Michael Hurley, President of Ontario Council of Hospital Unions, Vice-President of Canadian Union of Public Employees (CUPE) Ontario and Regional Vice-President on CUPE’s National Executive Board for Ontario. Credit: Photo provided by Michael Hurley
Today on Small Change, I’ll be unravelling the truth about nursing agencies, dissecting who really benefits from them and explaining how they are fuelling the nursing crisis across Canada.
Michael Hurley is well equipped to bust the myths and misinformation that Canadians are being fed by premiers like Danielle Smith and Doug Ford.
Michael has been president of the 40,000 member Ontario Council of Hospital Unions (OCHU) since 1990. He is the first Vice-President of Canadian Union of Public Employees (CUPE) Ontario as well as Regional Vice-President on CUPE’s National Executive Board for Ontario.
Michael has co-authored several academic articles on the healthcare workforce that have been published in New Solutions, International Journal of Occupational Health and Safety.
In September of this year, the Canadian Federation of Nurses Union (CFNU) released a report titled, Opening the black box: Unpacking the use of nursing agencies in Canada.
The CFNU worked with Queen’s University to conduct the mixed methods study led by Dr. Joan Almost. The study examined the use of nursing agencies across Canada and provides an understanding of the impact agencies have on human resources planning, privatization of the public healthcare system, as well as retention and recruitment of the nursing workforce.
The report stated that spending on for-profit agency nurses is expected to surpass $1.5 billion in Canada in the current fiscal year.
Agency nurses, also referred to as travel nurses, are employed by for-profit nursing agencies whose services are contracted out to short-staffed public healthcare employers to fill temporary staffing needs.
The report unveiled a sharp increase in spending on for-profit agencies and a concerning lack of regulations and transparency over how these companies operate. It also showed that spending on agency nurses is out of control.
That $1.5 billion cost to the public is a six-fold increase in just over three years.
But that $1.5 billion is also an underrepresentation because researchers were sometimes forced to rely on media articles and auditor general reports because only seven provinces and territories make this data available.
While agency nurses are used throughout the healthcare system including in long-term residential care (LTRC) facilities, critical care units, emergency departments and hospital medical units, they were never meant to replace full-time nursing staff.
Currently, 472 for-profit nursing agencies operate across Canada, but growing demand indicates this number is on the rise.
That growth is also being compounded by the number of nurses leaving the public system due to stagnated wages, burnout and the use of incentives by nursing agencies.
It’s ironic that hospital administrations actively fight against wage increases for nurses while paying agencies two to two and a half times the rate they pay public nurses who currently earn about $40 per hour.
Some agencies also pay private nurses a bonus for working an overnight shift. Then, there’s the agency’s fee which can bring the total cost per agency nurse to over $300 per hour -- although that’s an estimate because these private corporations don’t answer to the public.
It’s also important to point out that private nurses are often not able to do the entire job they were hired for. That’s because there’s no orientation, no training, little to no supervision and a lack of continuity.
The privatization of nursing not only costs taxpayers significantly more money, but it also pulls experienced healthcare workers out of the public system.
And, that should concern folks, because it’s been well documented that every time a patient is added to a registered nurse’s workload, the risk of an adverse effect or even death, goes up by seven per cent.
And, nursing agencies aren’t the only private sector enterprise competing for nurses.
The Canadian Federation of Nurses Unions (CFNU) says that the use of nursing agencies can’t be immediately curtailed because of the adverse impact that would have on staffing.
The report, Opening the black box: Unpacking the use of nursing agencies in Canada, also states, “While nursing shortages and deteriorating working conditions predate the pandemic, a tsunami has taken place across the country with many nurses deciding that they have had enough, spurring them to retire early, leave the public system, or leave the profession.”
I maintain that what happens within the healthcare system in the United States (US) comes to Canada via Alberta. The United Conservative Party (UCP) then share their playbook with Conservatives in Ontario who implement covert privatization plans that then play out across other Conservative provinces.
Kieran Fong’s brilliant documentary The MYTH of Canadian Healthcare/Hippocrates: A Guide to Treating Healthcare Workers showed exactly how Alberta’s public healthcare system was gutted under Ralph Klein and Jason Kenney.
In Ontario, Premier Mike Harris laid the groundwork ensuring his next source of income by privatizing long-term residential care (LTRC) and opening the door for private for-profit nursing agencies like his own, Nurse-Next-Door.
Ford continued diverting public healthcare funds to private nursing agencies, expanding private for-profit hospitals which are funded at double the rate per surgery, as well as implementing Bill 124 limiting public sector workers to increases of one per cent for three years – and that included nurses.
Bill 124 was declared unconstitutional in November 2023. That decision means at least $1 billion in back pay is now being reimbursed to nurses. Yet, not every health service board chose to prudently set money aside in the event that Bill 124 was over turned.
The billions in public money that Ford saved by chronically underfunding public healthcare was transferred to the provincial government’s contingency fund and budget surplus. Now, hospitals across the province are declaring massive deficits.
That is the opposite of what is happening in Manitoba. In February 2024, the NDP government under Wab Kinew’s leadership announced a provincial-federal deal that would pump $633 million into the provincial healthcare system – with much of that money being used to hire more front-line workers and to improve care for seniors.
Have a listen to find out what needs to be done to retain nurses in public hospitals in Ontario, and across the country, and what Michael sees as the outlook for publicly delivered universal healthcare across Canada.
Then, get ready to take meaningful action!
Important links:
Canadian Health Coalition (CHC)
Ontario Health Coalition (OHC)
Find a local OHC chapter near you.
Be present for one of the Trojan Horse Campaign events taking place in 65 communities across Ontario to protest the Ford government’s privatization of our public hospital surgeries.
Thanks to everyone who read today’s article and listened to my podcast. With your continued support, a little Nicoll can make a lot of change.
Music: Real Estate by UNIVERSFIELD is licensed under a Attribution 4.0 International License. freemusicarchive.org.
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