The international battle for health care workers, as seen from Tasmania

Photo: British Columbia emphasizes its natural beauty to try to recruit nurses, but it’s not the only place making that pitch. The Australian state of Tasmania also tries to lure health care workers with promises and pictures of its mountains, lakes, and coastlines. 📷 THP Creative/Shutterstock

If you’re a nurse who lives in, say, England and dreams of not living in, say, England, a British Columbia recruiter wants to talk to you.

They want you because they need you—to fill job vacancies in big cities, small hospitals, and long-term-care facilities of every size. And they want to convince you that if you love mountain biking, beautiful views, outdoor recreation and kayaking, you should start packing.

But so too does Todd Babiak. And he wants you to head east to an island called Tasmania.

Economies across the western world are in a perilous position. Their countries’ populations have been aging for decades, but recent years seem to have heralded a labour turning point, where jobs have become plentiful and the workers needed to fill them increasingly scarce. In response, Canada has increased immigration rates to try to bring balance to the country’s age profile.

The situation is particularly urgent in the health care sector, where the pool of potential workers is shrinking but the demand for their services is expanding dramatically. As more Canadians enter their 60s and 70s, they’re not just dropping out of the workforce: they are also in need of more frequent medical treatment—and support from nurses and doctors.

The consequences of this shift have been foreseen for years.

Capacity challenges in BC’s hospitals and long-term care homes are not new. A decade ago, hospitals in Abbotsford, Chilliwack and elsewhere in the Fraser Health region were operating over capacity and caring for more patients than they had funded beds or staff. At the time, though, most of those issues were the result of financial choices, as health care bodies sought to transition from hospital-focused care to providing more care in peoples’ homes and less-costly facilities like long-term care and community care sites.

Since COVID, however, worker shortages have increasingly imposed limits on what health care bodies can do. In BC, the province is building hospitals, long-term care homes, and urgent care centres at a scale not seen in recent decades. But the roll-out of urgent care centres, in particular, has shown that no facility can run without a complement of nurses and doctors. Those urgent and primary care centres are a key part of the government’s strategy to address emergency room backlogs. But some have opened without enough staff to actually provide services during some of ER’s busiest times, like weekends. Staffing challenges left Abbotsford’s UPCC providing urgent care drop-in services only two days a week more than a year after it opened (the site did eventually find enough staff to ramp up to a seven-day-a-week urgent care operation).

Similar challenges face maternity wards and other specialized care operations. The question, increasingly, is not how a government or a health care authority wants to spend money, but how it wants to allocate its short supply of workers.

All of which is to say British Columbia very much needs more nurses and health care workers.

But the province is not the only jurisdiction with a growing proportion of seniors and a stagnating or declining pool of workers. Across the western world, most countries are also trying to figure out who will care for their increasingly numerous retirees.

And they’re all eyeing each other’s nurses.

British Columbia, for example, operates two different websites focused on attracting foreign nurses to the west coast of Canada. And last year, the province flew recruiters and managers from across the province to trade shows in the United Kingdom and Ireland to try to convince job-seeking nurses that their future lies in British Columbia.

But the competition is stiff.

Meet Todd Babiak.

Babiak is a former Edmonton journalist whose job today is focused on “building the brand” of a place a lot like the Fraser Valley, but an ocean away: Tasmania—that triangular island off of Australia’s southeast coast.

When you hear the word “Tasmania,” you might think of a whirling and slobbering animated marsupial. It’s Babiak’s job to get you to think of beaches and mountains and the prospect of enjoying a relaxing but fulfilling life.

Traditionally, location-branding work has focused on tourism and economic development. Governments have long hired branding and marketing organizations to lure tourists, investors, and companies to their jurisdictions. The goal is simple: attracting outside money.

Those targets are all part of Babiak’s work for the Australian state of Tasmania. But increasingly, he and competitors in other countries are being tasked with attracting not just those cash-flush tourists or innovative tech workers, but skilled and dedicated health care workers.

“Like everywhere, certainly in the English speaking world, we have too few nurses, and doctors and health care workers in general,” he said. “There aren’t enough in the pipeline of people being educated to fill those roles.”

But some of the traditional ways a company or destination might lure a worker don’t quite fit. They can offer money, but public health care system budgets are limited and nurses who really want to make a mint can sign up with a private company that offers travel nurses to desperately understaffed facilities. And promising a nurse their “dream job” also isn’t that effective.

“All of our research shows that if you are trying to compete internationally just with jobs—if the words in the job descriptions are all the same and all that changes is the government logo at the top—it’s not enough now,” Babiak said.

So Tasmania, like BC, puts much of its effort into selling the place itself, and the life it can provide workers.

“What we have to do is, quite aggressively but with care and humility, find the people who will be happiest here: who would love to contribute to building a really powerful health care system but who also love to go on hikes and to the beach and mountain biking and live in wonderful little cities,” he said.

And just like BC, Tasmania has its own website, featuring its own happy health care workers, its own images of majestic beauty, and its own job opportunities.

The message is simple, Babiak said, “In a pretty streamlined way, we can get you here and change your life.”

The moral quandry

Canada, of course, has long relied on health care workers (and other workers) who have come from other nations. And Canada, for decades, has also struggled with how to ensure that everyone who comes here to work can actually use their skills.

The country infamously has skilled medical workers who have found it difficult or impossible to get accredited in their fields and end up driving cabs or working in other lower-paying industries. The provincial and federal governments have been trying to address those issues for years, with mixed success. Last year, Ottawa announced it was boosting its “Express Entry” immigration field to specifically target larger numbers of eligible health care workers who have applied to come to Canada and gain permanent residency

Canada and other nations have also come under criticism for trying to pull workers from less-developed countries that desperately need to retain their own employees, but which often don’t have the financial resources to compete.

Jamaica has lost hundreds of nurses to the United States, the United Kingdom and Canada, a conference heard last year.

“We found that our intensive care units and our emergency rooms were short staffed because of that poaching,” the vice-president of the Nurses Association of Jamaica said.

The CEO of the International Council of Nurses, Howard Catton, told CBC that Canada and a half-dozen other wealthy countries aggressively increased their recruitment efforts at the beginning of 2022.

“"[They're] in a rush to get a quick fix to their own nursing shortage, because they haven't invested enough in educating their own nurses, and because the nurses that they have, in many cases, are exhausted and burnt out."

The fact that so many workers come to Canada and then can’t work in their field makes the practice even more morally dubious.

Jobs, jobs, everywhere

Efforts to recruit health care workers from other wealthy countries avoids some of those pitfalls.

Immigrants from some nations—particularly those in the English-speaking west—typically face far fewer limitations and barriers. Because of that, recruiters can be more sure that a nurse coming to Canada from, say, the United Kingdom, is more likely to actually end up filling a key position in a hospital here.

So like Babiak does for Tasmania, BC’s nurse-recruiting websites stress the natural beauty of the province.

“During the warm BC summers, you can often find individuals near the beaches, at a lake, or visiting the many lush provincial parks,” it proclaims. “In the winter, skiing, snowboarding, ice climbing and snowshoeing are just some of the activities that can be enjoyed on the mountains or trails around BC.”

When every nation is trying to attract nurses from one another, the upside for the health care systems themselves can be a little less obvious. A country like Canada isn’t just trying to fill vacancies left by retirements but also those arising when one of its own health care workers is convinced that a life in Sydney looks better than one in Winnipeg.

But Babiak looks at the challenge on a more human level, where the goal is to match health care workers with the lives each wants, and to strengthen health care systems in the process.

As many British Columbia residents have found, health care facilities and services in more-rural communities can live or die on the lifestyle choices of nurses or doctors far away.

Babiak said he is enjoying his life in Tasmania and the ability to go on a leg-busting hike and a major concert on the same day. The weather also tends to be better than that in his old hometown. Now his job is to find health care workers who might also find life in Tasmania to be perfect for them. Just as his competitors/colleagues are trying to find the nurses who will help patients in Chilliwack and Hope in the decades to come.

“We’re not trying to steal people so much as say ‘Some people belong here.’ Some people belong in the Fraser Valley, it’s just the way it is.”