Manitoba to reduce ‘cottage industry’ of private nursing agencies

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This article was published 04/12/2024 (278 days ago), so information in it may no longer be current.

The Manitoba government is trying to rein in runaway spending on private, for-profit nursing agencies that it says are draining resources from the front lines of the public health system.

Health Minister Uzoma Asagwara said a “cottage industry” of dozens of private agencies have sprung up in Manitoba in recent years following health-care cuts by the previous Tory government.

The province had banned service delivery organizations from signing new contracts with private nursing agencies, the minister said at a news conference Wednesday.

The province has just issued a request for proposal to reduce the number of contracted agencies and set controls for the rates they charge, Asagwara said. It’s a step toward ensuring the majority of health-care funding is directed to public front-line workers and their patients, said the minister, a registered psychiatric nurse.

More than 70 agencies hold contracts with regional health authorities and health-care facilities, without any policies or controls that govern the rates they’re paid.

The minister said some charge exorbitant fees — up to six times what the public sector pays — to fill staffing gaps in the public system.

The RFP posted Wednesday says the province wants to work with up to three contract vendors per health region and service delivery organization. Its objectives are to “obtain the highest quality of services” in its hiring of nurses, achieve efficiencies in processes and services, enhance compliance with the service delivery organization’s policies, training and processes, and to “enhance customer satisfaction and improvements in service.”

The request for proposals says successful vendors will be subject to a governance process that could include an annual business review with government representatives. The deadline for proposals is Jan. 6.

The private agencies have benefited from a situation in which nurses had gone too long without a contract and left the public system, the health minister said.

Those who stayed endured staffing shortages and worked mandatory overtime as a result, which led to burnout, Asagwara said. Some nurses left the public system for private agencies that offered better work-life balance and profited from the public system exodus.

The Manitoba Nurses Union welcomed the plan to curb private agency spending.

“For too long we’ve seen resources drained into for-profit agencies,” union president Darlene Jackson said at the news conference.

In the first six months of the last fiscal year (2023-24), the province spent $61 million on private agency nurses. Over the same period this fiscal year, it spent $66 million, the health minister’s press secretary said.

“We’re heading in a direction where we have facilities that are are totally staffed by agency nurses,” Jackson said. “We need to get nurses back into the public system.”

The health critic for the Progressive Conservatives expressed concern about pulling back on private agency use too soon.

“I think it’s important the government explore ways to reduce spending on agency nurses, but I’m concerned that they haven’t first done the work to address the issues that lead nurses to leave the public system,” Kathleen Cook said.

The MLA for Roblin said many rural health facilities still rely on agency nurses.

“We can’t expect them to abruptly reduce or end agency nurses without first ensuring that they have adequate staffing in place in the public system,” Cook said.

“I don’t think that putting agencies out of business in and of itself is what nurses are asking for. They’re asking for more flexibility in scheduling, for an end to mandatory overtime, for their facilities to be safe places to work. This RFP isn’t going to accomplish any of that.”

When asked whether the former PC government is to blame for causing the problem, she deflected, saying the NDP government going after private agencies reminds her of its decision to shut down the diagnostic and surgical recovery task force after taking office “without first ensuring capacity in public system to handle patient need.”

Asagwara said they’re solving the problem now that the collective agreement provides incentives to woo private agency nurses back to the public system, including accepting them at their previous seniority level. It offers full-time incentives and pay bumps for nurses who work in emergency rooms and intensive care units.

The province created a float pool to give nurses flexibility and match the advantages offered by private agencies. It worked with the nurses union to expand a travel nurse team that allows nurses to choose their shifts, and has directed service delivery organizations to make joining the travel team as seamless as possible, Asagwara said.

So far, 250 have joined, a spokesperson for the minister said.

carol.sanders@freepress.mb.ca