Work carries on to throttle spending on private nurses, says N.L. health authority

Newfoundland and Labrador Health Services says more demand on nurses, retirements and expanding services were the reasons behind last year's jump in dependency on private agency nurses, but work is being done to throttle spending.

According to documents obtained by an access-to-information request filed by CBC News, Newfoundland and Labrador Health Services spent $18.4 million on travel nursing in 2022. The following year, it increased to $90 million.

NLHS human resources vice-president Debbie Molloy said the difference was COVID-19-related costs, compounded by retirements and a shortage of local nurses to fill in the gaps.

"We've also been increasing our service offerings with the Health Accord. We now have new services that we're offering, family-care teams, urgent care, expansions in cardiac-care expansions and mental health services," Molloy told CBC News on Friday.

She added the health authority is implementing a new electronic documentation record system, opening a new hospital in Corner Brook and planning to open a new mental health facility in St. John's.

"So all of those things combined, came together to increase the demand that we had for agency [nurses]," she said.

Number of nurses

In May, the health authority said it planned to reduce the number of private health-care staff from around 340 people to around 60 — which former N.L. Health Services CEO David Diamond said was the pre-pandemic level — by April 2026. 

Molloy said the health authority gets monthly updates on the number of travel nurses working in the province, adding the number changes depending on the specific contract. For example, she said, in February there were 285 travel nurses.

"That was the highest that it had been for the full year," she said.

In the fall of 2023, she said, the health authority decided to focus on the number of travel nurses to ensure it was using them appropriately.

"We put in a robust plan that had started really in April of this year to ensure that we're bringing that number down. And our goal is to have that number at pre-pandemic levels within two years," Molloy said.

NLHS plans to make a 30 per cent reduction by the end of the year.

Diamond, who has since retired, also said the health authority anticipates spending $70 million this year on agency nurses.

Molloy said NLHS has begun work to control the cost of agency nurses, including recently ending some of the more expensive contracts that were entered into during the height of the pandemic.

There will be a request for proposals going out in the fall to standardized nursing contracts, she added.

"That will standardize the rates for all contracts. And that will again bring the cost of when we do need to bring agency nurses into our facilities, it will standardize the cost."

Plans to boost local nurses

Yvette Coffey, president of the Registered Nurses' Union Newfoundland and Labrador, told CBC News earlier this week that a greater effort is needed to entice more people in the province to enter the nursing profession and get them to stay.

Molloy said efforts to boost the number of local nurses continues, including hiring as many nursing graduates from the province as possible.

"We go into the nursing classes right at their first year and talk to them about, you know, 'We have a job for you when you graduate.' And that is starting to bear fruit for us," said Molloy.

She said NLHS recently hired more than 300 bachelor of nursing graduates, accounting for 93 per cent of the class. The class sizes are also increasing, Molloy added.

The health authority has also been collaborating with the Health and Community Service Department and the nurses' union to talk to high school students about going into health-care professions.

Recruiting internationally trained nurses is another piece to the solution, Molloy said.

"I'm really happy to be able to say that between May and July of this year, we've welcomed 17 nurses from India into the province, and they're going into all corners of our province," she said.

"We're really focused on sort of a multi-pronged approach to ensure that we are able to keep our nursing workforce at a level that it needs to be."

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