Shedding private agencies in health care isn’t easy

Opinion

Hey there, time traveller!
This article was published 07/02/2025 (211 days ago), so information in it may no longer be current.

A certain part of the political spectrum is always talking about making government operate more like a business — and governments everywhere seem to have gotten into the habit of calling every scrap of government spending an “investment,” even when there’s no way those “investments” will ever have anything like a return.

Never mind that governments generally are poor at making real and timely business decisions, or that, in reality, given that their “customers” are always all of us, whether we’re taxpayers or not.

Even so, there are some elements of the business world that can shed some light on problems in government, and one of them might well be the business concept of “good will.”

Good will is an intangible business asset, at times very valuable, but often hard to pin down.

Let’s look the idea of good will, and let’s apply it to the Manitoba government’s major problem of paying tremendous amounts of money to private agency nursing firms to cover staffing shortfalls in the health-care system.

As Health, Seniors and Long-Term Care Minister Uzoma Asagwara put it last week, provincial health-care agencies should shed their dependence on private agencies.

“It’s about recognizing that the overreliance and over expenditures on for-profit, private agencies is not sustainable … That money being spent on for-profit agencies, enriching agencies, is money that should be spent at the bedside, and should be spent on the front lines of delivering public health care.”

Asagwara made the comments when ordering Prairie Mountain Health in western Manitoba to cut its spending on private agency nurses by 15 per cent before March 2026 — a position that Asagwara said the province’s other health boards understand, too.

We’ll get back to that in a second, but first, good will. Good will is as much of an asset as buildings or equipment, and in the sale of a company, it can drive the sale price well above what the strict assets and sales numbers suggest a firm is worth on paper. Loosely described, it’s a company’s reputation — for the quality of its products and services, talented workforce, brand identity, the size of its customer base, its proprietary technology and the list goes on. It’s hard to quantify precisely, but it has very real value.

It also can be quite a hefty amount — on Amazon’s books, the company listed its good will (along with other intangible assets) as being worth US$22.8 billion in September, 2024.

Now think about the good will this province’s public health-care system has with nurses — and with its other health professionals. And realize that good will has been completely drawn down by the way health boards decided to take advantage of their workplace power.

By degrading their workforces — using mandatory overtime, providing poor working conditions and safety — the people managing this province’s health-care system, right up to and including governments, took part in stripping assets out of the “business,” every bit as much as they would by closing hospitals, selling off capital assets or shrinking budgets. Management cashed in whatever good will it had, and nurses voted with their feet.

It was just a little better hidden from public view than other cutbacks.

One thing business professionals agree on when it comes to good will is that it’s easy to lose, and once gone or degraded, very hard to rebuild.

It can take years for a company to build a new bricks-and-mortar manufacturing plant, or for a government to build a new hospital.

It can take years longer to rebuild a reputation, or any semblance of good will.

And that’s why getting rid of private agency nurses is not as easy as having a health minister simply order it to be done.