Travel nurse costs help push Vitalité nearly $98M over budget

Vitalité Health Network says it's nearly $98 million over budget for the first 11 months of the 2023–2024 fiscal year, mainly because of expenses related to travel nurses.

Hiring the 190 full-time equivalent private agency staff accounted for $94.2 million of the cost overrun between April 1, 2023 and Feb. 29, 2024, according to vice-chair Réjean Després.

That's about 12 per cent of Vitalité's budget.

"These costs do not have to do with luxury expenses," said Després, who presented the figures as part of Vitalité's quarterly report at the board's public meeting in Campbellton Tuesday.

The travel nurses were needed to maintain patient services while supporting health professionals during the COVID-19 pandemic, he said.

Seeks to have province foot bill

Dr. France Desrosiers, president and CEO of Vitalité, said discussions are underway to have the province foot the bill.

"According to the latest news, the money must come from the Department of Health," she told reporters in French, following Tuesday's meeting.

The department did not respond to a request for comment about this.

But a Vitalité spokesperson told CBC News Wednesday the department "has been funding these costs overrun since fiscal year 2022-23."

The contracts Vitalité had between July 2022 and March 2023 were with four agencies — Canadian Health Labs, People2.0 Workforce Services Canada, Goodwill Staffing & Recruitment and Agence SPI.

The cost of those contracts totalled more than $19 million, according to figures provided by the regional health authority.

Horizon did not respond to a request for information about its travel nursing cost overruns or any discussions with the department to absorb those costs.

Audit underway

Nursing unions and opposition parties have criticized the use of travel nurses in New Brunswick, which is costing taxpayers millions of dollars. A Globe and Mail investigation found agencies such as Toronto-based Canadian Health Labs have charged rates of more than $300 an hour — roughly six times what a local staff nurse earns.

Deputy health minister Eric Beaulieu told a legislative committee in February that the government was aware of Vitalité's first contract, which was worth up to $20 million. It was informed of the other two after the fact, late in the 2022-23 fiscal year, he said.

Last month, Auditor General Paul Martin announced he has launched an investigation of travel nurse contracts with Vitalité and Horizon health networks and the departments of health and social development.

'Still using them as if it was Day 1'

Paula Doucet, president of the New Brunswick Nurses Union, doesn't believe the province should pay for any cost overruns because of travel nurses.

While the need might have been urgent at the peak of the pandemic, "here we are two years after the fact that they're still using them as if it was Day 1," she said.

Doucet blames a lack of planning and many years of not listening to the union warning about a nursing shortage on the horizon.

"And now find ourselves using taxpayer dollars over the last two years to use private for-profit companies to supply registered nurses and licensed practical nurses to keep our health-care system afloat."

Reduction in need expected by September

Vitalité plans to phase out the use of travel nurses by the winter of 2026, when the last and largest of its current contracts, with Canadian Health Labs at a cap of $93 million, expires.

It has six private agency contracts for 2023-24, with the same agencies as 2022-23, according to the spokesperson.

"The number of nurses to be provided varies by contract and is based on our needs to maintain hospital services. The cost is based on the number of travel nurse personnel provided."

Some of the strategies Vitalité has implemented should start producing results by this September, Desrosiers told CBC News. These include changes around models of care — introducing new types of professions to teams so fewer nurses are required, and recruitment and retention initiatives.

Health Minister Bruce Fitch said his department is working with Vitalité to try to find ways to alleviate its need for travel nurses and to increase recruitment.

"There's a number of missions that have occurred over the last little while to find people to replace those travel nurses," particularly in places where French is more prevalent, such as France, Morocco, Belgium, he said.

While Horizon expects to stop using travel nurses "in the very not too distant future," according to Fitch, it can be more challenging for Vitalité because there are fewer francophone nurses available, he said.

Vitalité also has vacancies in northern communities, which "are a little bit harder to recruit," he said.

"We're working together. We're trying to figure out a way forward. There's still some work to do, but we're moving forward on that."

The union president contends if Vitalité is at a disadvantage in recruiting because of language, it should invest in helping local anglophone nurses become bilingual.

When Doucet started her career many years ago at Chaleur Regional Hospital, French language training was offered in the hospital, she said. "It worked," but "they did away with that."

Vitalité does offer "over the phone" French language training, but it's "not the same," she said.

Minister looks forward to first-quarter results

It would be "impossible to do without [travel nurses] completely right now," Desrosiers said in a recent statement, "given the immediate needs that are still as great as they were in 2022," when Vitalité started to use them.

The staffing situation was "critical" because of the departures and early retirements during the COVID-19 pandemic — "to the point where we were facing imminent emergency department and even facility closures," she has said.

"This temporary but necessary measure allowed us to save lives, relieve our staff by reducing team exhaustion and turnover."

The province has allocated an extra $70 million for the regional health authorities in the 2024-25 budget to "help stabilize and ease pressures."

Fitch said he's "looking forward to first-quarter, second-quarter results, just to see if there's any way we can come in on budget without negatively affecting the clinical aspect of it."

Vitalité's remaining $3.6 million operating deficit for the first 11 months of 2023-24 is mainly due to expenses related to small equipment and professional services in laboratory, pharmacy and infrastructure, Després told the board meeting.

"These were unplanned but urgent spending," he said. No other details were provided.