Latest news with #DamienContandriopoulos
CTV News
4 days ago
- Health
- CTV News
EXCLUSIVE: B.C. paid private nursing agencies $508 million in just two years
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. B.C. health care agency spending '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.' B.C. health care agency spending 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.'
Montreal Gazette
29-05-2025
- Health
- Montreal Gazette
Bill 106 will not boost productivity of doctors: health policy expert
By There is scant evidence that the Quebec government's proposed bill to tie doctors' pay to their performance will lead to more patients being treated, argues a prominent health policy expert. Damien Contandriopoulos, a professor of public health at the University of Victoria who had previously taught at the Université de Montréal, is highly critical of Bill 106, which proposes linking up to 25 per cent of a doctor's pay to performance targets as an incentive for them to take on more patients. 'It's a government that likes the notion of direct control, top-down, all the way from the ministry to the worker,' Contandriopoulos said in an interview Wednesday after he testified on Bill 106 at a National Assembly hearing. 'Centralized systems, data collection, heavy monitoring, and this kind of top-down, direct-control approach is generally not a great fit for super complex, extremely large systems like the health-care system,' he added. Bill 106 has sparked an intense backlash in the medical community, with physicians charging that the legislation would drive some doctors away from the profession or the province — and worsen patient care. The bill follows Health Minister Christian Dubé's creation of Santé Québec in December to run the province's $65.5-billion-a-year public system. Despite opposition to Bill 106, Premier François Legault has said the Coalition Avenir Québec government intends to have the legislation adopted. Dubé tabled the bill on May 8 amid contract negotiations with two Quebec federations representing physicians. The 25-per-cent pay figure tied to performance targets was calculated in a mathematical formula that Contandriopoulos described as 'complete nonsense.' Even if the performance targets aren't met, doctors would still receive 10 per cent, according to the formula written in the bill. In Contandriopoulos's report on Bill 106, he wrote similar past incentives in Quebec have not notably increased doctors' capitation — which is the term used for the number of patients a physician has on their roster, and the new rules would only make it harder for them to do their jobs. He illustrates that financial incentive systems are prone to 'gaming,' meaning doctors will try to exploit the system's flaws to their advantage. He cited a recent initiative in Quebec, the 'Guichet d'accès pour la clientele orpheline,' which tied a payment incentive to the registration of new patients. Because of a flaw in the system, he suggested many doctors retroactively enrolled patients who had already been treated. This gave physicians the financial benefit despite the fact they didn't take on additional patients. He also suggested that with Bill 106, doctors may be less motivated to take on complex cases that require extra attention and expertise if their remuneration were based largely on the number of patients they see. As a result, doctors may flood their schedules with patients who could be treated by nurses, social workers or other health professionals on their team as a way to maximize their patient load and increase their remuneration, Contandriopoulos said. If a doctor delegated their straightforward patients to nurses and social workers, 'then they would be stuck with demanding, challenging, long visits,' he explained, adding that this approach would be effectively penalized under Bill 106. 'They would go bankrupt because the system doesn't reward them to do so. So if we want physicians to really focus on the work that they are the best trained to do and where the benefit for society is the highest, we need to incentivize them to really focus on (these complex cases), which we do not.' Dubé said during a scrum Tuesday afternoon that Bill 106 won't be adopted this session of the National Assembly and he would like for discussions to continue. Amid the hearings on Bill 106, Dubé reiterated he wants 100 per cent of Quebecers to have access to a health professional by the summer of 2026.
