New report finds hospitals across Ontario rely increasingly on private agencies to fill staffing gaps

Short-staffed Ontario hospitals paid out over $9 billion to for-profit staffing agencies between the 2013-2014 and 2022-2023 fiscal years, three times more than what it would cost to employ in-house hospital workers, according to a new report from the Canadian Centre for Policy Alternatives.

“The use of for-profit staffing agencies is part of a vicious cycle that hollows out the public sector workforce, thereby increasing hospitals’ dependence on private agencies,” said Andrew Longhurst, Research Associate with the Canadian Centre for Policy Alternatives and the report’s author.

His report, titled ‘Hollowed Out: Ontario public hospitals and the rise of private staffing agencies,’ did a deep dive into how public health care dollars are being allocated in Ontario’s 14 health regions.

In the South East region — which includes hospitals in the Kingston, Quinte, and Brockville areas — spending on private, for-profit staffing agencies jumped from $9.7 million in 2013-2014 to $34.9 million in 2022-2023, a staggering increase of 259 per cent, according to Longhurst.

In short, his research found hospitals are relying more and more on contracts with private agencies to fill chronic staffing shortfalls — not just nurses, but in other fields such as registered practical nurses, personal support workers, health care aides, respiratory therapists, and medical lab technicians.

“What this tells us is [that there is] a significant and much faster rate of growth on the private agency side than on the public hospital employee staff side,” Longhurst said.

Longhurst and officials from the Canadian Union of Public Employees’ Ontario Council of Hospital Unions (OCHU-CUPE), which commissioned the report, were at Kingston City Hall on Friday, May 16, 2025, to discuss the findings.

In an interview with Kingstonist, Longhurst said years of Ontario government under-funding of the health-care sector, coupled with increased staff workloads and burnout, have led to a dramatic rise and reliance on external for-profit agencies to fill the gaps.

“Hospitals could not negotiate higher wages and improved working conditions over the last decade. That has really been to the benefit of private, for-profit staffing agencies, because they benefit in this environment where hospitals can’t recruit and retain their own staff.”

He added: “People are choosing with their feet not to stay within public hospitals and it’s growing that private, for-profit market of staffing agencies.”

The report found that increasingly heavier workloads combined with real dollar wage cuts fuelled a 330 per cent increase in job vacancies since 2015, which has given rise to hospital reliance on for-profit staffing agencies to help fill the gap.

While private agency contracts are generally not made public, it’s not uncommon for an agency-supplied nurse to earn $80 an hour, about double what an in-house nurse would earn, he explained.

The British Columbia-based Longhurst suggested there is poor care for patients when hospitals can’t provide improved conditions at work.

“When you don’t have the capacity, when you have hallway medicine really becoming the norm, it creates such moral distress and you’re not going to be able to retain your health-care workforce. That’s one of the big stories in Ontario,” he said.

The report said per capita public funding for the province’s hospitals rose by six per cent compared with a 181 per cent jump in staffing agency reliance, and total spending of $9.2 billion during the decade that was studied.

“Saving our hospital services requires an investment in the staff who deliver them,” said Michael Hurley, President of CUPE’s Ontario Council of Hospital Unions.

The report’s prescription to resolve this “crisis” includes the development of a health-care staffing strategy, and investments in hospital services (a $2 billion annual increase), as well as primary and community care.

Longhurst also called on the government of Premier Doug Ford to follow Quebec’s lead to phase out and ban private, for-profit hospital staffing agencies within three years, and to adopt the model of British Columbia and create a public sector staffing agency to help hospitals facing staffing challenges, especially in rural and remote areas.

One of the big consequences of provincial under-funding is that Ontario is one of the most under-capacity hospital sectors in the industrialized world, ranking 33 out of 38 in high-income countries, according to the research.

“We are also at the bottom of this country in terms of staffed hospital beds on a per capita basis,” said Longhurst.

Further information on the Canadian Centre for Policy Alternatives is available on the organization’s website, and further information on the OCHU-CUPE is available on that organization’s website. The full report ‘Hollowed out: Ontario public hospitals and the rise of private staffing agencies’ is available on the Canadian Centre for Policy Alternatives’ website.