How nursing staffing agencies are costing Ontario hospitals untold tens of millions

Hospitals across Ontario have substantially ramped up their use of nurses from private staffing businesses to the tune of untold hundreds of thousands of bucks, in accordance to the province’s auditor basic.

A new auditor’s report finds that hospitals are filling staffing gaps by hiring company nurses at drastically higher hourly charges than they pay out the nurses they right hire. 

The report found some hospitals that more than tripled their shelling out on company nurses in the system of just just one yr, from 2021-22 to 2022-23, while hospitals in northern Ontario noticed a 25-fold increase in their use of company nurses around a 4-year stretch. 

The pattern “has place financial pressures on hospitals,” claims the report.

“There is certainly a massive dependence on company nurses,” acting auditor typical Nick Stavropolous told a news meeting Wednesday.

But even with his powers as the province’s economic watchdog, Stavropolous could not discover out precisely how considerably cash that dependence adds up to.

The auditor says that is because neither the Ministry of Overall health nor Ontario Health — the agency that coordinates clinic funding — especially tracks agency workers expenses. 

The report demonstrates agency nurses collectively worked much more than 1.7 million hours in Ontario’s hospitals in 2022-23, double the range of hrs in the earlier yr. 

At least $170 million on agency nurses

The report also cites ranges for how a lot hospitals pay the staffing companies: $99 to $106 an hour for a registered nurse to get the job done in the unexpected emergency office of a hospital in southern Ontario, though hospitals in northern Ontario pay wherever from $100 to $160 an hour.

If you acquire the base end of all those ranges, and multiply it by the hours labored, Ontario hospitals put in at the very least $170 million on agency nurses last year. 

The auditor’s report urges the government to keep track of how a great deal is remaining expended on nursing staffing agencies to “establish the reasonableness of payments.”

There is “no legislation that caps the quantity these personal, for-gain organizations can cost hospitals,” the report says, recommending the governing administration consider regulating the charges. 

Both equally the Ontario NDP and Liberal Occasion have proposed capping nursing company fees. Health Minister Sylvia Jones has declined to make that determination. 

“We do not want to restrict hospitals and operators in residence and neighborhood treatment to basically give the staff members and the expert services they need,” Jones informed a news conference at the Legislature on Wednesday. 

Jones states the govt is trying to deal with the situation by boosting the dimension of the nursing workforce, as a result of investing in the nursing instruction method and clearing the route for internationally-qualified nurses to attain accreditation.

“We’re opening up and making sure that there is no crimson tape to restrict people’s capacity to appear and exercise in the province of Ontario,” she reported. 

Hospital pays agency up to $106/hr for RNs

1 chapter in the auditor’s annual report centered on the unexpected emergency departments at a sampling of key Ontario hospitals, including Mount Sinai, SickKids, CHEO (previously Kid’s Healthcare facility of Eastern Ontario), Windsor Regional, and William Osler Wellbeing System (which delivers alongside one another Brampton Civic and Etobicoke Typical hospitals).

That chapter cites figures from one unspecified medical center unexpected emergency office: it pays its full-time long-lasting nurses $35 to $50 an hour, while an agency pays its nurses $75 an hour. To employ a registered nurse to operate in the crisis department, the hospital pays the agency up to $106 an hour. 

Doris Grinspun, main executive of the Registered Nurses Affiliation of Ontario, says although increasing the dimension of the nursing workforce is critical, the govt will not solve the challenge devoid of paying nurses superior wages. 

“They’re not heading to stay in the procedure if we you should not supply that aggressive compensation, very good added benefits, and also workloads that help them to do excellent get the job done,” Grinspun reported in an job interview.

She mentioned Ontario would not be in the exact same staffing crisis if the government had not capped nurses’ salary improves as a result of Invoice 124.    

NDP Leader Marit Stiles explained nurses are becoming driven to be a part of the privately-run staffing businesses because they aren’t getting paid out ample at their hospital employment.

“Hospitals are saying they’re worried they will not likely even make payroll because they are getting to spend so significantly much more, year just after 12 months, month immediately after thirty day period, on these non-public businesses,” Stiles advised reporters Wednesday.

“When it comes down to it, this is all about [the government] diverting far more of our community wellness treatment dollars into their personal shareholder friends’ pockets,” Stiles claimed.  

Ontario presently has the lowest hourly wages for nurses in Canada, according to an evaluation by the province’s monetary accountability officer. 

Liberal Overall health critic Adil Shamji has proposed a monthly bill that would protect against what he calls “selling price-gouging” by capping agency costs. 

Shamji mentioned Wednesday at Queen’s Park that his invoice “can take aim at some of the most predatory techniques that nursing businesses use, such as virtually parking in hospital parking a lot and poaching nurses as they appear out of get the job done.”  

The auditor found northern Ontario hospitals used agency nurses for 15,000 several hours in 2018-19, soaring to 391,000 hours in 2022-23, a 25-fold increase.