In a new study by Andrew Longhurst, we find Ontario hospitals have spent over $9 billion on agency staff over the past ten years. This figure factors in a historic investment on nurses alone. The massive spending has raised alarm bells. They lament the increasing dependence on private staffing agencies to fill hospital shifts, at a time when Ontario’s health care sector is experiencing record job vacancies.
The Pew study uncovers a shocking statistic. In fiscal 2022–23, agency staff accounted for only 0.4 percent of all front-line worker hours at Ontario hospitals. They made up only six percent of the hospitals’ total labor costs. Meanwhile, public hospital spending on private agencies exploded by 98 percent between 2013-14 and 2022-23. Total expenditures on hospital personnel hardly moved the needle, increasing just six percent over that same time span.
Ontario hospitals are in crisis with dangerous staffing shortages. In turn, the federal government has re-introduced legislation to shed more light on staffing agencies. This new legislation was introduced in late 2024 but ran into a barrier before the provincial election. Now, it’s asking agencies to disclose their billing and pay rate information. It requires the federal government to release more information about these agencies’ billing practices.
Longhurst said that the increasing reliance on agency staff just isn’t a sustainable solution. He stated, “The greater reliance and the increased spending on private agencies is really just driving hospital job vacancies.” He further echoed the sentiment that this corporatization trend is poisoning the public healthcare system.
“In fact, it is a tool that they have been using for decades… Our government will not take away this important tool.” – Sylvia Jones
This has led hospitals to rely more and more on staffing agencies to staff qualified nurses who can fill temporary shifts. The current prohibitive practice though these agencies can provide necessary expertise, they usually cost double—even triple—their standard hourly rates. This mounting fiscal stress beggars the question of what taxpayers are getting for their money on the American health care investment.
Andrew Longhurst emphasized the inefficiency of this approach, stating, “So we’re seeing a really poor value for money in terms of what Ontario taxpayers are getting in return.” He criticized the current reliance on agency nurses, stating, “(There is) a very minimal place for agency nurses in Ontario. Minimal. What’s happening right now is so fiscally irresponsible and actually means we’re paying more for less health care.”
Even still, Ontario hospitals are reporting they are working harder than ever to find solutions that limit their use of staffing agencies. The dramatic rise in healthcare job vacancies—331 percent between 2015 and 2024—has made many healthcare administrators rethink their approach to staffing.
In response to these findings, Mike Schreiner commented on the necessity for more effective care delivery, saying, “That’s how we can deliver more care and better care at a lower cost.” His message highlights the urgent imperatives to find answers that put common sense over costs while continuing to provide high-quality patient care.
“You’re hollowing out your public sector workforce, because those folks that are moving into agency work are no longer available to be hired as permanent employees.” – Andrew Longhurst
Ontario’s healthcare system is rapidly changing. We expect that these findings will inform the ongoing discussion between policymakers and health administrators. How we’ll do it We’ll put a premium on balancing financial stewardship. Equally important, we need to act now to preserve a robust and highly-skilled healthcare workforce.
