NDP bang-on to tackle private nursing agency free-for-all

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This article was published 06/12/2024 (323 days ago), so information in it may no longer be current.

The wild and profitable market for private agency nurses will soon be a thing of the past.

For much of the NDP’s first year in government, Health Minister Uzoma Asagwara has been working diligently to increase the number of nurses who work directly for the public system and reduce the reliance on costly private agency nurses.

There has been some progress but not nearly enough to effectively ease the nursing shortage.

So, after trying the carrot approach, by increasing pay and financial incentives for nurses in the public system, the minister has decided to use a stick — on the agencies.

On Wednesday, Asagwara announced the province had banned service delivery organizations from signing new deals with private agencies. Instead, the minister launched a request for proposals for agencies that want to provide contract nurses to the public system.

Why is this so important to the future of nursing?

Currently, regional health authorities buy nursing services from more than 70 private agencies in Manitoba. The lack of a centralized procurement process meant there was no provincewide controls or oversight of the rates charged by those agencies.

As the nursing shortage worsened and facilities faced the prospect of periodic closures, regional authorities were essentially forced to pay whatever exorbitant hourly fee the agencies wanted to charge.

That was then. Now, with an RFP being launched, the NDP government is dishing out tough love that will turn the private nursing industry upside down.

Agencies will have to bid against each other for the opportunity to provide nurses to the public system. Asagwara said the government will seek up to three contract agencies per health region.

What happens if your agency is not approved by the government to supply nurses? Those agencies, and the nurses that work for them, will be shut out. That alone may force some nurses back into the public system.

The RFP process will also force the agencies to be more competitive on the fees they charge and give the government the right to set maximum rates, more closely monitor agency operations and conduct annual financial reviews.

On paper, this has the potential to reduce overall costs and provide meaningful motivation for agency nurses to rejoin the ranks of the public sector.

Will the RFP put the private agency genie back in its bottle? Nothing is certain right now other than the need for the province to do something to reverse the system’s growing addiction to private agency nurses.

The practice of using private agencies to fill holes in shifts has been in place for decades. However, what started as a stop-gap became a lifeline when it was clear the public system didn’t have enough nurses to cover all its shifts.

Over the past seven years, the nursing shortage continued to grow as huge numbers of nurses left the public system to protest the re-organization of Winnipeg’s hospital system, a hallmark policy of the former Progressive Conservative government. The Tory plan to eliminate three emergency departments and redistribute medical specialties among Winnipeg hospitals had a huge impact on nurses by forcing many to move or consider profoundly different jobs.

As nurses fled the public system, those left behind had to work mandatory overtime to ensure shifts were properly staffed. That created a lot of burnout among the nurses and prompted some to retire early and others to seek the relative calm of the private sector.

It also didn’t help that the former PC government refused to negotiate a new contract for nurses.

It was a perfect storm that drove hundreds of nurses from the public system and into the waiting arms of private agencies. In turn, those agencies quickly contracted to provide the defecting nurses back to public health care facilities at premium hourly rates that were as much as six times the hourly wages of a public nurse.

The fiscal impact of this trend cannot be understated.

In 2017, the amount paid to bring in private nurses to public facilities was about $15 million; by the end of the 2023-24 fiscal year, that annual had skyrocketed to more than $75 million. Despite the NDP government’s concerted efforts to lure more nurses back into the public system, the trend has continued.

In the first six months of the current fiscal year (April to September), the province spent $66 million on private agency nurses, up from $61 million in the same period in the 2023-24 fiscal year.

The NDP government will likely continue to offer carrots to nurses to get them to return; the current contract, signed after the Tories were swept from office in October 2023, contains incentives and bonuses to ensure the gap between public and private compensation is less noticeable.

But clearly, incentives were not enough. In forcing the agencies to bid for the right to provide nursing services, the government is culling the private marketplace and imposing cost controls that really should have been in place a long time ago.

The nursing free market is effectively dead. Long live a stable and fully staffed public system.

dan.lett@winnipegfreepress.com