The nurses and docs are not okay

After COVID, we are all working to build back, or something like it. We need to talk about the losses and lessons a bit more, and then we can move on. Except health care. Canada's health-care system is still in a state of crisis. Why’s that? Canada hasn’t funded the health-care system enough to maintain a stable system for things like facility maintenance, computer systems, reasonable pay rates for the heroes who kept us alive—the things that keep a system healthy. We had starved health care in Canada, so COVID hit it like a wrecking ball. The British Columbia Nurses Association said one in three nurses is thinking of leaving nursing, which is somehow better than the survey in Ontario in 2022 that found three in four nurses are thinking of leaving. Between the salaries with small-to-no increases, and so much overtime, we should not be surprised. The nurses are not okay. Physician burnout is increasing as noted by many studies and stories. It’s now difficult to even hire family physicians. COVID didn’t create this crisis, but it greatly aggravated it. The docs are not okay. It’s just ironic given in the early months of 2020 we called them 'heroes', went out to cheer them on—banging pots and pans—and sending warm words of support on social media. Oh, how quickly we forget. In the face of incredible adversity, there are some pockets of health-care worker retention. Jason Klainchar leads the Churchill Health Centre in Manitoba with 100 per cent of nursing positions filled—since 2020. This is miraculous in this era. Subsidized housing for staff is a clear factor, but exemplary leadership is foundational. One has to be exceptional to lead in health because the health sector resists change incredibly well. But COVID might just have broken down that resistance. The rust-out of health care is—now more than ever—creating more parallels with Indigenous health, which has historically been underfunded since the creation of the federal Department of Health in the 1940s. First Nations health managers have to balance budgets that were never intended to include things like facility maintenance, or union wages with yearly increases. Imagine trying to duct-tape together a hospital bed frame because there’s no money to replace it. First Nations health managers are some of the most creative leaders out there. But you can’t increase life expectancy with dimes when dollars are needed. And creativity should not be the expected response to underfunding. As health care attempts to build back, please do it in partnership with Indigenous health. Don’t leave Indigenous health behind yet again. That would be a colossal once-in-a-generation failure. Canadian healthcare leaders have a role to play right now in reconciliation—don’t leave out Indigenous health. Your voices are needed to offset the Band-aid approach taken by Ottawa to Indigenous health (Band-aid approach: give just enough to keep them quiet, but don’t address real issues). Ottawa will argue that it can’t do this because health care is a provincial/territorial mandate. It’s time to call out this fraud. The federal government could choose to set the standard by funding Indigenous health to succeed, and so create the peer pressure on provinces and territories to do similarly. The Ottawa sidestep dance to push the conversation when there’s no provincial/territorial support is to do proof-of-concept within the federal realm. So, then, fund Indigenous health to succeed, to prove that it’s possible. Fund Indigenous health with state-of-the-art e-health systems, clinics, and hospitals with the equipment to save lives, and wages to retain workers for the long term. Prove that this is what is needed to stabilize Canadian health care, with Indigenous health leading. We’re waiting. Rose LeMay is Tlingit from the West Coast and the CEO of the Indigenous Reconciliation Group. She writes twice a month about Indigenous inclusion and reconciliation. In Tlingit worldview, the stories are the knowledge system, sometimes told through myth and sometimes contradicting the myths told by others. But always with at least some truth. The Hill Times