National Reporting Instrument 2018

Ontario and Saskatchewan responded to this action, namely: • Ontario is participating in pan-Canadian health workforce planning efforts. These include discussion of all variables affecting such planning, including the entry and cross-Canada migration of internationally educated health professionals. • Saskdocs (Physician Recruitment Agency of Saskatchewan) used the Code to adopt its own ethical recruitment framework that it uses while recruiting internationally trained physicians. The framework is posted publicly on the saskdocs.ca website.

Saskatchewan responded to this action, namely: • Saskdocs’ recruiters adhere to an ethical recruitment framework when contacting internationally trained physicians and health care personnel who enquire about practising in this province. Recruiters attend internationally recognized career fairs in the United States and United Kingdom in an effort to recruit physicians. They do not directly recruit internationally trained physicians from South Africa.

Saskatchewan responded to this action, namely: • Saskdocs‘ recruiters meet regularly with recruiters located throughout the province to share the ethical recruitment framework and discuss ethical recruitment practices. The framework is also shared with partner (government) recruitment agencies in British Columbia, Alberta and Manitoba.

See Saskatchewan’s reponse to 2d.

Ontario provided additional information below: • Ontario is committed to ensuring self-sufficiency in health human resource capacity in order to meet the health needs of the people of Ontario, now and in the future. As such, the Ministry of Health and Long-Term Care (the ministry) does not promote or actively recruit internationally-educated health professionals. • With respect to physicians, Ontario has introduced a number of initiatives to increase physician supply, improve retention, and enhance the distribution of physicians in the province. The ministry’s evidence suggests that the province has moved to an overall sufficient number of physicians; therefore, Ontario is shifting the focus away from “increasing supply” toward effective management of the expanded system in order to deliver the right mix and distribution of physician services across Ontario. This includes: o Maintaining a balanced and predictable supply of new physicians; o Managing the mix of specialties and new physicians to address population growth and changing healthcare needs (e.g. aging population) and services (e.g. addition of new roles such as Physician Assistant, Nurse Practitioner, etc.); o Ensuring newly educated providers go where they are most needed across Ontario and avoid clustering of services in communities that are relatively well-served (e.g. downtown Toronto) ; and o Making strategic new investments and targeted approaches (or strategic realignment of existing approaches) as needed to build capacity in areas of high need (e.g. psychiatry, rural and north). o Working closely with medical schools to monitor the flow-through trainees through the medical education system, gather and assess evidence to support planning and management of the size and mix of Ontario’s training system. • Ontario has increased its evidence base to inform health workforce planning to meet the needs of the Ontario population. The ministry uses its data and physician forecasting tools in conjunction with other evidence, to support planning in collaboration with other key system stakeholders in Ontario. This includes working with medical schools on the allocation of physician residency positions. • Additionally, through a federal/provincial/territorial Committee on Health Workforce, a pan-Canadian physician forecasting tool is being developed to provide jurisdictions and medical educators with pan-Canadian projections of physician supply and population needs to help identify potential physician imbalances across specialties. • It is anticipated that having this information will facilitate greater collaboration between the ministry and medical schools in residency planning, and promote improved alignment between physician supply and the health care needs of the population. • Ontario will continue to closely monitor its physician supply and the number of postgraduate training positions available and with the schools, through a collaborative process, will use the best available evidence to plan for any changes to the postgraduate medical education training system. • The ministry is nearing completion of a nursing model that will allow estimation of: • the supply of nurses available to care for the people of Ontario; • the number of nurses required to meet the health care requirements of the Ontario population; • the number of nurses the health care system will be able to employ; and • “gaps” between each measure. • Ontario is also working to bring an even more strategic focus to planning the province’s health workforce. Too often health workforce planning in Ontario has involved a series of disparate strategies and initiatives focused on short-term goals. • The ministry is working with sector partners to build a comprehensive framework to guide provincial and local planning that would shift the planning paradigm from a focus on physician supply and demand to a much greater emphasis on skills mix, distribution and other providers in the system.

NO

Canada’s laws, policies and enabling programs uphold equality for citizens and immigrants alike. Canada’s inclusive laws are embedded in the 1981 Canadian Charter of Rights and Freedoms with its provisions related to equality and freedom from discrimination. Canada’s 1977 Citizenship Act, 1977 Canadian Human Rights Act, 1988 Canadian Multiculturalism Act and 2001 Immigration and Refugee Protection Act also uphold these principles. The TFW Program has a comprehensive compliance framework in place to protect TFWs and the Canadian labour market. The cornerstone of the compliance regime is employer inspections, which serve to protect TFWs from abuse and exploitation, and to protect the integrity of the Canadian labour market, by encouraging employers to comply with Program conditions. When an employer fails to meet these conditions or does not cooperate during an inspection, a range of consequences can be imposed, such as administrative monetary penalties, bans from accessing the Program, or revocation of Labour Market Impact Assessments. In addition, integrity tools such as the on-line fraud reporting tool (www.canada.ca/en/employment-social-development/services/foreign-workers/fraud.html) and the confidential tip line (1-866-602-9448) encourage disclosure of possible wrong-doing. Matters of a criminal nature are referred to the Canadian Border Services Agency or the Royal Canadian Mounted Police for further investigation.