Ontario proposes requiring health staffing agencies to disclose their rates

Ontario Health Minister Sylvia Jones listens to questions from reporters following a press conference in Etobicoke, Ont., on Jan. 11, 2023. THE CANADIAN PRESS/ Tijana Martin

Ontario is proposing to increase transparency and accountability around health staffing agencies, as hospitals and long-term care homes spend about $1 billion a year to fill shifts with temporary workers at rates far higher than full-time staff are paid.

It's a positive — if small — step toward regulating or lowering the fees of agencies that charge double or even triple the rates of staff nurses and personal support workers, some critics and advocates hope.

Health Minister Sylvia Jones introduced legislation earlier this month that would require health-care staffing agencies to report billing or pay rate information to her, and would allow the minister to publish some of that information.

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"It will allow us to more easily measure and see whether we are seeing stabilization, increasing use, decreasing use, and where," Jones said.

She would not, however, commit to treating the collection of that information as a first step toward some sort of regulation of the sector, which both hospitals and long-term care operators have long urged.

Lisa Levin, CEO of AdvantAge Ontario, representing the province's non-profit long-term-care homes, said the legislation marks an important start to addressing the issue.

"I think it's a good step to have transparency in what temporary agencies are charging, but we do also need to hold them to account so that they aren't able to price gouge," she said.

"Temporary agencies are a critical part of our system, and I support them wholeheartedly. I don't think that we can get rid of temporary agencies. They, in fact, saved lives during the pandemic and were indispensable ... but there are a few that take advantage of the system, and we need to have stronger regulation to stop that from happening."

A report last year by Ontario's auditor general noted that the province does not cap the rates for-profit staffing agencies can charge, and while the average pay for a registered nurse directly employed by a long-term care home was $40.15 an hour, the average hourly agency rate was $97.33.

There is also significant variation within the same classifications, the report found, with the hourly rate for a registered nurse at a staffing agency ranging from $55 an hour to $139.65 an hour.

A November 2023 staffing agency update previously obtained by The Canadian Press through a freedom-of-information request shows that hospitals and long-term care homes were projected to spend about $600 million on agency nurses in 2022-23, a 63-per-cent increase over the prior year.

When the cost of personal support workers from agencies is added, the total for the latter year became more than $952.8 million, the document said.

Anthony Dale, president and CEO of the Ontario Hospital Association, said hospitals have been working closely with the government to reduce reliance on agency nursing.

"The Ontario Hospital Association is pleased to see the government move forward with this important first step towards providing greater transparency and accountability," he wrote in a statement.

"The requirement to share this information may help encourage the agencies to reduce their fees and will also inform future policy decisions on this matter."

NDP health critic France Gelinas sees that section of the bill as largely positive, though doing the bare minimum to address the problem, and she noted that a lot of the details are to be sorted out later.

“I would say it’s the tiny, weeny little step that they had no choice but to make, and they made it as small as possible, with all of it left to regulation,” she said.

This report by The Canadian Press was first published Dec. 20, 2024.