From Nurses to Nannies: Filipina Women and Canada’s Live-in Caregiver Program

The job market saturation of nurses in the Philippines’ healthcare industry has meant that about 200 000 experienced nurses cannot find jobs in their profession; while an additional 80 000 new nurses are trained each year. Temporary domestic programs that send new nurses to work in the country’s rural areas still leaves hundreds of thousands of nurses seeking work elsewhere.

Canada, in the meantime, would appear to be a prime destination for this surplus pool of skilled labour. Provincial healthcare administrators have been asking the federal government to address the current nursing labour shortage that has affected hospital and long-term care services throughout the country. Homegrown nursing skills training cannot keep up with the pace of the healthcare system’s needs in addition to the current rate of retirement of older nurses. Understaffing has led to burnout and unsatisfactory service in hospitals across Canada. Though the solution to both the Philippines’ nursing labour surplus and Canada’s nursing shortage seems pretty straightforward, little has been done to ease the difficult migration process.

Ate K is a young, experienced registered nurse in the Philippines who comes from a large family of healthcare professionals. She has successfully treated a number of tropical diseases, assisted in surgical operations, and tended to victims of vehicular accidents since becoming a registered nurse over three years ago. The current situation for nurses in her country, however, has led her to look for work in Canada where a number of her relatives currently live and where she has a support network. But she has yet to apply to work as a nurse. Instead, she is currently waiting for a response from Canada’s Live-in Caregiver Program (LCP).

Ate K’s profile is typical of most of the 52 502 caregivers that have worked in Canada under the LCP before 2009. The LCP has existed since 1992 under the fold of the Temporary Foreign Worker Program (TFWP) and aims to give foreign nationals the opportunity to work in Canada as private housekeepers or care providers for two years, after which they are eligible to apply for permanent residency. Ninety per cent of caregivers that enter Canada through the LCP are Filipina women who come directly from the Philippines, though it should be noted that a number of other Filipina women are recruited into the program via other source countries.

Though an overwhelming majority of the Filipina women in the LCP are trained healthcare professionals, most remain as nannies or move on to lower-level service jobs. Strict rules on foreign nurses set by the College of Nurses of Ontario, for example, are only some of the prohibitive barriers for these would-be nurses. Precarious immigrant status, low-income, and little social capital in a new country present larger obstacles. Even after completing the two years of work demanded by the program in order to be granted permanent resident status, many still do not get back into nursing due to other difficulties in addition to the thought of having to ‘prove yourself again’. Many end up working as fast food workers, janitors, and even staying on as live-in caregivers, despite owning a bachelor’s degree.

In general, the Filipina supply of labour to the LCP has existed as a cheap Band-Aid solution to Canada’s lacking federal childcare and old-age care programs. A live-in nanny costs around $1200 to $1600 a month and would have to respond to their employer’s needs 24 hours-a-day. Similarly, child daycare costs around to $960 per child per month, and up to $1500 per month in BC alone. Without these social programs, it’s often argued that it’s the Filipinas who fulfill the familial obligations which liberate Canadian middle and upper-class women to pursue professional careers of their own. The deprofessionalization of the Filipina nurse in Canada has meant that thousands of well-trained nurses resort to the LCP only as a pathway to immigration.

While many Filipina women do not feel that live-in caregiver work is a lowering of their status and the program has worked somewhat in providing an honest shot at Canadian immigration, it is clear that there is some misallocation of skills and labour. The TFWP, already mired in its own controversy over the misallocation of jobs and labour, has done little to recruit healthcare workers. 1,342 immigrants arrived in 2011 with the intention of working in either high-skill or assistant healthcare occupations and approximately 3,050 under the TFWP currently work in healthcare and social assistance jobs, mostly because the program presently focuses on private sector employment. Meanwhile 5,882 workers, most trained as healthcare professionals, arrived through the LCP just in 2011 alone.

In resolving this discrepancy in labour market supply and demand between Canada and the Philippines, a number of immigration and social policies need to be revised in order to make it easier for foreign-trained nurses to find work in our healthcare system. Federal investment in childcare would also relieve LCP workers from the strenuous jobs of looking after someone else’s kids, 24-hours a day. Immigration programs in the UK, for example, have allowed 16 000 Filipino registered nurses to work in the British National Health Service. It is up to Ottawa and Manila to take leadership in making policies that resolve the problems that plague their respective healthcare labour markets. Reforming the LCP and TFWP would be a good start

The views expressed here are those of the author, and do not necessarily represent the views of the Asia Pacific Foundation of Canada.

Clement Nocos

I am currently a Master of Public Policy student at the Hertie School of Governance in Berlin after graduating with a Hon BA from the University of Toronto. My rather broad, but somehow connected, research interests include Southeast Asian gender history, Canadian immigration policy, Filipino Barangay politics, European affairs, and social capital’s relationship with political economy. Back home in Toronto, I am a part-time political activist, working on a number of initiatives such as public transit advocacy.
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