Private health agencies in Quebec launch legal challenge to new law limiting their use

The association representing private health agencies in Quebec, Entreprises Privées de personnels soignants du Québec (EPPSQ), has launched a legal challenge to Bill 10, the law that aims to eliminate the province's reliance on such agencies to address chronic staff shortages in the health-care system.

In recent years, the province has become increasingly reliant on agencies to provide nurses and patient aids to fill its hospitals, care homes and clinics.

The law has the goal of eliminating the systematic use of such agencies by 2026.  

Health Minister Christian Dubé has said he instead wants to focus on improving working conditions in the public system.

The private agencies say that won't work.

"We are a very important part of the public health-care system and we think that patients need us," Patrice Lapointe, president of the EPPSQ, told CBC News in an interview Thursday.

"Managers that need to find staff to care for patients, they're very, very hard pressed at the moment," Lapointe said.

"By preventing us from helping, they're not fixing the problem. They're taking away a solution," he said.

The EPPSQ has filed an appeal for judicial review, asking a Superior Court judge to invalidate the law.

Lawsuit argues agencies provide better working conditions

The EPPSQ's legal filing names Krystel Villeneuve as a co-plaintiff, and uses her situation as an example.

Villeneuve is a 35-year-old homecare nurse who worked for the local health agency in Saguenay, Que.

Villeneuve left the public system in 2020 after a doctor-ordered burnout leave.

"She therefore has personal knowledge of the unfavourable working conditions existing within the public health network," the legal filing says.

Villeneuve found work at a private agency which offered better work/life balance.

"If the ban on using agencies were to come into force, Ms. Villeneuve has no intention of returning to the public network," the filing says.

"She will try to find a job in a private clinic, despite the extreme rarity of these jobs. If she doesn't succeed, she will work for her partner's taxi company," the filing says.

Lapointe said Villeneuve is not alone.

He said the EPPSQ surveyed its members' workforce, and found that 70 per cent said they would never return to the public system.

Unions say public system has improved

Health-care unions say the government is on the right track phasing out private agencies.

"We believe they're part of the problem, because they offer alternatives to the government that don't allow us to improve working conditions," Réjean Leclerc, president of the CSN's federation of health-care and social service workers (FSSS-CSN), told CBC News in an interview Thursday.

Leclerc said that recent collective agreements signed in the health-care sector are the beginning of real change that will make the public system more appealing.

"We're aiming to improve salary conditions, working conditions, but also stability in the network," Leclerc said. 

He implored nurses who've left the public system to come back and give the new agreements time to work.

"Instead of completely disconnecting yourself from the network, let things settle down then try it," Leclerc said.

Debate over cost

One of the arguments Dubé and the unions have used against the agencies is cost.

Dubé introduced the new law in part because of horror stories that emerged from the public inquiry into the deaths of seniors in long-term care homes during the pandemic, where agency workers were paid more than their public counterparts and sometimes delivered substandard care.

"We find it ill-advised for private companies to make a profit at the expense of the population,"  Leclerc said.

Lapointe said even though agency workers might be paid a higher hourly wage, they actually cost the system about the same as public workers because they don't have the same pension and benefits.

"What we give to the health-care systems in terms of flexibility, no one else can do at the moment," Lapointe said.

He said if Bill 10 goes ahead as planned, it's patients who will ultimately suffer.

"It will inevitably lead to service breakdowns which will cause psychological and physical suffering to network users and, potentially, an increase in mortality," the EPPSQ's legal filing says.

Dubé's office responded in an emailed statement, saying more than 1,100 workers from private agencies have returned to the public sector since the law was passed. 

"Our government wants to change things and wants the health and social services network to become an employer of choice," the statement said.

"Gradually ending the use of agencies will help achieve this objective."