'The use of private agencies is a vicious cycle of parasitic dependence'
Ban private staffing agencies used for Ontario's health sector—that’s one of the recommendations made in a new report from the Canadian Centre for Policy Alternatives (CCPA).
“Ontario government legislation tabled in 2024 (Bill 231, the More Convenient Care Act) only requires agencies to report billing and rate information to the minister, and the government can choose whether to make this information public. Public disclosure of public payments to individual private staffing agencies, billing rates, and wage rates is a minimum standard to regulate this industry,” says Andrew Longhurst, researcher and political economist, in the report.
“Following Quebec, Ontario should phase out and ban for-profit staffing agencies over three years and create a public sector alternative, similar to B.C.’s approach, to ensure that temporary staff are available to prevent closures and disruptions.”
Previously, a former minister of health in British Columbia called on the B.C. government to make some changes when it comes to how it awards contracts for private nursing companies.
Growing staffing crisis in Ontario hospitals
The call for the ban comes because Ontario’s public hospitals are in the midst of a staffing crisis, fuelled by years of provincial underfunding, wage suppression, and a growing reliance on costly private staffing agencies, according to the CCPA report.
It reveals that from 2015 to 2024, hospital job vacancies surged by 331 per cent, while real wages for vacant positions declined by 13 per cent. These shortages have led to record levels of emergency department closures, with 14,980 hours of downtime reported in 2024 alone.
According to the report, the growing number of job vacancies in Ontario’s hospitals has forced facilities to contract private agency staff—nurses, allied health professionals, and support staff—to maintain services and avoid closures.
Ontario public hospitals paid for-profit agencies $9.2 billion for services between 2013–14 and 2022–23, says Longhurst.
During that period, real per capita private agency costs nearly doubled (98 per cent), while spending on public hospital staff increased by only six per cent, he notes.
Longhurst highlights that in 2013–14, private agency costs accounted for less than six per cent of total labour costs in all Ontario health regions. By 2022–23, however, although private agency staff contributed just 0.4 per cent of frontline hospital hours, they accounted for six per cent of total labour costs—$725 million that year.
“Ontario has become one of the most under-capacity hospital systems in the industrialized world as a result of the hospital funding and staffing crisis,” says Longhurst. “Ontario ranked number 33 out of 38 OECD countries in staffed hospital beds per capita, and fell behind many other high-income countries with universal, publicly financed health systems.”
Also, “in Canada, Ontario had the second fewest staffed hospital beds per capita in 2022-23,” he says.
“Hospitals are struggling to recruit and retain permanent staff while public dollars are working at cross purpose by subsidizing private interests with a business model based on hollowing out the public sector workforce and feeding off the public purse,” says Longhurst in the report titled Hollowed out: Ontario public hospitals and the rise of private staffing agencies.
“Similarly concerning, a significant number of hospital departments across the province experienced staffing and spending cuts on a population-adjusted basis, especially in areas that are subject to privatization by the provincial government, including operating rooms and medical imaging.”
Earlier this year, the federal and Ontario governments recently signed a $3.1-billion, 10-year agreement for major enhancements to the health care system in the province.
Nurses call nurse-to-patient ratio
The Ontario Nurses’ Association (ONA) is also urging the provincial government to address critical issues in the health care system.
“The Ford government has created a crisis in our health care system, and they are failing to fix it,” says Erin Ariss, ONA provincial president. “Any front-line nurse can tell you they have failed to improve staffing shortages and have withheld billions in funding from our public health care system, while Ontarians face closures and service cuts.”
“Ford is pursuing a reckless agenda to dismantle public health care piece by piece and make it private. Ford needs to listen to nurses, who have real solutions to ending the staffing crisis and improving care — and it’s not brain surgery.”
ONA is advocating for mandatory minimum nurse-to-patient staffing ratios, describing it as “a straightforward way to guarantee there are enough nurses to care for patients.”
“They have been shown to help retain and recruit staff, including attracting back nurses who have left the profession,” the association states. “Nursing ratios have worked around the world, saving health care dollars by improving patient outcomes. They are proven to not only fix staffing issues but ensure health and safety and improve access to timely care.”
The organisation is marking May 12 to 18 as Nursing Week.
“We are not only celebrating the work of Ontario’s registered nurses, nurse practitioners and registered practical nurses this Nursing Week, we are speaking out about what the Ford government is doing to our health care system — and how we can fix it,” says Ariss.
Recommendations to for better health care in Ontario
Based on the findings of his study, Longhurst shares the following recommendations for the Ontario government:
- Immediately stabilize hospital finances and increase hospital capacity.
- Develop a provincial health workforce strategy and capital plan.
- Phase out and ban private staffing agencies over three years and create a public sector alternative.
- Build a stronger primary care foundation with community health centres.
A Toronto-based private staffing firm was said to have received payment from two provinces so nurses and personal support workers they brought to those places can enjoy free meals — but the firm never gave the workers their free meals, according to a previous report from The Globe and Mail.
