Health Care and Social Services Sector Profile

Current Conditions

Health care and social services is one of the largest and most economically significant sectors in Canada. More than a million people are employed in hospitals, long-term care facilities and residential care facilities alone. The sector experienced a 27% increase in employment over the past decade and now contributes $144.5 billion annually to Canadian GDP.

The COVID-19 pandemic has exposed significant gaps in our health care and social services systems. Hospitals have been strained throughout the pandemic and there is a large backlog for diagnostic procedures and surgeries. The devastation in the long-term care sector – which has included a disproportionate number of outbreaks, resident deaths, and staff infections – has been well-documented.

Meanwhile, there is a critical shortage of workers in health care and social services, spurred by the pandemic. Workers have left in droves because of burnout, poor working conditions and inadequate compensation. The federal government, along with provincial and territorial governments, have a central role to play in ensuring that the health care systems are properly funded and staffed. However, insufficient funding and the privatization of certain health care segments have placed the system on life support.

Unifor in the Health Care and Social Services Industry

Unifor represents approximately 29,000 health care workers and 3,500 workers in the social services. The membership in this sector is distributed across more than 425 bargaining units, with heavy regional concentration in Ontario and Nova Scotia. Unifor’s health care members work in a range of settings, including hospitals, long-term care homes, retirement homes, emergency paramedic service providers, home care providers and clinics. Unifor’s social service members work in providing services focused around women, Indigenous communities, adults with disabilities, youth, and child care.

Some segments of the sector are publicly-funded and employers are public entities, including hospitals and emergency services. Other segments of the sector are comprised of private (often large corporate) employers who have contracts with government bodies (home care, for example) or receive government subsidies for part of their operations (long-term care homes, social services) or are completely privately funded (retirement homes).

Unifor’s hospital bargaining units range in size – from as small as two members, up to 1,650 members. In long-term care, bargaining units also range in size, but some units share a common (often corporate or private) employer. In the social services, most of the units are part of small workplaces (with some exceptions) where the operations are heavily dependent on government funding.    

Moving Forward: Developing the Health Care and Social Services Industry

The health care and social services sector is directly affected by government policy, both fiscal and social, at the provincial and federal levels. Federally, the Canada Health Transfer to the provinces and territories contains a formula that sees the transfer grow annually by 3% + an additional capped amount based on the growth of the economy. As Canada’s population continues to age (and is more reliant on health care services), negotiations between the federal government and the provinces and territories will be a challenge. The Premiers have been pushing for increased funding with less strings attached. However, the federal government has signalled future negotiations to involve funding with some strings attached, while committing to a new dental care program. Despite a previous commitment to implement universal pharmacare, the Liberals have dragged their heels and have been non-committal on this file.

Provincially, the Ontario government passed legislation in 2019 that limited compensation increases for many health care and social service workers to 1% annually over a three-year period. The government also passed long-term care legislation in 2021 that set out a target of four hours of care per resident per day, but without the teeth to ensure the target is achieved or enforced in each facility. At this time the care increments as targeted by the province have not been met.  The government has continued to prop up for-profit long-term care providers with license renewals and new beds.

In Nova Scotia, the current Premier promised to fix health care in the summer 2021 election campaign but has been slow on implementing a comprehensive plan. The government did increase the rate of pay for Continuing Care Assistants (CCAs) in the province by more than 20% in February 2022.

Major Sector Development Issues

• End for-profit long-term care and enforce mandatory care standards across the sector.
• Implement universal pharmacare immediately.
• Address recruitment and retention issues across all health and social service sub-sectors by respecting workers and ensuring that they are compensated fairly.
• Enforce the Canada Health Act and prevent any further privatization of health care services.