Pre-Budget Submission 2023: Canada’s Health Care Crisis

Open Letter to the Minister of Finance

Hon. Chrystia Freeland, P.C., M.P.

Minister of Finance

Ottawa, ON K1A 0A6

Dear Minister Freeland:

In advance of Budget 2023, I am writing on behalf of my constituents in Perth—Wellington, many of whom have growing concerns regarding the state of health care and long-term care in Canada. Though most health care services in Canada are delivered by the provinces, these concerns are vast and require significant work from the Government of Canada.

Last year I had the honour of jointly hosting a federal-provincial roundtable with numerous health care and long-term care representatives from throughout Perth—Wellington.

Our health care workers and administrators continue to do important work to heal and help the ill, the injured, the elderly, and those facing a wide variety of health-related complications.

Though the past three years have been immensely challenging for them, the issues faced within our health care system precede and go far beyond the COVID-19 Pandemic.

It is clear, since 2015 the state of health care in Canada has grown worse, not better.

Ongoing challenges in health care and long-term care include:

  • Inadequate Access to Mental Health Services
  • Continuous Staff Shortages
  • The Family Doctor Shortage
  • Insufficient Skilled Immigration Services; and
  • Disincentives to Work

I would like to provide you with a brief summary of each of these issues.

Inadequate Access to Mental Health Services

Since early 2020, prolonged isolation and new causes of stress have done immense harm to the mental health of millions of Canadians.

As I informed your government early in the pandemic, Canadians living in my riding and in rural areas across Canada do not have adequate access to mental health services.

The Canadian Psychological Association has reported that urban areas in Canada have an average of one psychologist for every 3,848 people, whereas rural regions have only one psychologist for every 28,500 people.

The current waitlists for appointments to see mental health professionals are far too long, especially for those who are in crisis and require urgent attention. Some Canadians residing in rural areas do not have access to even basic services, as was observed in 2019 by the Standing Committee in Agriculture and Agri-Food, which noted that inadequate internet access contributes significantly to these health care barriers. This is unacceptable.

I urge you to listen to Canada’s premiers, health ministers, and health care professionals and ensure the provinces are receiving the support and services required to provide wholesome and timely mental health services.

Continuous Staff Shortages

One of the most pressing issues in health care and long-term care is the continuing systemic staff shortages.

From hospitals, to clinics, to nursing homes, there is persistent understaffing and an ongoing struggle to find enough nurses and personal support workers to fill shifts. Statistics Canada has confirmed increasing job vacancy rates in health care and social assistance.

As Canada’s population ages and an increasing number of seniors will require more care, simultaneously more health care workers will be retiring from their profession. Consequently, staff shortages will only worsen.

Unfortunately, staffing agencies that offer immediate relief to worker shortages end up contributing to this problem in the long term. By creating an additional level of administration these agencies increase costs on care providers. These costs quickly become an unmanageable burden on care providers and must be passed on to families or the provinces. This problem is especially evident in long-term care homes.

Though this is primarily a responsibility of the provincial governments, the federal government should work collaboratively with the provinces in areas such as research, student loan support, and immigration to assist with this shortage.

Family Doctor Shortage

Many Canadians, including those in my riding do not have a family doctor.

Family doctors are the primary health care providers for Canadians. Regular contact with a doctor can provide early detection of health challenges in Canadians, which in the long run, will save lives, prevent long-term suffering, and reduce pressure on the rest of our health care system.

The Canadian Medical Association had indicated even before the pandemic, that 4.6 million Canadians did not have access to a primary care provider. They also report that the percentage of medical graduates choosing family medicine dropped from 38.5% in 2015 to 31.8% in 2021.

The College of Family Physicians of Canada has reported the administrative burdens of maintaining a family practice have made the current situation unstainable. They have called for an immediate reduction of their administrative burdens.

The federal government needs to work with family doctors and the provinces to find innovative solutions such as financing for education and training.

Insufficient Skilled Immigration Services

For many years Canada has relied on temporary workers and new Canadians to reduce the labour shortage, especially in long-term care.  

The Canadian Nurses Association states that those who trained and worked as nurses internationally are likely to have most of the basic requirements to work in Canada.

For many immigrant nurses, language training is an important element of transitioning to working in Canada. This is especially important for health care professionals working with seniors and those living with a hearing impairment.

As part of our national immigration strategy, the Government of Canada must ensure immigrants in all fields, but especially in health care and long-term care, have timely access to language training.

I also urge you to ensure a straightforward and uncomplicated pathway to citizenship exists for workers in health care and long-term care.

Disincentives to Work

The current social support network offered by the federal government has the unfortunate side effect of creating disincentives for Canadians to work or improve their social and economic situation through employment.

Social assistance programs such as income assistance, housing, and medication subsidies are clawed back from recipients if they chose to work when and where they can. This is fundamentally unfair to everyone who has a disability and yet still wishes to participate in the labour force to contribute to their communities, support their families, and experience the social benefits of working.

This hurts both individuals living with disabilities and the Canadian economy as a whole.

In 2017 the Standing Committee on Human Resources, Skills and Social Development and the Status of Persons with Disabilities advised your government to work with the provinces and territories to strengthen and coordinate income support program policies so that participants are not discouraged from labour force participation. Nearly six years later you have yet to take meaningful action.

As you should recall, in 2018 the Honourable Pierre Poilievre attempted to remedy this situation with his Private Members’ Bill C-395, Opportunity for Workers with Disabilities Act.  Unfortunately, the Liberal majority in the House of Commons at the time defeated this legislation. I am hopeful, should a similar proposal make its way through the legislative process, you will reverse your position and support this common-sense solution.


In addition to inflation and the cost of living, access to quality health care is among the top concerns faced by my constituents in Perth—Wellington, and Canadians in all parts of the county. I strongly encourage you to consider long-term structural solutions to these challenges as you develop this year’s budget. The continued pattern of simply increasing federal transfer is not a comprehensive solution.

Health care was once a point of pride amongst Canadians. It is now in a state of crisis.

I urge you to work within the federal framework to provide our health care professionals with the training and support they need to help and heal Canadians.

I also strongly encourage you to work in partnership with the provinces and ensure any barriers to improving health care services that have been imposed by the federal government are quickly removed.

Unless bold action is taken immediately these problems will only continue to worsen.


John Nater, M.P.



Hon. Carolyn Bennett, P.C., M.P.

Minister of Mental Health and Addictions

Associate Minister of Health

Hon. Jean-Yves Duclos, P.C., M.P.

Minister of Health

Hon. Carla Qualtrough, P.C., M.P.

Minister of Employment, Workforce Development and Disability Inclusion

Hon. Sean Fraser, P.C., M.P.

Minister of Immigration, Refugees and Citizenship

Hon. Kamal Khera, P.C., M.P.

Minister for Seniors