Concerns a 'vicious cycle' underway as private companies increasingly staffing B.C. hospitals

As B.C.’s hospitals falter under the burden of staff resignations and illness, sources say private companies are quietly filling the gaps with growing numbers of well-compensated nurses with an unclear price tag. 

The BC Nurses’ Union confirmed its members are reporting what front-line staff have been telling CTV News for months: so-called “travelling nurses” employed by private agencies are increasingly contracted by health authorities to staff hospitals plagued by departmental closures and long wait times.

Neither the province’s health authorities nor the Ministry of Health publicizes the costs or contracts for those agencies, meaning very few people have any idea how much it’s costing to employ nurses walking away from unionized staff jobs for increased pay, better working conditions and sometimes even thousands in retention bonuses.

“It's no wonder nurses are electing to take these private contract jobs because they have control over their lives, they can accept or decline what work they want,” said Adriane Gear, BCNU vice-president.

“Its very critical and we've never seen it this dire so of course any nurse coming in is absolutely appreciated but what we're seeing now is on some shifts there's more agency nurses than regular staff.”

Gear said agency nurses typically make 50 to 100 per cent more than staff nurses, plus meals and living expenses, which are holdovers from when the national corps of travelling nurses would go and live in small towns for weeks or months at a time filling temporary vacancies at hospitals.

She added that the full-time staff nurses are also increasingly stressed and burnt out trying to orient new coworkers to their facilities while doing their own jobs, but are often sent to unfamiliar hospitals themselves since agency staff only work at the same facility for the duration of their contract, which “is really adding to the destabilization of the current baseline staffing.”

A GOOD USE OF TAX DOLLARS?

Simon Fraser University doctoral student and health policy researcher Andrew Longhurst says without transparency around contracts and costs, the public can only wonder how much money is being spent to hire back many of the same nurses at agency rates, with agency profit markups.

“These companies are there to make a profit and that's built into the price they charge the health authority,” he said.

"We're increasingly short staffed in the public sector and then more people exit to work for agency staffing companies. So that's a really vicious cycle of more people leaving, workload gets more intense in the public system, and then private providers increasingly called upon at much steeper cost.”

Longhurst also raised concerns about consistent, quality care, pointing to a U.K. study that found, “Private sector outsourcing corresponded with significantly increased rates of treatable mortality, potentially as a result of a decline in the quality of health-care services.”

In response to a CTV News inquiry earlier this year, B.C.’s Ministry of Health acknowledged it has continued to increase annual spending at private surgical clinics to catch up on wait times and backlogs. 

AN INTERNATIONAL ISSUE WITH LOCAL VARIATIONS

The exodus of health-care workers in public and private systems alike is an international phenomenon largely blamed on the workload and pressures of the pandemic. A survey last month by Statistics Canada found 95 per cent of Canadian medical personnel feel their work-life balance has suffered as a result, as has their mental health, with 136,800 job vacancies in the health sector.

Almost one in four nurses responding to the survey said they planned to change or leave their job within the next three years.

And while the health minister has reiterated that the province is aggressively recruiting and training new nurses, dozens of front-line staff have told CTV News that without fixing the systemic issues of inadequate pay, poor working conditions, forced overtime and chronic short-staffing, the system will simply burn out a new generation of nurses rather than fix the issues.

The “Band-Aid solution” of agency nurses is simply generating a new problem that’s not easily undone, according to those familiar with the inner workings of the health-care system.

“There are people that are profiting from (contracted nurses),” emphasized Gear. “This is taxpayers’ money that would be better spent retaining the nurses in the system we have, as well as educating and training nurses for the system.”