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Interior Health is contracting out an increasing number of nursing jobs as its spending climbed to more than $30 million last year.

From 2017 to 2021, the health authority spent up to around $2 million per year on agency nurses. That jumped to nearly $8 million in 2022, according to figures obtained through a freedom of information request.

Interior Health then spent $33.5 million for agency nurses across the region in 2023.

BC Nurses' Union president Adriane Gear said she's not surprised. She's heard recently from nurses across the province about a growing reliance on contracted nurses, including the Interior where she visited health-care sites in recent weeks.

"It makes sense in terms of what we're seeing," Gear said. "It's extremely concerning, however, because when you think about it, this is taxpayer's dollars. This is definitely not good stewardship of taxpayer's dollars."

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She said there are very few health-care settings immune from seeing outsourced nurses from private agencies. Sometimes it's that outsourcing that keeps the doors open.

While nurses may lose some of the benefits, like pensions and insurance, they get from union work, they often get a higher wage than their peers employed with the health authorities, she said. The higher wage, travel expenses and the company profits are all paid for by health authorities like Interior Health.

"If we're willing to spend all this additional money on privatized nursing services — because that's what this is, the privatization of healthcare — why can't we treat our health authority nurses a little better?" Gear said.

The increase in spending, however, is something that's occurring quickly and across the province, she said.

There are multiple companies that employ nurses then contract to health authorities, and they've been around for years. Often it's not only for nurses who are looking to travel for work, but to do it in more remote communities.

Gear has learned of placements in hospitals and facilities in more urban areas, too. She said nurses have left their health authority jobs only to contract back with the same employer.

Working with agencies, nurses are typically able to have more "autonomy" over their schedules, like getting time off with ease instead of working within the health authority's structure.

"Nurses work 24/7, so if you can get time off for the special times in your life, that's what's driving people to this. It's just increased flexibility," she said.

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The ongoing nursing shortage is something health regions across the country have been anticipating for years, she said. The COVID-19 pandemic didn't cause it, and it doesn't appear to have caused a reliance on private companies, she said.

The pandemic did, however, speed the trend along, Gear said. Some who haven't left the job entirely, turned to agencies for some work-life balance, she said.

In order to meet the demand for nurses and to staff remote communities, the province has created its own organization with GoHealth BC. It appeals to nurses with rural and remote job postings, claiming to offer flexibility over their schedules.

Gear said they can keep their benefits with the union if they work with GoHealth.

According to Interior Health Authority, nurses with GoHealth work in Interior Health, Northern Health and Island Health. As of March 1, Interior Health is now offering signing bonuses for nurses that sign on with GoHealth.

The proliferation of contracted nurses comes at another cost, Gear said. With each new placement, nurses have to be trained on the setting they're working in.

That takes away time from another nurse who could be with patients, focused on bringing a temporary employee up to speed, only to likely leave again for another placement.

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It's a trend seen across the province, with spending on the rise in all other health authorities, according to CTV News.

iNFOnews.ca requested an interview with Interior Health on March 12, then again on March 20. No one was made available for an interview in time for publication.

In a statement provided March 20, the health authority said using agency nurses is a last resort, adding the Health Ministry placed a moratorium on new agency contracts in 2022.

While the outsourcing has spiked, it still pales in comparison to overall spending on unionized nurses, according to statistics provided by Interior Health.

In 2017, the health authority spent $524.5 million on unionized nurses, compared to $860,240 on agencies.

The unionized spending increased annually, reaching $751 million in 2023. Of that total, 27% accounts for benefits.

Interior Health said less than 5% of its spending on nurses is dedicated to agency staff, while noting it also contracts outside agencies for "many professions" when it needs to supplement staffing levels.

The figures provided in the freedom of information request do not compare the overall cost per employee for each, nor is it clear how much profit private agencies pull from public health-care funding.

Interior Health said the province has stepped up efforts to train new nurses, and more than 6,000 registered with the BC College of Nurses and Midwives from Jan. 1, 2023, to Jan. 31, 2024. The health authority is also incentivizing nurses with GoHealth, while exploring ways to retain its own nurses that may consider leaving the health authority.

"Through these efforts, and our range of health human resource initiatives to recruit, retain and redesign the healthcare system, we hope to eliminate the need for agency staffing," the statement from Interior Health read.

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