British Columbia’s health authorities have cut cheques to private staffing agencies totalling a little more than half a billion dollars in just the last two years, in order to have enough nurses to keep the province’s hospitals, operating rooms and care homes open to patients.
CTV News spent months trying to update the figures, which show the province has been spending more and more every year since the pandemic, despite trying to scale back reliance on the short-term contractors.
Read more: Explosion in reliance on for-profit health-care staffing agencies in B.C.
For example, Vancouver Coastal Health spent $5.7 million in the 2019/20 fiscal year and $43 million in 2024/25. Northern Health spent the most of any health authority, going from $12.6 million in 2019/20 and soaring to $92.2 million last year, with 19 per cent of their nursing costs paid to agencies.
“It’s a trap for the healthcare system,” said University of Victoria nursing professor Damien Contandriopoulos, who described it as a vicious cycle with more staff opting to leave full-time work and the inability to refuse overtime for higher hourly pay and the ability to dictate their own schedules.
Read more: Outcry and pushback against B.C.’s ‘outrageous’ spending on health-care temp agencies
“There is no easy way out because when you look at the workforce, we have more nurses per person in B.C. now than we had pre-COVID,” he said. “The only reason (this is happening) is dysfunction, but that dysfunction is not going to be miraculously solved by agency nurses.”
Unionized travel growing, but not enough
The BC Nurses’ Union has been encouraged to see members who are interested in working in communities across the province doing so through the GoHealth program, but isn’t surprised the reliance on the temp agencies continues to grow.
“If health authorities and government are willing to spend this kind of money on for-profit, private nursing services, then why wouldn’t we want to invest in the nurses that are already here in British Columbia?” said BCNU president, Adrian Gear. “They have been holding up the system for a number of years.”
So-called “agency nurses” used to be a valuable resource in rural and remote communities to cover vacations or medical leave, but have become the norm in every health authority in the province. They have the same licensing and qualifications as unionized, publicly-employed staff but make more per hour to plug scheduling holes in various acute and long-term care facilities.
Gear urged the government to follow through on their promises to establish reasonable nurse-patient ratios and to understand “nurses require (better) working conditions and could be treated better,” in order to stay in the public system.
The ministry responds
It’s always been difficult to obtain the numbers on how many public dollars are going towards private staffing agencies, and when CTV News first started reporting on this issue in 2022, the health authorities insisted that contact tracing and vaccination clinics required during the COVID-19 pandemic were driving the numbers.
But now that nurses have experienced the hefty paycheques and ability to determine days off, it’s hard to go back on that kind of flexibility and cash in hand. Last year, then-health minister Adrian Dix acknowledged they’d need to rely on the agency staff to keep hospitals and other facilities open while they tried to ramp up recruitment for permanent, union positions.
Current health minister, Josie Osborne, was unavailable to speak to the issue on Tuesday, and a ministry spokesperson sent an email statement pointing out the rate of increase has slowed and that agency staff are only used as a last resort. The ministry said contracts have been standardized and they’re working on making disclosure of agency expenditures more transparent, but they made the same claim last year and the payments are just as opaque and difficult to obtain as they’ve always been.
With mounting pressure to control costs as they already face a record deficit, the B.C. NDP has been looking for areas to scale back spending. At first blush, it might seem that slashing agency expenses could be one area, but then they’d essentially have to choose between balancing the books and shutting down even more emergency departments or making for longer waits for care.
Gear is urging them to cut out the middlemen and “to invest in the people that are delivering the care, not investing in for-profit, businesspeople that are, frankly, exploiting the situation.”