A sign reading "comprehensive community care" with an elderly man walking in front of it. Image: Government of Alberta/Flickr

Labour shortages throughout the care sector are worse than ever as the economy rebounds from the pandemic. The problems are a result of a long-standing lack of planning for labour in health care, long-term care and childcare. The pandemic magnified these chronic labour shortages.

The job vacancy rate in health care and social assistance increased 39 per cent from the first quarter of 2020 to the first quarter of 2021, with almost 99,000 jobs needing to be filled. With over two million employees on payroll, this sector experienced larger increases in vacancies than any other. In nursing and residential care facilities, the vacancy rates are up 49 per cent and in hospitals, job vacancies are up 53 per cent.

New money from the federal government flowing into the early learning and childcare sector is trying to deal with the reality of crucial shortages of trained workers. Even if there are new spaces and better pay, upgrading skills and getting trained workers to return to the sector presents a serious bottleneck. And any attempt to create new spaces in long-term care will similarly face the reality of an already inadequately staffed sector and not enough trained workers to take the jobs.

The most talked about labour shortages, featured in the news, come from employers in the traditionally low-paying hospitality and retail sectors, who say they can’t find enough workers. Undoubtedly higher wages and better working conditions will attract more workers. But “pay more and they will come,” while a necessary condition to attract labour, is not a sufficient condition to deal with labour shortages in the care sector.

The shortages in specific job categories sometimes relate to inadequate planning for education and training, while in others, shortages relate to either inadequate planning to make working conditions reasonable, or the failure to anticipate the need to replace aging workers.

The necessity of government intervention in labour in the care sector has long been recognized by international bodies (including the OECD, ILO, WHO) who warned of severe labour shortages unless there were significant improvements in wages and working conditions. All organizations recognize this is skilled work and needs to be treated that way. These warnings were not heeded and conditions deteriorated as the entire sector moved more toward managerial strategies that reduced staffing to a minimum, increased part-time work (with few benefits or job security), and kept wages for many workers as low as possible.

The see-saw of governments’ attention to care issues is a serious obstacle to getting reliable and decent care in Canada. The goal should be to provide consistency in care that can be so expected by the public that successive governments cannot undermine progress in the care sector. To do this, the federal government, in consort with provincial and territorial governments needs to plan for both the level of care that is needed throughout a lifetime, but also for the workforce to deliver this care.

Here are some essential features that should characterize long-term labour planning in the care sector:

  • Recognize that planning is necessary and why “market forces” will not solve the labour shortage problem.
  • Understand the problems and dimensions of labour needs in the care sector. This will involve frequent updates on distinct labour needs in various areas and collecting the appropriate data.
  • Understand and change the conditions of work that cause high turnover and prevent people from working in the sector.
  • Plan for the time and effort involved in the education and training of workers, and plan to remove the bottlenecks that can delay or prevent training (including the cost of education for individuals).
  • Construct a path to solve the problem, one that includes short-term emergency needs and planning for long-term demographic changes.
  • Have a realistic timetable, but one that does not take decades to fully implement.
  • Understand costs and who pays for various aspects of the plan.
  • Identify the scale of labour shortages (through the use of vacancy rate data and other metrics) and monitor progress in reducing labour shortages in the care economy, adjusting plans when necessary.
  • Ensure the development of a civil service that has the capacity to plan and institute the plan.

People who vote these days are accustomed to big promises of money for a specific issue at election time with almost non-existent plans for implementation. Too often, change is vaguely planned for decades away, meaning that a party has to be voted in two or three times before it can be held accountable.

If political parties are forced by the electorate to show us their practical and detailed plan, things could be different. So far no party has a plan for labour that provides the care in the care sector. We should insist on one.

Marjorie Griffin Cohen is a feminist economist and professor emeritus at Simon Fraser University, Burnaby, B.C. For more information and resources see The Care Economy.  

Image: Government of Alberta/Flickr