Based on current commitments on funding and reform, we have set a number of specific targets which we believe are achievable within two to five years. The Health Council acknowledges that substantial efforts are underway toward many of these objectives - yet we challenge governments, professional associations, regulatory bodies, employers, unions, and educators to go further, to work together and to work with us in reporting back to Canadians on their progress. Action on each of these recommendations requires collaboration among key stakeholders, but active leadership is essential.

1. Expand opportunities for interprofessional education and postgraduate collaborative practice.
   Lead responsibilities:
   · Universities and colleges to design new programs;
   · Governments to fund programs;
   · Employers and unions to create workplaces supportive of teamwork.
   By 2008:
   a. Each of Canada's university health sciences programs should offer an interprofessional educational program through collaboration among appropriate disciplines.
   b. Incentives such as tuition subsidies should be available to encourage students and post-graduate trainees to enter interprofessional education programs.
   c. A collaborative practice workplace fund should be created to enable primary health care settings to provide high-quality interprofessional care and education (for example, to fund mentorships and logistical support for such costs as transportation in rural areas and information technology).
   d. All health professionals - both new graduates and the existing workforce - should be able to access an interprofessional clinical learning experience.

2. Create more interim training and certification steps along pathways to health careers.
   Lead responsibilities:
   · Universities and colleges to design and implement programs;
   · Governments to fund programs;
   · Regulatory boards to work in partnership with educational institutions and professional associations to design and accept new credentials;
   · Employers and unions to embrace new roles for providers.
   By 2010:
   Existing health science programs in each jurisdiction, in partnership with college-level training institutions, should offer tiered pathways in the health professions.
   

3. Increase the numbers of First Nations, Inuit and Métis professionals in the health workforce.
   Lead responsibilities:
   · Universities and colleges to implement, in partnership with governments as well as with Aboriginal leadership, national organizations, and communities;
   · Employers to develop recruitment and retention programs for Aboriginal graduates.
   By 2008:
   a. Colleges and universities should complete an assessment of their internal capacity to support Aboriginal students (e.g. financial support for education and living expenses, and psycho-social supports such as mentoring and peer counseling) and take action to improve insufficient supports.
   By 2010:
   b. Outreach and support programs to encourage Aboriginal students to consider a health professions career should be established.
   c. The number of Aboriginal students in health professions programs should rise to at least four per cent of total enrolment (to achieve a minimum of proportional representation).
   d. An interprofessional educational cohort program for Aboriginal students in a range of health professions should be established.
   

4. Strengthen a national approach to managing the role of international graduates in meeting Canada's health human resource needs.
   Lead responsibilities:
   · Certification agencies and regulatory bodies to develop assessment processes;
   · Governments to fund and to reform regulations as required;
   · HHR planning authorities to specify the role of international graduates in future HHR planning;
   · Federal government, in partnership with provinces and territories, to jointly develop and implement policies on ethical recruitment.
   By 2008:
   a. Assessment processes to enable the integration of international graduates in regulated health professions should be standardized across Canada.
   b. The contribution of internationally-educated health care providers should be clearly articulated in HHR plans.
   c. Federal government, in consultation with provincial and territorial governments, should report publicly on progress in collaborating with international health organizations on implementing ways to improve the ethical recruitment of health care professionals.
   

5. Enhance opportunities for professionals to work to optimal scope of practice to ensure the system's capacity to meet local patient and population health needs.
   Lead responsibilities:
   · Governments, regional health authorities, employers, unions, professional associations, educators and regulators.
   By 2008:
   a. Professional associations and health professions regulators should engage with employers and governments to foster better understanding of the uniqueness and commonalities in key health professions.
   b. Regional health authorities and other employers should review current workforce roles in existing health care settings to assess where people are working to optimal scope of practice and where, with appropriate supports, the workforce could better meet local patient and population health needs.
   By 2010:
   c. Changes should be implemented in how work is organized to better match skills and scopes of practice to patient/client needs, and progress on these changes should be publicly reported.
   

6. Accelerate the shift to provider payment schemes that stimulate interprofessional teamwork.
   Lead responsibilities:
   · Governments, professional associations, and employers.
   By 2008:
   Alternate methods of compensation should be promoted so that the proportion of publicly-funded providers paid through flexible alternative schemes has increased by least 20 per cent.
   

7. Resolve concerns about liability in collaborative practice.
   Lead responsibilities:
   · Professional liability protection organizations, governments, regulators, and patient safety organizations.
   By 2007:
   a. A common understanding of liability issues in collaborative practice and what remains to be done to resolve them should be publicly reported.
   By 2008:
   b. An integrated approach to professional liability and accountability consistent with patient safety, risk management, and teamwork should be collaboratively developed.
   

8. Invest in financial and non-financial incentives to improve recruitment and retention, and report publicly on the progress of healthy workplace initiatives.
   Lead responsibilities:
   · Health care employers.
   By 2008:
   a. Employers - in collaboration with researchers, professional associations and unions - should use comparable indicators on workplace health to publish annual assessments in such areas as employee retention and satisfaction and other aspects of work life quality.
   b. Through public reporting on indicators of workplace health, employers should regularly demonstrate improvements in the quality of work life in health care settings.
   c. Employers should increase by 10 per cent above current levels the time staff spend attending professional development opportunities and providing career mentoring and coaching.
   

9. Ensure that HHR planning is based on population health needs, fully integrated across jurisdictions, and properly resourced.
   Lead responsibilities:
   · Federal, provincial and territorial governments in partnership with regional health authorities to improve and report on planning;
   · The Canadian College of Health Service Executives to develop competency requirements in interprofessional HHR planning.
   By 2008:
   a. Population health needs should be the building blocks of forecasting tools used by governments and others to plan for health human resource requirements.
   b. Federal, provincial, territorial and regional health human resource plans should be mutually integrated.
   c. Governments and others should report publicly on their forecasting tools for HHR planning.
   d. The growth of management skills in planning should be supported by the requirement for competency in HHR planning in an interprofessional care environment.