Stuck

Nurses are exhausted, their ranks depleted by the ravages of the pandemic. As many as 12 per cent of hospitals in Ontario are working understaffed. Few are coming to relieve them. It is about to get worse. About a quarter of the remaining nurses say they are retiring or simply leaving the profession in the next three years. ICUs have been forced to close and transfer patients. As many as 14 hospitals have closed emergency rooms this summer due to staff shortages. The head of the Canadian Medical Association says the healthcare system in Canada is nearing collapse.

It isn’t just healthcare. In every sector of the Canadian economy, labour shortages are hobbling recovery from Covid. It is more acute—and painful—in healthcare, but the disease infects our entire economy, hobbling productivity and output, and dampening any recovery.

Meanwhile, 2.4 million folks are stuck in Canada’s immigration queue. Up 300,000 since March. Many have been waiting for years.

I expect some readers may have trouble with this juxtaposition. Fair enough. Wages are part of the workforce shortage story. Inadequate recruiting too. So is the gutwrenching toll of the pandemic on healthcare workers, service workers, and all the other folks who had to show up to work when the rest of us stayed home. Perhaps some of the more acute shortages are transitory—like inflation—after Covid. But the medium and long-term prognosis for Canada’s workforce doesn’t look any better.

So Canada’s immigration backlog isn’t the cause of the crisis—nor is it a ready solution. It is, however, the only durable way to restore Canada’s workforce. Money alone won’t do it. Nor a creative policy solution. Neither is it an economic problem. It is primarily a demographic challenge. One that we have been sleepwalking toward for a long time.

We don’t make enough babies. We haven’t for decades. Canada hasn’t had a replacement rate fertility level—defined as 2.1 children per woman— since 1971. The fertility rate today is estimated at 1.4. An aging population and fewer babies spell trouble.

As Darrell Bricker and John Ibbitson observe in their book Empty Planet: The Shock of Population Decline, a fertility rate of less than 1.5 is likely to produce a steep fall with painful and far-reaching consequences. During the next two decades, 13.4 million people are projected to exit the workforce, but only 11.8 million will finish school and join it. Who will do your job? Who will pay taxes to fund your pension? Who will care for you? Will we merely add the burgeoning costs of our care to the debt burden we have accumulated for our children?

Canada isn’t alone in this challenge.

Many western nations are grappling with a declining population. As populations age, they require more services and assistance— but too few young people are coming along to serve in these roles.

Canada has been generous in welcoming others to our country—about 300,000 immigrants each year. It is one of the highest rates per population in the world. The United States, by comparison, has ten times more people than Canada but managed only to grant lawful permanent residency to 700,000 folks in 2020.

But is it generosity? Or enlightened self interest?

Our country has a long track record of opening our doors to displaced folks—to those fleeing hardship and persecution. Meanwhile, our nation has become richer as a result. We know this is true. Yet, 2.4 million people are in the queue. Stuck.

To illustrate, let’s return to the healthcare sector: immigrants account for one out of every four healthcare sector workers, according to 2016 census data. One in four. Immigrants make up 23 per cent of registered nurses, 35 per cent of nurse aides, 37 per cent of pharmacists, 36 per cent of physicians.

Immigrants are filling the gaps created by a declining workforce. But not quickly enough. Worse, we are leaving these folks to wait years in line. The assistant high commissioner for protection at the United Nations refugee agency has described Canada’s immigration backlog of more than two million applications as “very distressing.”

The cohort waiting in limbo includes more than 100,000 refugees, about 70,000 sponsored refugees—with committed support from organizations, including PEC Syria. Many have waited years to join their families—to begin life anew.

We can’t just put this down to bureaucratic bungling—the stakes are too high, not just for the lives of those in the queue, but for Canadians expecting their standard of living to be sustained through retirement. The reluctance of our American neighbours to welcome immigrants has given Canada a massive competitive advantage. But it is being squandered because Ottawa appears incapable of processing the paperwork.

rick@wellingtontimes.ca