One out of every five contracts Alberta Health Services (AHS) awarded to private nursing agencies over the past two-and-a-half years sent contract nurses to health-care facilities in the Calgary and Edmonton areas, according to documents obtained through a freedom of information request.
Chris Gallaway, executive director of Friends of Medicare, told the Progress Report that the contract nurses’ deployment to hospitals in Alberta’s major metropolitan centres reflects “a widespread normalization of their use.”
“Historically, agency nursing was about filling those hard-to-fill positions in northern and remote areas,” explained Gallaway.
“If we can't staff hospitals in our largest cities in the province without bringing in agency nurses, there's a problem.”
Photo via Cedric Fauntleroy on Pexels.
The Progress Report requested a breakdown of private nursing staff employed at each health-care facility by fiscal year from April 2019 to September 2024. AHS said it only had data “readily available” for 2022/23, 2023/24 and the first half of 2024/25.
This outlet previously reported that AHS is on pace to have spent $330 million on private agency nursing staff since April 2022, which Health Minister Adriana LaGrange has conceded is a “problem.”
Between April 2022 and September 2024, AHS hired 1,606 registered nurses (RNs) through various staffing agencies. In the same period, they also hired 332 licensed practical nurses (LPNs) and 338 health care aides (HCAs) through the agencies. This was all done through 5,011 placements or contracts via 21 different agencies.
Over the 30 months examined, the top destination for contract nurses was AHS Northern Zone, with 2,291 placements (46 per cent), followed by the Central Zone, with 1,540 placements (31 per cent), and then the Edmonton Zone, with 747 placements (15 per cent). The Calgary and South zones had 261 (five per cent) and 172 placements (three per cent), respectively.
Graphic by Duncan Kinney
The majority of nursing staff contracted out to AHS health-care facilities in Alberta were RNs, representing 72 per cent of the total for the 2022/23 and 2023/24 fiscal years, and then 65 per cent for April to September 2024. The number of LPNs and health-care aides remained roughly equal for the two full years and one half-year examined, representing about 14 per cent each and 17.5 per cent each, respectively.
Gallaway said his “mind is just blown” that AHS is resorting to private staffing agencies to hire LPNs and HCAs, given how underpaid LPNs and HCAs directly employed by AHS are.
“It shows the misplaced priorities of the government that they're willing to pay agency staff more than they're willing to pay their own workforce to retain them,” said Gallaway.
When we look at the individual health-care facilities that recruited the largest number of RNs, all of them are based in cities, with the University of Alberta Hospital in Edmonton’s 493, Grande Prairie Regional Hospital’s 412 and Red Deer Regional Hospital’s 295 leading the way.
Graphic by Duncan Kinney
Two-thirds of RN placements in the Edmonton Zone from April 2022 to September 2024 were at the U of A Hospital while 31 per cent of RN placements in the North Zone were at Grande Prairie Regional Hospital and 28 per cent in the Central Zone were at Red Deer Regional Hospital.
When it comes to contract LPNs and health-care aides, the facilities that used them the most tended to be outside the major cities and were disproportionately concentrated in the North and Central zones.
More than three-quarters of all LPN placements during the period examined were in the North Zone alone. The top five placements, unsurprisingly, were all in the North Zone, all but one of which were located outside a major city.
St. Theresa General Hospital in Fort Vermillion led the way with 56, followed by Peace River Community Health Centre with 37, Grande Prairie Regional Hospital with 35, Edson Health Care Centre with 34, and tied for fifth was Fairview Health Complex and Manning Health Care Centre, each with 33.
Graphic by Duncan Kinney
Health-care aide placements were more evenly dispersed between the Central and North zones, with those two zones together making up 97 per cent of placements.
The health-care facilities that used the greatest number of aides were entirely outside major city centres, with Hanna Health Care Centre and Drumheller Health Centre using them the most, with 62 and 60, respectively. They were followed by Bar-V-Nook Manor, a long-term care facility in Barrhead, with 51, Vegreville Care Centre with 49 and Dr. W. R. Keir Barrhead Continuing Care Centre with 46.
Graphic by Duncan Kinney
By AHS’s own admission, contract nursing staff make more per hour than in-house employees, in addition to provincially funded airfare, accommodations and daily allowances—so containing health-care costs isn’t a factor here.
Gallaway said the increasing use of private agencies to fill gaps in the health-care system, rather, reflects the provincial government’s ideological approach towards health care.
“They would rather flip a switch, hire an agency, give them money and not have to deal with things like bargaining at the bargaining table, demands for living wages or positions that folks don't have to work multiple part-time jobs just to afford to live,” he said.
The bifurcation of the workplace into a unionized AHS workforce and outside contract staff creates a “toxic” dynamic, Gallaway added.
“You have folks working next to each other making vastly different salaries and wages. Some have requirements for overtime, for shifts, for schedules, and others can come and go as they please,” he said.
“It creates a real inequity in the workplace that undermines the actual ability for those workers who work there to have solidarity and bargain together.”
Disclosure: This story is a part of a series on the effects of private staffing agencies on Alberta’s public healthcare system. The reporting for this story was made possible via a grant from the United Nurses of Alberta, a labour union representing Registered Nurses in Alberta. The Progress Report maintains editorial independence throughout the investigation and reporting process.