Minister directs health authority to cut private nursing cost

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Health Minister Uzoma Asagwara has ordered a regional health authority in western Manitoba to cut its spending on private agency nurses by 15 per cent before March 2026.

The directive to Prairie Mountain Health, which recently has spent far more on agency nurses than any other RHA, is part of the government’s push to halt an exodus and bring employees back to the understaffed public system.

”It’s about recognizing that the overreliance and over expenditures on for-profit, private agencies is not sustainable,” Asagwara said Wednesday.

“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.”

The minister said the directive was not issued to Manitoba’s four other RHAs, but administrators in all five understand an overreliance on agencies is not sustainable or fiscally responsible.

PMH has spent $24.5 million on private nurses (RNs and LPNs) in the first three quarters of the 2024-25 fiscal year (April 1-March 31), a spokesperson said. The region, which includes Brandon, Neepawa and Swan River, spent $28.6 million in 2023-24 and $25.1 million in 2022-23.

The second-highest spender in 2023-24 was Northern Heath Region ($15.7 million).

Prairie Mountain “supports and commends” the province’s work to reduce reliance on agency nursing, CEO Treena Slate said in a statement.

“We are working with the province on steps to ensure there will be no gaps in care as we transition from a heavy reliance on agencies to employing enough staff to meet our needs,” she said.

“We’re working diligently to reduce the use of agency staff within our operations. We will strive to meet the direction provided and are confident that we can assist ourselves in reducing agency use.”

Asagwara said the province’s recruitment and retention office is working with PMH to add public system nurses. Grants and financial incentives have been offered.

Spending on private nurses has continued to soar since the COVID-19 pandemic.

Manitoba’s RHAs spent about $75 million on nursing agencies in the 2023-24 fiscal year, Shared Health said. The 2022-23 total was $60 million, up from $40 million in 2021-22.

In December, the NDP banned public health providers from signing new contracts with agencies amid efforts to rein in spending.

The government issued a request for proposals to reduce the number of contracted agencies and set controls for rates. Asagwara said the province will begin reviewing and evaluating proposals this week.

The Manitoba Nurses Union, which supports efforts to scale back the use of agencies, said Prairie Mountain had a vacancy rate of 30 per cent as of October.

Union president Darlene Jackson said the government’s directive to Prairie Mountain must come with a plan to ensure facilities are adequately staffed with public employees.

“It’s about recognizing that the overreliance and over expenditures on for-profit, private agencies is not sustainable.”–Health Minister Uzoma Asagwara

“In order for that to work, they have to fund the provincial travel nurse team,” said Jackson, referring to a float pool that uses public system nurses.

The government last year agreed to expand the team, which the nurses union said now has 286 nurses, with 20 more waiting to be added.

A lot of those came from private agencies, said Jackson, who wants to see the total increase to 400 this year.

A private agency owner said Manitoba will continue to struggle to properly staff facilities if it cuts back on private agencies.

The owner, who requested anonymity because they fear losing contracts, said health authorities are struggling to keep open some rural or northern hospitals or emergency rooms that rely on agency nurses.

“That’s how much trouble our province is in with regard to staff,” they said.

The owner said nurses they employ don’t want to return to the public system because agency positions offer better pay and work-life balance.

“They’re all very disappointed in the government, and very stressed out,” the owner said. “They will be overworked and exhausted like before (if they return).”

Asagwara blamed cuts by the former Progressive Conservative government for Prairie Mountain’s “overspending” on agencies.

The minister claimed the Tories spurred a “cottage-like industry” that took resources from the public system and led to an overreliance on private nurses. The PCs rejected the claim.

“It strikes me as a knee-jerk reaction in response to the realization that the NDP has spent considerably more on agency nurses in 2024 than in 2023,” Tory health critic Kathleen Cook said in response to the directive to Prairie Mountain.

“Attempts to blame the previous government are nothing more than a deflection from the fact that after nearly a year-and-a-half in government, the NDP still have yet to put forward a credible plan to address these issues.”

The government said Manitoba had hundreds of distinct contracts with more than 70 private agencies in the past, with little to no policies to limit the agencies’ impact on public system nurses or the rates charged.

Asagwara has said some charged up to six times what the public sector pays.

The private agency owner who spoke anonymously disputed claims that health authorities are being overcharged. They expect some agencies will be forced to close due to government measures.

“They used us when they needed us during the pandemic, and now they are kicking us to the curb when they don’t think they need us anymore,” the owner said.

The Manitoba Government and General Employees’ Union called on the province to halt the continued use of private agency health-care aides. The union has filed a grievance against Prairie Mountain.

“The use has been getting greater and greater every year, and it’s public dollars being fed into a private system,” MGEU president Kyle Ross said.

Asagwara said the province has had discussions about the use of private agency health-care aides.

chris.kitching@freepress.mb.ca