. Louise Sweatman: You have to be careful of the terminology. Sometimes the term “association” is used and it's an advocacy group.

Mr. Pat Martin: Okay, I'm sorry.

Mrs. Louise Sweatman: Sometimes it has a dual function and sometimes it's strictly regulatory.

Mr. Pat Martin: Certainly the regulatory function is for consumer interests more than practitioner interests, I agree.

I only have two minutes left, but I was very interested in what you had to say in the CNA brief. One of your comments here seems to be pointing a direct...well, actually it's pointed at Canada, I believe. On page 4, in the second paragraph, you say the “CNA condemns the practice of recruiting nurses from countries where authorities have failed to implement sound human resources planning and to seriously address the problems that cause nurses to leave the profession”.

Does that mean you're condemning the practice of the United States coming to Canada and recruiting our nurses, where the occupation has become so difficult that nurses are leaving?

Mrs. Lisa Little: Yes, I guess we could fairly say we don't support it, because we have identified a nursing shortage in Canada. We have identified that it's going to get much worse in the years to come. We support that countries take.... While people are free to migrate where they choose to go, sending international recruiters to take hundreds of people from one country to another country and depleting the resources significantly in a country that already has a shortage is not ethical.

Mr. Pat Martin: The United States doesn't even train nurses any more in many states. They simply harvest Canadian nurses. It's cheaper to pay more money and let us do the training and then take them away from us. I'm aware of that.

I don't think I have any more time. I wish I did.

The Chair: I have one question before I go to Ms. Fry. You mentioned there's a shortage of nurses. At the same time, a few minutes ago you mentioned that there is a shortage of spaces for employment for nurses, that there are no jobs, so they cannot work and they go away. Did I get something wrong here or what?

Mrs. Lisa Little: There's a shortage of spaces for training for nurses. We have more applicants than we have numbers of seats at the current time.

I did say that we have a lack of full-time employment opportunities. The shortage right now is just beginning, and many of the shortages that we have now are in very specialized areas--the OR and critical care especially. Those are areas for which new graduates don't traditionally have the skills and experience to come into it directly. So the jobs they're looking for are more in a medical-surgical kind of unit, where we don't have vast shortages right now.

As well, the shortage is a maldistribution problem. We have shortages of all kinds in rural areas. So if you're willing to go work in a rural area, there's a full-time job for you, but in downtown Toronto as a new graduate, there's probably not a full-time position in a medical-surgical area where you would be appropriate to work.

· (1300)

The Chair: All right, thank you.

Ms. Fry.

Hon. Hedy Fry: I just wanted to say that I think principle six in your paper, Louise, is an extremely important one, because I think it highlights the complexity of the problem. It's not a problem for which there's one solution and a problem that is based on only one issue. Even if we could wave a magic wand and credential everybody who came into the country, we would still have the problems of getting into rural areas, language proficiency, Canadian experience, and the culturalization to work in a Canadian environment. So there would still be a whole lot of other problems.

I want to respond to one of the things that I think Mr. Martin suggested, which was that if we took the credentialing and gave it to the provincial governments, maybe it would solve the problem. I would like to suggest that it may not, because one of the problems is that governments have to deal with their own financial resources. I think the big problem with the lack of physicians today stems from the fact that in the 1980s all provincial governments decided to cut back on medical school enrolment, and they actually decreased the number of students each year. Many of us in the profession said this was going to be a problem 10 years from now, and lo and behold, it was. Provinces did it because they didn't have resources, and they were trying to cut back on funding for schools.

We have some problems. There's no magic bullet answer. I think the collaboration one that you're talking about is the one we need to really talk about. We need to think outside of the box here. I think if we bring in private employers as well as public employers, governments, immigrant-serving organizations, and educational bodies, we can sit down and come up with the best possible ways of finding the answers.

I think the international medical graduate task force was a very good example of that kind of collaboration. The international medical graduate task force was one in which physicians and regulatory bodies from every province and territory came together with provincial and territorial governments, the federal government, and the different departments in the federal government. There are at least eight departments.

I think we keep thinking that this is purely an immigration issue. It is not. For instance, because of the cutbacks in enrolment in medical schools, a lot of Canadians who could not get into medical schools went to study somewhere else. They want to come home. They are foreign graduates. They have foreign credentials. There is an inability for people to move from one province to another to work and to accept their own credentials. That's a problem as well. So it's a multiple kind of problem. The collaborative model is one that we would find most important.

Mr. Pickard made a suggestion that I think is the key to it all. He said if we found that provincial and federal jurisdictional wrangling on constitutional issues was preventing us from moving forward, then if the credentialing bodies in each province, as they did with the IMG task force, would come together and find pan-credential assessment and tools to help to move that forward, that could be a model for moving the agenda forward. There would be a pan-Canadian model, and people would be able to get their jobs.

I want to congratulate you on a very good presentation, with your six principles being key to one of the things we were looking at under the foreign credential thing. That was a key piece.

I want to ask one question of Ms. Little. There are some current questions--and I don't want you to give me the politically correct answer, but rather the answer--about why many nurses are not being employed full time and therefore they are not getting the pension benefits, health benefits, and dental benefits, all of those ancillary benefits. This is one of the reasons that many of them are leaving, because they are just doing temporary work, casual work, etc. Why do you think that's happening, and how do you think we could fix that?

· (1305)

Mrs. Lisa Little: That's a great question. It goes back to the funding for health care institutions in this country. Their budgets have been cut. We've seen through restructuring and other initiatives that they're all running a deficit and need to trim and come to a balanced budget. Nursing and health care providers in general make up one of the largest components of their budget. Often the first place they turn to is nursing, because we're the largest provider in the health care provider group as well. The way to trim the budget is we eliminate full-time positions and we create casual and part time, where there is no commitment to job security and secured hours every week. We don't have to compensate for sick time and overtime and all of those other issues. I was a nurse manager at one point, and when I wanted to hire more staff because we had expanded services, I was told by the financial officer of that institution,“You can hire as many casual and part time as you want, because we have no commitment to them, but you cannot hire full time. I will not commit those resources and that funding in our current fiscal situation”.

Hon. Hedy Fry: Do you see an equivalent decrease in the number of administrators within the same institution?

Mrs. Lisa Little: There has been.

The Canadian Nursing Advisory Committeereport talked about the stats and that we used to have many more middle managers, front-line managers, nurse managers, whatever you—

Hon. Hedy Fry: No, I don't mean in the profession. I mean the administrators, the people who run the hospitals themselves.

Mrs. Lisa Little: I would say that I don't personally see a loss in those positions.

Hon. Hedy Fry: Yes, I just thought you'd say that.

Some hon. members:Oh, oh!

Hon. Hedy Fry: Sorry, that was a leading question.

I'm sorry, Lisa.

The Chair: That's not a politically motivated question?

Hon. Hedy Fry: No, it's not a politically motivated question. I just think that we cut back on the providers of health care and we don't cut back on the people who push the paper around the tables. It's just something that I've lived with, that's all.

The Chair: Art Hanger.

Mr. Art Hanger: Thank you, Mr. Chairman.

I find this a very fascinating discussion. I know it's been centred around health care workers and maybe some of the other professionals, such as engineers and the like, but it really goes far beyond just those professions. I can look at airline pilots running into the same problem of maintaining various positions, that they're being drawn away to foreign fields to use their skills.

Going back to nursing, what does it cost to train a nurse?

Mrs. Lisa Little: For the individual or for the government side?

Mr. Art Hanger: The government side.

Mrs. Lisa Little: On the government side, we have certain provinces and not a full national picture, but I believe it is approximately $8,000 a year for an undergraduate. So times four years in a baccalaureate program, and you're talking $30,000 to $40,000 for the four-year term to graduate a nurse.

Mr. Art Hanger: About $40,000 for four years.

Mrs. Lisa Little: Right, and that's excluding the tuition the student pays.

Mr. Art Hanger: Right, and the other living expenses they would incur.

Mrs. Lisa Little: Right.

The Chair: It spends $100,000 for four years, or $100,000 for an individual portion and living expenses, as you mentioned, per nurse for a four-year graduation?

Mrs. Lisa Little: I think the estimate for an individual in terms of tuition and school for nursing is probably $12,000 to $15,000 a year, so times four would be about another $80,000 to $90,000 total. That's a best guess. I don't have complete numbers in front of me.

Mr. Art Hanger: You say that 1,500 nursing students leave this country every year?

Mrs. Lisa Little: One of the studies we did a few years back showed that three out of 10 who graduate will leave the profession or the country within the first five years.

Mr. Art Hanger: So you're looking at $50 million-plus trained personnel just in the nursing profession alone who go elsewhere. It's a substantial dollar.... I don't know if it's been evaluated in that fashion.

You relate to this committee that there's a lack of full-time employment opportunities. I would assume again that it applies to many of the other professions, and especially for new graduates. They're hot to trot, wanting to apply themselves as best they can. They've taken their studies—I would assume it's four years—and now they're looking for a position and are having a difficult time finding one.

Why shouldn't they look elsewhere, I guess, would be my question?

Ultimately, the only way to correct that is to adopt a new priority. Again, I guess this reflects back to provincial governments, would it not, because they all seem to be applying the same principles, I assume, in their hiring practices or employment opportunities? Is that correct?

· (1310)

Mrs. Lisa Little: I don't know if I can say that. I think it has implications for more than just governments; I think it also has implications for employers.

Mr. Art Hanger: Most of your nursing profession, if you will, is government.

Mrs. Lisa Little: Right, if you extend the employer to mean the government.

Yes, I think there are wonderful examples of people who have been creative and who have pushed the envelope to make sure they can hire new graduates full time. So it can be done. There are ways to achieve it.

I was just at a meeting on Friday with the chief nursing officer from Nova Scotia, who said that they made a purposeful effort to find ways to ensure full-time employment for new graduates. I think we're just not being creative enough in using those opportunities to understand the importance of why we need to fund those full-time positions. There are best practices. There are things that other provinces can learn from some who are leading.

Mr. Art Hanger: So it's a priority issue--

Mrs. Lisa Little: Yes.

Mr. Art Hanger: --what is your priority when it comes to this profession. And that falls on the shoulders of provincial governments across the country.

Should an immigrant with the professional skills or a trade skill have a job before they're accepted into this country? Should they have a job to come to? I'm just speaking broadly, now.

This is directed to Ms. Sweatman.

Mrs. Louise Sweatman: In fairness, I can't answer the question because we haven't turned our minds to that particular question. But as you've already heard, definitely they ought to know what the requirements to work here are. Your question is sort of a subsequent one. It's a good one. Maybe, yes.

I really can't help you out too much there, I'm afraid.

Mr. Art Hanger: Well, I think it's an issue that provincial governments kick around, since they have the labour issue to deal with in those particular provinces. It's one that, I might point out, they have had very little input into in the past, because the criteria on the immigration side, even on skills, have always been set on a federal level. There is only one province that has it otherwise, and that's Quebec.

I guess that's why I asked the question, and really, you haven't addressed that here. I still didn't get an answer.

Mrs. Louise Sweatman: No, and I'd have to say I'd be happy to take it back to my group and ask them and get back to you.

Mr. Art Hanger: I know there are two ways of looking at it. You can look at it from the point of view that here are the jobs available, the skills required, and then open the door looking for people who would generally fit into that category and would be capable of fulfilling that need.

Mrs. Louise Sweatman: Just while I'm thinking, while you're asking the question, it might actually be that the question is a bit beyond the mandate of the regulatory work. Your question is more of a social question, related to employment, compared to a regulatory question.

Mr. Art Hanger: Well, in principle six, you say that regulators must have frameworks in place that maintain public protection. That can mean a lot of things. It could also mean protecting, in a sense, an excess flooding of certain areas to the point where you might end up with a structure where organizations, and even government, no longer want to provide, if you will, permanent jobs for people.

As an employer, then, I would like to be able to get the best bang for my dollar, so I'd hire as many casual people as I could who maybe come from overseas, and then I wouldn't have to commit myself to pensions, to a whole myriad of things. On the other side of the coin, for the most part in this country we've worked at hiring people and providing them jobs for life, really, although that's changing, and it's been changing now for a number of years.

So I guess the regulatory agencies are going to set up a framework here. What's that framework going to look like?

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Mrs. Louise Sweatman: I think your point gets back to what Dr. Fry was reinforcing in terms of it being a collaborative approach. You have the employers. They're the ones who have the jobs or don't have the jobs, who offer the jobs. You have the regulators who provide or don't provide the licence. So it truly is an integrated system.

When we talk about public protection, I'd submit to you it isn't about controlling the numbers. It's about, for example, public safety. It's a public safety net in terms of ensuring that the Canadian public has the confidence that the bridge they're on or the physician or chiropractor they're seeing has met the standards that are viewed to be those necessary in order to provide safe--

Mr. Art Hanger: I appreciate that. Your comment, though, related to both sides here, not just for the public in general but also for the educated professionals as well, that then they are able to reach their full potential. This is what you're saying here in principle six.

The Chair: We'll come back to that point afterwards. You went way over time. Sorry.

Hedy Fry, please.

Hon. Hedy Fry: I want to make a comment on the whole concept of people coming to Canada and being guaranteed a job.

I think a lot of the people who are in the position of not being able to work in Canada are not necessarily the primary immigrants. Some of them come in as families. The primary immigrants come in and find jobs. They are coming in, they have skills, and they're going to work, but they bring in a spouse who may be a physician, or who may be an engineer, or who may be a nurse, and who then can't work. The thing that makes this such a complex issue is that it's.... The cost of a nurse would be, you said, roughly, what, maybe $70,000 or $80,000 over the course of the training. We're looking at about $400,000 for the cost of a physician. That's just the training. That doesn't include the residency programs and the other pieces of it, whereby we're looking at almost about $500,000 to $600,000 to train a physician in Canada.

I think we then have to look at what the freebie is that we're getting here when this person comes in here, trained somewhere on somebody else's tax dollar or on their own money. I think we need to look at the balancing of how we are training Canadians and the balancing of the brain waste that comes in trained somewhere else, by somebody else's money, and consider how do we take advantage of this, given that it's something that's also happening in Europe and in a lot of the developed world, both of which are looking, for the same reasons as we are, to fulfill their labour market needs.

We're in a competitive mode right now with other countries in Europe. Europe is ahead of us because Europe has a credentialing that goes across the European Union. You can go from England and work in France and you can go from France and work in Germany tomorrow. Not that it works. It's a bit of a mishmash because of all of the language problems. It's been done so quickly to satisfy labour market needs that they're not having good credentialing. But that's what we don't want to have happen here, the kind of hurried response to something that will not give us the equality that you're talking about.

The Chair: Thank you.

Art, the last chance for you, the last call.

Mr. Art Hanger: I'm just going to step away from the last question I asked. I appreciate the fact that it may be a difficult one to address, because it applies, but it is the social element broadly that immigration policy has to deal with as well.

You talked about a regulation framework and then you allow the professions, if you will, to assist in assessing someone with foreign credentials. They would decide whether the individual or the university met the criteria. Am I reading this correctly, basically?

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Mrs. Louise Sweatman: The regulatory bodies--

Mr. Art Hanger: They would set the framework.

Mrs. Louise Sweatman: --in general review the credentials, the experience. Many of the professions have an exam that also has to be written.

Mr. Art Hanger: You're saying that regulatory bodies set that.

Mrs. Louise Sweatman: Yes, they set the criteria in order to get the licence to practise in whatever the profession is.

Mr. Art Hanger: They set the criteria, and the assessment is done then through what? Private agencies or associations?

Mrs. Louise Sweatman: There's a mix. Some do the credential assessment in-house within the regulatory body, some use private agencies like IQAS and WES-Canada, and some use Canadian universities to review credentials.

Mr. Art Hanger: I can appreciate that.

The reason I asked that question--and obviously your organization has thought it out well--is that if it's left any other way, then it becomes an uncontrollable industry. In other words, there will possibly be decisions made on credentials by people for whom--not that they're not qualified--there's something in it for them to do it one way or the other. We have that problem already with immigration consultants who have gone amok; vast sums of dollars have been taken and received on evaluating applications and pushing them along.

I wouldn't want to see that happen here. Your answer tells me that it wouldn't happen if it's framed that way and that tight and there's an oversight to it.

Mrs. Louise Sweatman: The current regulatory structure for the self-regulating professions and occupations requires them under law to protect the public. Therefore, to meet their mandate, they determine what is necessary in order for the licence to be given to ensure that the individual with that licence can do their work safely and competently.

The Chair: Thank you very much.

From what I understand today, and correct me if I'm wrong, we have no shortage of registered nurses, we have a shortage of specialized registered nurses. Is that right?

Mrs. Louise Sweatman: I think your question is for Mrs. Little.

Mrs. Lisa Little: We don't have the specialization structure for nurses that we have for physicians in Canada. You are licensed in a broad category of a generalist in terms of a registered nurse. People then choose to go toward a speciality, but it's not a licensed piece the way the medical profession is.

When I say we have a shortage predominantly in some of the specialty areas, you're still coming from that base of the broad general registered nurse pool. They don't have any specific other designation per se. They may have advanced training and expertise in that area, but they're not licensed as a specialist in that area. So we're still talking about the broad general pool of registered nurses.

The Chair: We have no shortage of registered nurses in the country. That's what you're telling me.

Mrs. Lisa Little: No, they're one and the same.... There is a shortage of registered nurses, it's just that the shortage is different in different areas. There are many shortages in rural areas, whereas a downtown Toronto hospital may not have a shortage. In northern B.C., or rural Newfoundland, there are shortages.

As well, there may not be vacant positions in a medical unit in downtown Toronto, but there may be many vacancies in the intensive care unit, where it requires nurses who have much more experience in that kind of area.

The Chair: As politicians, then, when we make the statement that we have a shortage of nurses, that would be wrong unless we qualified it by saying that it's in northern Ontario we have a shortage, not in GTA or Ottawa or Montreal or Vancouver.

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Mrs. Lisa Little: I think the estimate is that we have a shortage of about 15% currently, if we look at the vacancies that are posted by hospitals and employers across the country. I mean, we have a shortage. It's just a matter qualifying it, perhaps. Some provinces will say, “Well, there isn't a shortage in our hospitals here, but in the community there is.”

So broadly speaking, we do have a shortage, and it will get much worse in the years to come. The average age of a nurse in general in this country is about 45, and the average retirement age is about 55 to 56. Now, 50% of the nurses in this country are aged 45 and over, so we're going to lose 130,000 nurses in less than ten years.

The Chair: In those areas where we have shortages, in the rural areas outside the major cities, what's wrong with telling a person coming here from overseas, a registered nurse from country X, that if they come here we have openings for them only in this spot, not in GTA but maybe a small town in northern Ontario or northern B.C. or Quebec, or whatever the case may be? What's wrong with the nursing association doing that?

Mrs. Lisa Little: We just finished a report with physicians and the pharmacists association on rural practice. Many of the nurses and physicians and pharmacists who work in rural areas report professional and personal isolation as a major issue. They're often the only provider there. Their textbooks are 20 years old. They have no Internet access, or else it's on a telephone line that sometimes works and sometimes doesn't. Their next colleague is hundreds of miles away.

They are struggling in the rural practice, and they were Canadian educated. They understand the system, and know and have their own personal connections in the system. So I think there are issues that would need to be considered in taking a person who's new to the country, new to the culture, and new to the roles and responsibilities and putting them in that situation where our own Canadian-educated health professionals are experiencing much difficulty.

The Chair: Thank you very much. That was fascinating testimony. We look forward to working with you.

That concludes our meeting.