Canada's medical system 'severely damaged' by use of nursing agencies, Gardam warns

As a country, Canada needs to find a way to control the hiring of nurses through agencies or costs will only spiral further, says Health P.E.I. CEO Dr. Michael Gardam.

"Our system is being severely damaged by this," Gardam told a P.E.I. legislative committee last week.

"People are being moved around for substantial profit and there doesn't seem to be a mechanism at this stage to try to contain that."

Health departments across Canada have been turning to nursing agencies to fill shifts that can't be covered by current staff. The use of these agencies has grown quickly, with business owners hiring nurses away from health systems in some cases with promises of higher pay.

At the end of 2021, the Nova Scotia Department of Health allocated $3.1 million for agency nurses. Before the end of 2022, that budget had expanded to $18.4 million.

The cost in Manitoba for the 2021/22 budget year has been estimated at $40 million.

Gardam described Ontario and Saskatchewan as being completely dependent on agency nurses.

"We're not there yet, but it's only going to grow," Gardam told CBC News after the committee meeting.

"This really is a Canada-wide issue that we need to — as a country — deal with, because we're spending three times as much for any individual nurse, and it's driving all our systems into the ground."

The agencies offer not only higher pay but greater flexibility. Nurses can pick up shifts as they want, instead of being pressured into taking on extra shifts or working overtime, as is common for nurses working directly for an organization like Health P.E.I.

Not only are the agency nurses costly to engage, but their use is dispiriting for nurses working inside the public system, who can find themselves on shift with someone they know is getting paid twice what they are.

'Fundamental transform'

Health P.E.I.'s contracts with agencies do not let them poach existing workers and hire them back to work on P.E.I., but that doesn't prevent nurses on P.E.I. from going to an agency and then working in another province.

"We've made it really easy for people to work in agencies and we have to turn that around," said Gardam, adding that doing so will require a fundamental transformation "of how we treat our workers in health care."

Primarily, that is going to mean hiring a lot more people, he said. In that way, the public system can offer more flexibility to its workers, and also reduce the need to turn to agencies to fill shifts.

Health P.E.I. said it couldn't provide a figure for how much it has spent on agency nurses in the current fiscal year.

Last spring, the P.E.I. Nurses Union said there are about 300 vacant registered-nurse positions in the province. One-third of nurses on the Island worked overtime in July, the highest rate of overtime work in the country.