QUEBEC – While health facilities spent $443 million in 2019-2020 on freelance labour, that sum reached $1 billion in 2020-2021, reveal data from the Ministry of Health compiled from annual reports from health facilities.
These reports, which must be produced by the 103 public and private health establishments under agreement in Quebec, detail the total hours worked by independent workers, whether they be nurses, Personal Care Attendants, or housekeeping employees, security guards and many other job titles.
In the office of Minister of Health and Social Services Christian Dubé, one can observe that the pandemic is not unrelated to the significant increase in the use of private agencies. At the height of the first wave, more than 12,000 health care workers were absent from the sector. “Our number one priority was to provide care to sick Quebecers,” summarizes Marjaurie Côté-Boileau, the minister’s press secretary.
She adds that the pandemic has heightened the need for non-caring job titles, such as security and housekeeping. “These two professions alone account for 51.6% of the increase in independent labour expenditure between 2019 and 2020,” says Côté-Boileau.
Data from the Ministry of Health and Social Services (MSSS) show that health institutions spent $344 million for these services in 2020-2021. A 262-per-cent jump from the previous year.
In recent weeks, Québec solidaire commissioned researcher Yves Lévesque to analyze the annual financial reports of health care establishments and summarize the extent of the use of independent labour in recent years. No job title is spared by the rise of the freelance workforce.
Some regions used the freelance workforce much more than others in 2020-2021. This is particularly the case in the Laurentians, where costs have gone from $28 million to $96 million. Spokesperson for the CISSS des Laurentides Mélanie Laroche says that 26 per cent of the increase is attributable to security expenses. “The security guards from private agencies had to ensure, among other things, that sanitary measures were respected at most of our facilities,” she said.
Laroche adds that the CISSS also had to send reinforcements to “dozens of private resources in the region” during the pandemic. “In several cases, the mobilization of these employees with our private partners has forced the CISSS to partially compensate for their absence with independent labour,” she said.
Health spokesperson for Quebec solidaire Vincent Marissal believes that recourse to private agencies is a “vicious cycle that never ends” and that it is time to “wean oneself from agencies.” His party believes it can be done in three years by, among other things, eliminating the use of agencies in different care sectors. Marissal also believes that the solution lies in better working conditions and better wages for health care workers.
Nancy Bédard, president of the union that represents 76,000 health care workers in Quebec (FIQ) maintains that the abusive use of compulsory overtime, the overload of nurses and the government decrees adopted during the pandemic have pushed many nurses to the private sector. “We saw dozens of people a day leaving the [public] sector to go private,” she says.
In April, the government adopted a ministerial decree that prohibits, among other things, a nurse who leaves the network from returning to work there through an agency for a period of 90 days. This decree has had a certain effect, says Bédard, who believes, however, that a lot remains to be done.
On Monday, Premier François Legault said the shortage of nurses in the network “made it impossible to sleep.”
“There, things are moving. It’s never too late to do it right. But it’s appalling to have waited until you get there before doing something,” said Bédard.
“Since 2006, the sector has been attacked with restructuring. […] The solution lies in better working conditions. But also, we must recreate the feeling of belonging,“ said Jeff Begley, president of the union of health and social services (FSSS-CSN).
At a press conference last week, Dubé said that the situation of nurses is set to change as their new collective agreement will soon come into force.
“We have not yet seen the full benefits of the collective agreement that has just been signed. We have not seen all the positive impacts [that there will be] to reduce mandatory overtime,“ said Dubé, who asked nurses ”to wait until they have the benefit of everything that was signed as a [collective] agreement.”