Report slams province for failing to get more nursing grads, despite $100M investment

New Brunswick's auditor general slammed the province Tuesday for its hands-off approach to the millions of dollars it has been giving universities over the past decade to increase their numbers of nursing graduates.

A program was put in place in 2005, through which the Department of Post-Secondary Education gave the University of Moncton and University of New Brunswick close to $100 million in an effort to address the province's critical nursing shortage.

But it resulted in no additional places for students in their nursing programs. 

There are about 400 nursing vacancies in the province, across all hospitals and departments, which have forced some services to shut down altogether over the past year.

Demographics are only expected to worsen the situation, with the nursing association anticipating a shortage of 5,000 nurses in the next five years.  The head of the health network has even come out to say patients are at risk.

Incentives failed

Kim MacPherson found the program hasn't resulted in a single additional nursing seat, and in fact, there are fewer nursing students in the province today than when it started.

She released two volumes of her annual report in Fredericton on Tuesday.

Under the program, an agreement provided funding for a target number of new nursing spots, as well as funding for clinical training of existing students. It was supposed to include clawbacks when the objectives weren't met. 

Not only did universities fail at getting more nursing students, MacPherson also found the province continued to give them money for years afterward.

"The department was monitoring the enrolment associated with the program, and aware the targets weren't being met," MacPherson said during Tuesday's hearing at the legislative assembly.

"Yet they made no changes."

MacPherson called the program "unsuccessful" and "ineffective."

Since 2005, the total number of undergraduate nursing students at the University of Moncton has gone from more than  500 to just over 400, while UNB managed an increase until 2013-2014, at which point the number of nursing students started to decrease dramatically, by as much as 40 per cent.

According to the latest available numbers, there were 464 students in UNB's bachelor of nursing program, well below the target of 824.

"This was the case even though there was a wait list for the nursing program at UNB," said MacPherson.

Shocked at lack of oversight

MacPherson was shocked at the lack of monitoring of the program, given the significant amounts of money involved. She noted there was no direct oversight by the department.

The province did not require reports from the universities on how they used the provincial funding, even though it represented up to 50 per cent of their total revenue.

MacPherson was also surprised the program provided funding for clinical training for existing nursing students, saying that if existing funding was not sufficient to meet the needs of a program, the department should have re-examined how it distributed funding to universities.

She recommended reviewing the funding formula, and for the department to provide funding to universities only after targets have been achieved.

The agreement expired at the end of last year.

The program covered both the bachelor and master of nursing programs, the latter of which was even less successful at getting more nursing students enrolled.

MacPherson audited the Department of Post-Secondary Education, Training and Labour, as part of her annual review.

Province agrees

Post-Secondary Education Minister Trevor Holder said the government agrees with the auditor general on the need for a change in the policy around funding, adding they've been asking for changes for years.

He said he didn't want to point fingers at any particular stakeholder, but the program isn't getting results. 

"I feel validated by what the auditor general is saying today that yes, we have to have accountability measures in place," said Holder.

Holder also appeared to blame the status quo on the opposition Liberals, who he said didn't support government efforts to change the funding regime.

"As we've had this conversation for the last six to eight months, the opposition was just interested in beating us over the head instead of having a thoughtful conversation on this."

Universities respond

The University of Moncton, said demographic factors prevented the university from meeting nursing position targets. With the province's demographics, fewer students are applying to the university in general.

Interim president Jacques-Paul Couturier also said that whenever the university was unable to meet nursing student targets, it gave money back to the province.

"We tried very, very hard to recruit new students in our program," Couturier told Radio-Canada.

"For the money that we got for the new seats, we gave it back to the government."

UNB president Paul Mazerolle said his university also repaid the money meant for additional seats when the growth didn't happen. The exception was "the unused funding for 2018-2019, which is still in the reconciliation process."