Ontario hospitals and nursing homes spent nearly $1 billion on temporary staff last year | CBC News

Hospitals and nursing homes spent nearly $1 billion last year to fill shifts with nurses and personal support workers from private staffing agencies, according to a Health Department document.

A November 2023 staffing agency update, obtained by The Canadian Press through a Freedom of Information request, shows staffing agency use increased from 2021-2022 to 2022-2023 in every measure – in hospitals and long-term care, in Reference to hours worked and total costs.

Hospitals and nursing homes turn to staffing agencies when they cannot staff all shifts, and agencies’ temporary nurses and PSWs allow them to continue offering services despite staffing shortages.

But hospitals and nursing homes say agencies are charging double or even triple the regular hourly rate for their staff.

Health Minister Sylvia Jones recently reiterated that utilization of agencies in the province is declining.

“With all due respect, Mr. Speaker, facts count in this discussion,” she told Parliament in October. “The use of health workers – agency nursing – has actually declined in the province of Ontario.”

A politician makes an announcement while the premier of a province stands behind her.
Ontario Health Minister Sylvia Jones previously said utilization of agencies in the province is declining. But the ministry’s data says otherwise. (Frank Gunn/The Canadian Press)

A spokesman for Jones wrote in a statement that the percentage of agency nurses and total agency staff hours have declined since 2017.

However, this was not the case in the period 2021-22 to 2022-23, the most recent data at the time the ministry document was prepared. It says organizations’ reliance on agencies to address staffing issues “continues to increase”.

“There are still staffing problems in hospitals and nursing homes. Vacancy rates remain consistent despite staffing increases through health human resources (HHR) programs,” the department’s Capacity and Health Workforce Planning Division wrote.

“This is due to migration of staff away from hospitals/long-term care to other sectors (public health, telehealth) and agencies and an overall higher demand for staff due to capacity being added to the system (increase in hospitals and long-term care). -time beds etc.).”

According to the planning department, understanding the issues at play is critical.

“It is important to identify the problem we are trying to solve (high stakes, high costs) and respond to the choices employees make when they choose to work for agencies (higher pay, higher flexibility)” , it says.

“This balance is critical to ensuring the retention and satisfaction of our workforce.”

Agency costs crowd out care budgets: advocates

Lisa Levin, CEO of AdvantAge Ontario, which represents the province’s not-for-profit nursing homes, said surveys of her organization’s members suggest the situation has not improved significantly since 2022-23.

“We have heard from our members that agency costs are crowding out care budgets,” she said.

Hospitals and long-term care homes spent about $368.64 million on temporary nurses in 2021-22, and the projected cost in 2022-23 was $600.18 million, an increase of 63 percent, it said it in the ministry document.

Adding in the cost of personal assistance from agencies, the total for last year was more than $952.8 million, the document said.

A profile photo of a woman.
Lisa Levin, CEO of AdvantAge Ontario, says hospitals and nursing homes say the cost of hiring agency staff is “overwhelming care budgets.” (Delivered/AdvantAge Ontario)

The percentage of hours worked in hospitals by temporary nurses was 0.7 percent in 2021-22 and rose to 1.5 percent the following year, the document said, an increase of 123 percent when looking at total hours.

In long-term care, the proportion of hours worked by temporary workers rose from 7.6 percent to 14.9 percent over the same period, which corresponds to an increase of 103 percent when considering total working hours.

Agency staffing is a tool that many northern and rural hospitals rely on, Jones’ spokesman said.

“We will continue to take action to grow our healthcare workforce in these communities, building on our progress by adding 17,000 new nurses this year through programs like the Learn and Stay Scholarship and reducing barriers to make it more accessible “To make it easier for internationally and interprovincially educated people to practice nursing in Ontario,” Hannah Jensen wrote in a statement.

The opposition criticizes the dependence on agencies

Green Party Leader Mike Schreiner said Ontario’s growing reliance on staffing agencies means more taxpayer dollars are ending up in the hands of agencies that are allowed to charge whatever they want.

“It is completely inappropriate, financially unsustainable and not a real solution to the problems we face,” he wrote in a statement.

NDP Leader Marit Stiles said her party and its experts have long been ringing alarm bells about staffing.

“The Ford Conservatives are so severely underfunding our health care system that hospitals and nursing homes have no choice but to use these private care agencies,” she wrote in a statement.

“Not only does this cost us all more money, it also takes even more workers away from the public system.”

Hospitals and nursing homes have said staffing agencies are necessary and that they don’t want them banned, but many are calling for an end to what they call price gouging.

The Ministry of Long-Term Care is “exploring the possibility of creating a registered provider for licensed long-term care agencies to potentially assist with price regulation,” the document says.

AdvantAge has made this recommendation to the ministry, but also says any measures applied to long-term care staffing agencies must be applied across the health sector so that no part of the system is disadvantaged.

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