N.W.T. spent $5.2M last year on agency nurses, who are paid more than local nurses

An employee of the N.W.T. health authority says the territory's use of agency nurses is becoming a labour issue and they want the government to present a plan to reduce its reliance on those workers. 

CBC News granted confidentiality to the employee of the Northwest Territories Health and Social Services Authority (NTHSSA) because of possible implications to their employment.

Agency nurses are typically employed on short-term contracts through a hiring agency, and often come from elsewhere in Canada.

The NTHSSA employee said the territory's use of agency nurses is affecting morale among those N.W.T. nurses who work directly for the health authority.

The employee says N.W.T. nurses are often forced to train those visiting nurses who may make twice their pay and require a lot of instruction, specifically on how to offer culturally-appropriate health care in the territory. Meantime, N.W.T. nurses are still waiting for a new collective agreement, the employee said.  

Lesa Semmler, the territorial health minister, says agency nurses are only used as a last resort to avoid cuts to some health services. She said there are currently only seven agency nurses working in the territory — six at Stanton Hospital in Yellowknife and one in Inuvik — and they are being used to help with critical services that might otherwise close. 

Despite the limited usage, nursing agencies cost the territory $5.2 million last year according to David Maguire, a spokesperson for the NTHSSA, in an email. He said the average cost of an agency nurse is $125 per hour, but the costs range from around $105 to $164.  

However, Maguire said how much of that goes to the nurses and how much goes to the agency isn't known, as the territory just pays the rate.

A job posting last month from one of the agencies contracted by the territorial government says that nurses working in the N.W.T. would make over $100 an hour. CBC News was provided the screenshot of the advertisement by the Union of Northern Workers.   

The posting, from an agency called Solutions Staffing, said that nurses with the agency who took jobs in the N.W.T. "just got a raise." 

"This is an excellent time to earn more while experiencing true northern Canadian life," the ad reads. 

The advertisement says there was a $500 bonus for nurses who work in the N.W.T. for over two weeks. This is on top of per diems and housing costs that are covered. 

By comparison, a nurse working full time for the N.W.T. health authority can expect a base salary between $48 and $59 per hour, and with additional benefits they can make around $71 to $85 per hour, Maguire said.

Agency nurses considered union workers

Despite the discrepancy in pay, agency nurses are considered unionized in the N.W.T. and the health authority pays their union dues, according to last year's financial statement. 

In an emailed statement, the Union of Northern Workers (UNW) says it is seeking clarity as to why agency nurses make more than their counterparts in the territory despite being under the same collective agreement. 

Under the collective agreement, the union has a pay scale where employees receive the same amount depending on their specializations and experience. 

Gayla Thunstrom, the president of the UNW, which is part of the Public Service Alliance of Canada, said that as a result of the union fees being paid, the agency nurses are considered casual employees. 

"However, this should mean these workers are bound by the provisions of our collective agreement when it comes to job classification and pay scales," she wrote in an email to CBC News.

"Because casual employees should be getting paid according to the collective agreement, this is an issue that the UNW has been trying to seek some clarity on."

CBC News reached out to five out of six nursing agencies, including Solutions Staffing, that the territory has contracts with. Four of them didn't respond and the fifth didn't agree to an interview. 

The NTHSSA employee said they don't blame the nurses who work for the agencies, as it can be a lucrative opportunity. But they also believe that it means some nurses who may be interested in working for the territory are instead opting to work for an agency. They said they know of some locum nurses — which the territory relies on — who are thinking of working for agencies instead to make a better salary.

The health minister, who was a nurse herself, said she understands the frustrations health-care workers would have with agency nurses.

"In a perfect world, I would never use an agency nurse and I would fill all the positions with permanent local nurses," Semmler said.

"But in order to not shut down beds and units then we have to be able to provide the service somehow." 

Semmler said the territory went 15 years without using nursing agencies and only started doing so again because of a months-long closure of the obstetrics unit in Yellowknife a couple of years ago.

Semmler said staffing in health care is an issue Canada-wide and it involves the federal government, the provinces and the territories working together to reach a solution. 

The subject was discussed in the Legislative Assembly last week, with members urging Semmler to consider banning the use of agency nurses.

As for a long-term strategy to move away from the practice for the N.W.T., Semmler told CBC News the territory needs to attract and retain more staff and it is working to do that.  

The NTHSSA employee who spoke to CBC News said one way the territory could retain and attract more staff is to work on a new collective agreement with the nurses currently employed by the territory.