Ontario is taking steps to increase transparency in the health staffing sector, with proposed legislation aimed at shedding light on the costs hospitals and long-term care homes incur to fill staffing gaps with temporary workers. These facilities currently spend about $1 billion annually on such agencies, which often charge significantly higher rates than full-time staff earn.
Health Minister Sylvia Jones introduced the legislation earlier this month, mandating health staffing agencies to report billing and pay rate information to the ministry. The proposed law also grants the minister authority to publicly disclose some of this data.
“This will help us better measure trends and understand whether we’re seeing stabilization, increased usage, or a decrease in the reliance on temporary staffing,” Jones said.
The legislation stops short of imposing regulations on the fees charged by health staffing agencies, despite long-standing requests from hospitals and long-term care operators. However, some advocates see it as a step in the right direction.
Lisa Levin, CEO of AdvantAge Ontario, which represents the province’s non-profit long-term care homes, called the legislation an “important start” but stressed the need for stricter oversight.
“Transparency is crucial, but we also need to hold agencies accountable to prevent price gouging,” Levin said. “Temporary agencies were indispensable during the pandemic and remain vital to the system, but stronger regulations are needed to stop a few from exploiting the situation.”
Ontario’s auditor general highlighted the issue in a 2023 report, noting that the province does not cap the rates staffing agencies can charge. The report revealed that while registered nurses directly employed by long-term care homes earn an average of $40.15 per hour, agency nurses cost an average of $97.33 per hour.
Within the same classification, rates vary widely, ranging from $55 to $139.65 per hour for agency nurses.
A government document obtained through a freedom-of-information request showed that hospitals and long-term care homes were expected to spend $600 million on agency nurses in 2022-23, a 63% increase from the previous year. When including costs for personal support workers, the total surpassed $952.8 million.
Anthony Dale, president and CEO of the Ontario Hospital Association, welcomed the proposed legislation, viewing it as an essential first step toward addressing the issue.
“The requirement to disclose rate information could encourage agencies to reduce their fees and inform future policy decisions,” Dale said.
NDP health critic France Gélinas acknowledged the transparency measures as positive but described the move as “the bare minimum” to address the problem.
“This is a tiny, tentative step that leaves most decisions to be settled later through regulations,” Gélinas said.
While the proposed legislation aims to provide greater transparency and accountability, many stakeholders are calling for further action to regulate agency fees and reduce reliance on temporary staffing. For now, the focus will be on gathering data and monitoring trends to inform future policy changes.