Rise in for-profit agency nurse costs in Ontario hospitals 'exorbitant,' says researcher

Amina Zafar · CBC News

· Posted: May 12, 2025 4:00 AM EDT | Last Updated: 9 minutes ago

Ontario hospitals paid for-profit staffing agencies $9.2 cardinal implicit a decade, a uncovering that comes arsenic 1 infirmary aims to halt its usage of temp services by September.

The Canadian Centre for Policy Alternatives commissioned Monday's report, titled Hollowed Out: Ontario Public Hospitals and the Rise of Private Staffing Agencies. It focused connected accrued spending connected the agencies for nurses, allied wellness professionals and administrative enactment unit from 2013-14 to 2022-23.

Hospitals and semipermanent attraction homes crook to staffing agencies erstwhile they can't capable each of their shifts with employees. Temporary bureau health-care workers let them to proceed providing services during unit shortages, though they complaint up to triple the regularly hr rate, hospitals person said.

Real spending connected agencies astir doubled, from $21 per capita to $41 implicit the survey period, according to Andrew Longhurst, a governmental economist astatine Simon Fraser University, and the report's author. In comparison, nationalist infirmary employed unit accrued from $604 per capita to $641 implicit the aforesaid clip successful the province.

"What we're seeing crossed the committee with the usage of backstage for nett providers is the nationalist governments are paying an exorbitant magnitude and getting comparatively small successful return," Longhurst said.

Longhurst says provincial fiscal austerity destabilizes hospitals conscionable arsenic colonisation maturation and aging enactment much unit connected infirmary staffing, which exacerbates hallway medicine and the agelong hold times patients look astatine exigency departments oregon for scheduled surgeries. 

Using backstage agencies becomes a "vicious cycle," according to the report, arsenic hospitals go dependent on these much costly services portion the staffing situation successful the nationalist sector increases.  

Working to beryllium 'agency free'

Meanwhile, astatine Markham Stouffville Hospital, unit are moving to trim reliance connected backstage agencies that supply impermanent hires specified arsenic nurses to capable shifts successful the exigency department, oncology and different units.

"Our extremity is that by the extremity of September we'll beryllium bureau free," said Mark Fam, president and CEO of Oak Valley Health, which includes the Markham infirmary that serves a accelerated increasing portion northeast of Toronto. "We've been capable to trim our bureau nursing by 2 thirds."

To get there, Oak Valley provided recently graduated and internationally educated nurses with other grooming and enactment from seasoned nurses, created a nursing assets squad who enactment crossed antithetic units, hosted an unfastened location and accrued hiring.

The provincial authorities funds the grooming for caller nursing graduates and internationally educated nurses, Fam said.

Under the Ontario government's Nursing Graduate Guarantee program, employers person 20 weeks of backing to enactment caller postgraduate nurses and internationally educated nurses modulation into full-time practice. The programme has hired much than 3,300 nurses since 2020, according to the province.

Nurses moving for temp agencies, meanwhile, accidental they tin gain much than treble the wages of unit nurses doing the aforesaid jobs successful the aforesaid hospitals, with afloat power implicit their enactment schedules.

Vickie Idowu, interim manager for the assets squad and staffing office, said the infirmary provides extended predisposition to its nurses, truthful that they much efficaciously integrate into the workflow — a cardinal favoritism from temp workers.

WATCH | Struggle to bring internationally educated nurses to Canada: 

"They get to cognize what's happening connected the unit, truthful erstwhile they're acceptable to spell and commencement working, they're good prepared," she said. "And what really volition marque them antithetic from utilizing the bureau is that these are our staff."

Idowu said having their ain unit helps supply continuity of attraction compared with bureau folks who whitethorn lone spot a diligent erstwhile a week. "They're acquainted faces and patients are much comfy with them."

How Ontario compares to different provinces

Longhurst said compared with large cities, infirmary budgets were peculiarly strained successful smaller and bluish areas of Ontario, wherever hospitals person revenues nether $100 cardinal and reliance connected for-profit agencies is higher.

In 2022-23, backstage bureau costs consumed a larger stock of staffing expenditures, particularly successful Ontario's North West (17 per cent) and North East (11 per cent), according to the report. That's up from 2013-14, erstwhile backstage bureau costs arsenic a stock of full labour costs were beneath six per cent successful each Ontario wellness regions.

Ontario had the lowest per capita infirmary spending successful Canada astatine $1,805, down B.C. ($1,902) and Quebec ($2,028) successful 2022, according to the report.

"I deliberation longer word if we proceed down this road, we're going to spot our publically funded wellness attraction systems crossed the state struggling to present attraction successful a outgo effectual mode that really meets the needs of patients," Longhurst said.

Elsewhere crossed Canada, Quebec passed a instrumentality to signifier retired the usage backstage placement agencies by 2026, which is being challenged successful court. Similarly, New Brunswick introduced authorities that would cancel a question caregiver contract, and the institution is suing over alleged breaches of declaration .British Columbia besides plans to signifier retired usage of the agencies.