Increasingly, because of the impact of the pandemic, Canadians have been questioning the capacity of its health care system to meet their current and future needs. Recently, staffing issues and staff absenteeism due to COVID have caused several emergency and operating units to shut down across the country, especially in more rural areas. In addition, due to burnout and retirements, more and more medical professionals are leaving the profession. Replacing them has become a greater concern, especially in the field of family physicians.
Nevertheless, Canadians still believe that they have better access to health care, live longer than Americans and rarely go bankrupt because of medical bills. Canada’s mortality rate from Covid-19 is a third of the U.S. rate, a reflection of Canada’s more widespread use of health restrictions and its collectivist approach to universal health care. Where it falls down is in what is referred to as ‘surge capacity’ where hospitals are capable of handling a sudden or longer-term surge of patients. Even in normal times, Canada has fewer hospital beds per person than almost any other developed country, particularly when it comes to the number of available intensive care unit (ICU) beds. For example, it is reported that on average, the U.S. has one ICU bed for roughly very 4,100 citizens. In the largest province of Ontario that ratio is one to 6,000.
Then there are the issues surrounding the number of nurses and doctors available to serve Canadian patients. While Canadian nursing schools are seeing a surge in interest amid the pandemic, experts warn it may not be enough to alleviate the shortage of people working in the profession. In a 2009 report, the Canadian Nurses Association predicted that Canada could see a shortage of 60,000 full-time nurses by 2022. The Association wants to see more financial assistance to nursing students and more clinical placements available for students to get hands-on experience in hospitals or other health-care settings. Better compensation and working conditions are also on the table. As for doctors, fewer graduates are choosing family medicine as a discipline, despite family-doctor shortages across the country. This is despite the fact that the total number of medical school graduates applying for residency positions in Canada has risen over the past 10 years. Access to family doctors and primary care is a problem for a large portion of the country. According to a 2019 Statistics Canada report, 4.6 million Canadians over the age of 12 did not have a regular family doctor. With an aging workforce and an increase in the numbers of retiring physicians, the primary care situation has even become worst.
The pandemic exacerbated already serious problems within the Canadian health care system. Fortunately, the consequences of the pandemic for the system have stimulated a much needed national conversation on inadequate health care capacity, staffing shortages and under funding. Part of the problem rests with the overseeing associations that regulate and control access to medical licenses across Canada. For years, there have been systemic barriers to both qualified domestic and foreign trained medical students/practitioners to find residency positions in Canada. While it is understandable that such bodies as colleges of physicians and surgeons want to ensure the highest of standards within the profession, there have been at times failures to really consider the impact of restrictive practices on the overall health care system. The pandemic further demonstrated that among the biggest bottlenecks in the system is the staffing required by acute care, particularly in the emergency departments and ICUs.
With an aging population and people living longer due to the marvels of modern medicine and treatments, the discussion about the capacity of our health care system to meet the needs of Canadians has to take place now and not later. Groups representing all facets of the system, from medical practitioners to patients, have to be allowed to provide their input to governments. While the pandemic created several serious drawbacks for the overall system, the subsequent reactions of governments and health care providers demonstrated that collectively we can meet these future challenges as a nation. Despite evident challenges, Canadians generally continue to be proud of their health care system, its workforce and its universal coverage. However, as always, there is room for improvements.
FROLITICKS 
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