Changes in HSSN employment numbers vary considerably from one province to the next. While the workforces of all provinces have experienced net growth since 1981, coupled with a more or less lasting and marked decrease during the 1990s, some provinces have continuously consolidated the workforce in this sector (British Columbia in particular), whereas others (Quebec, Ontario and Alberta) significantly reduced the number of sector employees during the 1990s after having massively increased this workforce during the previous decade. Among this latter group of provinces, Quebec is the one that reduced the number of HSSN employees the most during the second half of the 1990s. The decrease was particularly sharp between 1995 and 1996 – i.e., -8.6% in a single year. While the 2000s (decade) have been marked by a generalized increase in HSSN employment, some provinces nevertheless show a relative stability – in particular, Newfoundland and Labrador, Prince Edward Island, Nova Scotia, New Brunswick and Ontario. 2010 data nevertheless confirm that the workforces in all provinces have again begun to increase. Between 2008 and 2010, the number of health and social service employees increased in the nine provinces of Canada for which data are available. The strongest increase during this period occurred in Alberta (+ 11.8%) and the weakest in Manitoba (+ 0.3%). For the entire country, the average increase for the 2008-10 period was 5.6%. Aside from Manitoba, only Quebec and Ontario posted increases below this average, at 3.4% and 4.5%, respectively.
In a comparison limited to Canada’s three most populous provinces (Ontario, Quebec and British Columbia) and the average for Canada, Quebec presents the highest ratios in terms of the proportion of HSSN employees to the total workforce (6.8%) and the number of employees active in this sector per 1000 inhabitants (33.7). To explain these interprovincial variations, a number of hypotheses can be advanced, including: the integration of health and social services; the concentration of these services within a single network (whereas in other provinces, and particularly in Ontario, a number of health and social services come under the responsibility of local administrations), and the handling of non-medically required services (which thus are not governed by the Canada Health Act). That being said, Quebec does not post the highest ratios in Canada for these two indicators, being outclassed on this score by Newfoundland and Labrador, Manitoba and Saskatchewan for year 2010. Moreover, for the same year, the proportion of HSSN employees to the total workforce was higher in New Brunswick (7 %) than in Quebec.