‘The report includes misleading claims on private agency usage that are significant’
The Ontario Hospital Association (OHA) is calling on the author of a Canadian Centre for Policy Alternatives (CCPA) report concerning the provincial government's use of private staffing agencies to withdraw the publication.
That’s because the report contains inaccurate assertions, according to Kirk LeMessurier, chief of communications and public affairs at the OHA.
“The OHA's analysis found that the report includes misleading claims on private agency usage that are significant,” he said.
The CCPA report—authored by Andrew Longhurst, researcher and political economist—claims that Ontario's public hospitals paid for-profit agencies $9.2 billion for services between 2013–14 and 2022–23.
During that period, real per capita private agency costs nearly doubled (98%), while spending on public hospital staff increased by only 6%, he noted.
However, these figures are inaccurate, said LeMessurier.
“The report combines agency staffing with all purchased services, such as housekeeping, food services, security, logistics, and others,” he explained. “This means that the amount reportedly paid to private staffing agencies actually includes a large number of purchased services that have been misrepresented as agency staffing costs.”
According to the OHA, the total expenditure for all purchased services—including agency costs—was $3 billion from 2013–14 to 2022–23.
“The data referenced in the report aligns with this figure; however, the amount has been erroneously tripled by adjusting for inflation. It is not accurate to adjust previously purchased services expenditures to current dollars—and the report does not do the same for hospital compensation expenditures.”
LeMessurier added that Ontario hospitals were actively responding to the COVID-19 pandemic over multiple years, requiring many one-time service expenditures as part of the province’s response—including assessment centres and vaccination clinics
LeMessurier also said that Longhirst—in describing what Ontario hospitals spent on employed staff in the CCPA report—only included the hourly wage costs for employed hospital staff and ignored other costs, such as pension and benefits.
As a result, the report overlooked approximately 20% of hospital compensation costs, he said.
“The total spending on employee hospital staff compensation over 10 years was $109 billion, which was an increase of 45%.”
The report also compares hours worked solely by agency nursing staff with the costs of all purchased services, implying that hospitals are paying more for less.
“When all purchased service hours are factored in, the overall hours worked and costs of these arrangements are essentially balanced,” said LeMessurier.
LeMessurier also disputed the claim that the government’s use of private staffing firms is undermining long-term workforce investment.
Since 2019–20, the hospital workforce has grown by over 40,000 healthcare workers to more than 280,000. This includes 7,500 additional Registered Nurses (RNs) and 5,600 more Registered Practical Nurses (RPNs).
Hospital vacancy and turnover rates have also improved significantly since the pandemic. Vacancy rates dropped from 10.74% in October 2022 to 4.97% in March 2025, while turnover rates fell from 14.66% to 8.93% over the same period.
“Agency usage at the provincial level is still only a small portion of total nursing hours worked, and the distribution of those hours across regions and hospital types is varied,” said LeMessurier. “While there has been overall growth in agency nurse usage, the total number of hours worked by all RNs in Ontario hospitals has also substantially increased due to growing demands on the healthcare system.”
LeMessurier added that hospitals are “continuing to reduce their reliance on staffing agencies” and emphasized the commitment to working closely with the Ontario government “to strengthen its workforce by providing stable, in-house staffing solutions to meet patient care needs.”
“Hospitals are struggling to recruit and retain permanent staff while public dollars are working at cross purpose by subsidizing private interests with a business model based on hollowing out the public sector workforce and feeding off the public purse,” said Longhurst in the report titled Hollowed out: Ontario public hospitals and the rise of private staffing agencies.
Previously, a former minister of health in British Columbia called on the B.C. government to make some changes when it comes to how it awards contracts for private nursing companies. Also, a Toronto-based private staffing firm was said to have received payment from two provinces so nurses and personal support workers they brought to those places can enjoy free meals — but the firm never gave the workers their free meals, according to a report from The Globe and Mail.
