$1.5 billion spent on for-profit nursing agencies: report

The Canadian Federation of Nurses Unions (CFNU) has released a report showing nationwide spending on for-profit nursing agencies has ballooned to 1.5 billion dollars within the last fiscal year.

Provincial governments have tried to address the nursing shortage in the public health care system by spending millions in contracts to private for-profit nursing agencies.

For CFNU President Linda Silas, “One thing is now crystal clear: for-profit nursing agencies are not a sustainable solution to Canada’s staffing crisis.”

The CFNU partnered with Queen’s University’s Dr. Joan Almost to produce the report, ‘Opening the black box: Unpacking the use of nursing agencies in Canada.’ Besides showing a sharp increase in spending on nursing agencies, the report reveals a lack of regulations and transparency over how the agencies operate.

In the 2023-2024 fiscal year, more than $1.5 billion of public health care money went to for-profit nursing agencies, six-times the amount spent just three years ago in 2020-2021. These estimates are also considered conservative given the lack of transparency that comes with the contracts.

Dr. Almost, an expert on the nursing profession, argues that the nursing agencies require greater public accountability and oversight.

“Employers are being put into pressured situations when an agency they are working with further increases the rates, leading to a lot of conversations about the ceiling and deciding when enough is enough,” said Dr. Almost. “Do they go along with the unexpected rate hikes, or leave units without adequate staffing, or cancel services?”

For Silas, staffing shortages can be solved through already proven retention and recruitment strategies.

“Billions of dollars have been pushed into short-term fixes when we could have had an incredible impact on the nursing shortage and our health care workplaces with that investment,” said Silas.

The report recommends governments immediately work towards phasing out private for-profit nurse staffing agencies as it also works to solve the nursing shortage crisis. The report also calls for regulations and oversight to be implemented until private for-profit nurse staffing agencies are completely phased out.

“We can’t allow this profiteering of the health care crisis to continue,” said Silas. “It’s time to do right by nurses and do right by the public and implement sustainable solutions to pull our country out of this crisis.”

The New Brunswick Progressive Conservative government came under fire by Attorney General Paul Martin earlier this year for spending $173 million on travel nurses. Most of that spending was on the Vitalité Health Network’s three contracts with Canadian Health Labs.

After years of registering surpluses, New Brunswick Finance Minister Ernie Steeves linked the province’s projected deficit to spending on travel nurses in August. The agencies have charged more than $300 an hour, about six times what a local staff nurse earns.

The Horizon Health Network has said it no longer uses travel nurses, while the province’s other regional health authority, Vitalité, plans to stop using travel nurses by 2026.

New Brunswick rapidly losing younger nurses

Another recent report on nurses shows New Brunswick is losing younger nurses at a faster rate than anywhere else in Canada.

According to the report by the Montreal Economic Institute, ‘Which provinces struggle the most to keep young nurses?,’ for every 100 people who became a nurse in New Brunswick in 2022, 80 left before the age of 35. That rate is double the national average, and 51 per cent higher than it was in the province a decade ago.

Economist Emmanuelle B. Faubert, author of the report, told CBC, it’s a “staggering number and very worrying when we know that the young nurses of today are the experienced nurses of tomorrow.”

According to Faubert, nurses are leaving their profession because of their working conditions and poor work-life balance. They are overworked and work in stressful environments.

Faubert argues that financial incentives may attract nurses and retain them for a short period of time, but if working conditions do not improve, it is likely nurses will not stay in their profession.

According to CFNU’s latest survey of 5,000 nurses, nine in ten are experiencing burn out, and four in ten are planning to leave the profession within the next year.

Paula Doucet, president of the New Brunswick Nurses Union, told CBC the report’s findings are “very concerning” considering the province currently needs to hire 750 nurses.

Earlier this month, the New Brunswick Nurses Union voted against a tentative collective agreement with the province. Negotiations over a new collective agreement are now paused until after the provincial election on October 21. The union wants the province to focus on recruitment and retention.

The three major political parties in the province, Progressive Conservatives, Liberals and Greens, have all promised to offer retention bonuses to nurses.

Doucet wants the province to do more to retain nurses. She recommends New Brunswick follow British Columbia in implementing minimum nurse-to-patient ratios. British Columbia is losing far fewer younger nurses than New Brunswick, approximately 32 in 100 in 2022, just behind Manitoba that lost 29 in 100 in 2022, according to the Montreal Economic Institute’s report.

“I think that is the one of the most attractive things to a nurse, knowing that there is some safeguards in place for their workload,” Doucet told CBC.

Tracy Glynn is the National Director of Projects and Operations for the Canadian Health Coalition.

This article was first published by the Canadian Health Coalition.