Health staff shortages a double cut with locum sourcing

 The current shortage of health professionals in nursing and personal support workers (PSWs) is placing a strain on Manitoulin’s institutions. Although commitments (including funding) have been made to increase the number of care hours for residents of long-term care by the province, the escalating costs of hiring locums to fill in gaps in the roster at local institutions is resulting in budgets being burned at both ends.

As current and former administrators have confirmed “off the record,” a kind of “stealth” privatization is taking place in the health care system. As hospitals and long-term care facilities scramble to fill nursing and PSW vacancies they must compete in the labour market with private for-profit agencies which are able to offer both much higher salaries and more flexible working conditions than the public institutions and nursing homes.

Health care institutions are essentially being held over a barrel as their funding is dependent on meeting care targets set by the province but filling in the gaps on their rosters to meet those targets requires paying private locum agencies a much higher hourly rate than would be the case for salaries and benefits for a regular employee. The result of those employment premiums is a strain on health care budgets already operating on razor-thin contingencies.

Since private health care professionals can choose their working hours to better suit their family situations and lifestyles, the more challenging shifts on weekends and through the night may not even be possible in some situations, leaving the health care facility short of its mandated service levels—with a potential clawback of the additional funding meant to increase service to society’s most vulnerable citizens.

This situation is not local. The entire province, and nation, has been battered by the impact of systemic shortages of doctors, nurses and PSWs as governments have historically limited the number of class spaces for the training professionals (in Canada’s case with the result that the country now finds itself near the bottom of patient to doctor ratios). That, coupled with the strains of the global pandemic causing burnout and a torrent of healthcare professionals leaving the field have come together in a perfect storm that will not be solved overnight.

Government policies are not looking to improve matters very quickly either.

At the recent Federation of Northern Ontario Municipalities meeting, Dr. Sarita Verma, president and vice chancellor of Northern School of Medicine University (NOSM), noted that although the province recently announced an additional 41 spaces for training new doctors, half of those spaces are reserved for a new medical school being set up at the institution formerly known as Ryerson (now Toronto Metropolitan University).

“I can tell you from experience that it will take years before they graduate a single doctor,” she noted, predicting that first doctor will enter the stream 10 years down the line. Dr. Verma said that those positions would be far better utilized now at NOSM.

Caps on public servant wages at one percent imposed by government fiat during a time of escalating inflation are also shackling the production of new health care professionals. Dr. Verma noted that, despite being painted as entitled whiners, in her opinion doctors are paid far below the level that they should be receiving.

Adding to the toxic mix is the massive amount of media focus during the pandemic highlighting the challenging working conditions being faced by health care practitioners. A factor that acts to dissuade youth from following those career paths.

Another challenge that has come to the fore specific to Manitoulin is the difficulty in securing accommodation for locums, severely limiting competition among agencies to provide fill-in staff to those located in nearby Sudbury.

In some cases, accommodation had to be secured in Espanola for temp staff for Manitoulin Centennial Manor.

So far Island health care institutions are weathering the labour market perfect storm by seeking out innovative approaches to recruitment and retention, but remain concerned about meeting mandated care targets as the strains on the system look to last for some time yet.