At least $146M: B.C. health spending at for-profit staffing agencies continues to soar

In a trend that began pre-pandemic, the provincial government continues to spend more money each year with private for-profit companies providing contracted staff for British Columbia’s health-care system.

Over five years, at least $146 million tax dollars were paid to the staffing companies, though the actual number is considerably higher.

CTV News has spent months trying to compile the figures for all such staff including nurses, X-ray technicians, sonographers, physiotherapists, perfusionists, pharmacists, CT and MRI technicians as well as laboratory staff across the province from B.C.’s health authorities.

Northern Health is the only one withholding much of the information CTV News has asked for, which they claim to have been “working on” since we first requested details Aug. 31, 2022. They still have not provided nursing spending for the 2020/2021 fiscal year and none for technicians and other workers. 

In the 2018/2019 fiscal year, about $9.4 million was spent across Vancouver Coastal, Fraser, Northern, and Interior Health. The Provincial Health Services Authority says it did not use agency staff at that time and Vancouver Island Health says they’re unable to determine how much was spent due to their record-keeping methods. 

By 2021/2022, the most recent complete fiscal year, that number had ballooned to at least $65.6 million dollars.

The $146 million figure includes only partial accounting of spending for the 2022/23 fiscal year, ranging from September to December depending on when each health authority finally replied to our months-old request for information.

HEALTH MINISTER ON THE DEFENSIVE

Traditionally, these companies had been used to backfill vacations and medical or parental leaves in smaller communities with limited staff, and are sometimes still called "travelling nurses" or "travelling pharmacists," for example.

The Health Minister blamed the pandemic for the escalating spending with for-profit staffing agencies.

“We stood up a massive network of testing centres and immunization,” said Adrian Dix. “We didn't want to do that by taking away from other parts of the health-care system and so that meant keeping stability in acute care and seeking obviously the necessary staff to do that.”

But his ministry’s own statistics refute that explanation: the trend began before the world had heard the term “COVID-19.”

Agency spending was just $9.4 million in 2018/2019, more than doubling to $19.9 million the following year. The 2020-2021 fiscal year saw a decline to $17 million, but it does not include any statistics from Northern Health, which spent $8.6 million the year before ant $17.8 the year after. Spending spiked to $65.6 million in 2021/2022 when vaccination efforts were in full swing.

NURSING THE BIGGEST AGENCY SPEND

Agency nursing costs make up the lion’s share, with at least $140 million spent since 2018, which the health authorities emphasized is a tiny percentage compared to overall staffing costs.

Critics have argued that relying on contracted nurses to prop up the public system is highly problematic because unionized, permanent staff often work for nearly half the pay and are mandated to work overtime hours at assigned locations. 

Contracted nurses make about twice as much, which also lures more staff to work at those agencies, which has been described as "dangerous" to the public system.

A University of Victoria professor of nursing describes the situation as a spiralling, vicious cycle where better working conditions and compensation continue to draw more and more workers from a limited pool of staff.

"It had been tried many places; it always proved to be a disaster," Damien Contandriopoulos told CTV News last year. "Once a system is sufficiently disorganized from the inside, the damage is awfully hard and extremely expensive to control."

CTV News asked Dix whether he was trying to reverse the trend, he did not address that aspect of the question and touted public polling of the province’s pandemic response. Last week, he downplayed the increasing delivery of public healthcare by private clinics which has also taken place during his tenure as health minister.