The use of private for-profit nursing or staffing agencies is rising dramatically, warns a study from the Canadian Federation of Nurses Unions (CFNU).
Released in September, the report estimates that Canadian hospitals, health authorities and continuing care facilities paid at least $1.5 billion to these private businesses last year to fill staffing gaps.
“This is an example of creeping privatization of the healthcare system. These agencies are siphoning off money and resources away from the public system where it could better be used to solve the staffing crisis in our hospitals and healthcare facilities,” said Adam King, an assistant professor of labour studies at the University of Manitoba.
“Staffing agencies were not designed to do this. It reminds me of contract teaching in universities, it was supposed to be used in emergencies or in edge cases but now it's become a central way of staffing up your workforce. Now it has become the norm,” said King.
The CFNU report does not detail how much these agency nurses are paid, but it does note how much the agencies are charging to provide them: on average, an estimated $133 per hour last year. A registered nurse working in their first year at AHS makes $39.21 an hour.
How much money did Alberta spend on private nursing agencies? Joan Almost, the author of the study and a nursing scholar at Queen’s University doesn’t know, since AHS didn’t respond to her requests for that information.
“The only data we were able to obtain was from media reports from the list of AHS’ procurement contracts on their website, which wasn't up to date at the time,” said Almost. She was only able to track down just over $5 million in spending by AHS on agency nurses in the 2021-2022 fiscal year.
Sources told the Report that the use of agency nurses has continued to drastically increase since—at the same time that AHS has instituted a hiring freeze and restricted the ability of local, public nurses to get overtime, as the Report noted earlier this year.
“With any of these contracts the government signs with these private providers there’s so much we don’t know,” said Chris Galloway, the executive director of Friends of Medicare. “How much is the profit? How much is going to the worker? What are our obligations? We don’t get to see any of that. We have no idea if it’s a good contract. We don’t know anything, really.”
Galloway has also heard reports of staffing agencies being used not just for registered nurses but also for licensed practical nurses and even health care aides. “These health care aides are getting paid poverty wages, having to work at 2-3 different locations just to make ends meet. It’s so offensive that the government is willing to put up money to pay so much more money for those agency HCAs to work next to HCAs working for barely over minimum wage,” said Galloway.
Those anecdotes line up with Almost’s report, which points to an explosion in the use of these agencies countrywide. While the report estimates last year’s use of agency nurses in Canada to have exceeded $1.5 billion, back in 2020, Canadian hospitals were spending only $248 million.
Linda Silas, the president of the Canadian Federation of Nurses Unions said she fears for the future of the public health care system “when the workforce that keeps it running is being siphoned into for-profit companies to line the pockets of stakeholders.”
“For-profit nursing agencies are not a sustainable solution to Canada’s staffing crisis. We cannot continue to slap a band-aid on a gaping wound. For the future of nursing and our public health care system, we must reverse this costly trend. Governments and employers must begin phasing out the use of for-profit nursing agencies, while taking immediate action to solve the nursing shortage,” said Silas in the report itself.
CFNU’s report recommends creating a public-funded, government-run centralized staffing agency to regulate the use of agency nurses and to control costs. But most importantly the report urges public health care authorities that employ nurses to become “employers of choice.” That will require not just improvements in wages, but better working conditions including more-flexible scheduling and better opportunities for professional development.