Private nursing agencies cashed in while BC hospitals struggled
A national surge in public healthcare dollars flowing to for-profit nursing agencies has highlighted long-standing structural failures in Canada’s nursing workforce, with British Columbia emerging as one of the most costly and systemically unstable examples on a per-capita basis.
A recent report from the Canadian Federation of Nurses Unions (CFNU) estimates that more than $1.5 billion has been spent by health authorities across the country on private nursing contractors in just the past five years. Intended originally to fill temporary staffing gaps in rural areas, such agencies have become a financial mainstay of provincial health systems. BC alone accounted for $162 million of that total in 2022 — a 29 percent jump from just two years earlier.
But while other provinces face similar pressures, BC’s public spending trajectory is increasingly alarming.
According to a recent CTV News investigation, British Columbia’s health authorities have paid $508 million to private nursing agencies over the last two fiscal years. The figures, obtained following months of requests, show that every regional health authority in the province has significantly increased its reliance on outsourced nursing staff since 2019.
Northern Health, the geographically largest authority, went from $12.6 million in agency spending in 2019–20 to $92.2 million in 2024–25. That total represented nearly one-fifth of its nursing budget. Vancouver Coastal Health grew its agency spending from $5.7 million to $43 million over the same period, despite housing the province’s largest concentration of full-time, unionized healthcare workers.
‘BC has created a parallel workforce it can barely afford and cannot function without’
The exponential cost growth runs counter to the provincial government’s claims. In public statements, the BC Ministry of Health has said it placed a moratorium on new agency contracts in 2022, followed by a renegotiation of existing agreements in 2024, which it claimed would “significantly limit” their use. Yet the data indicates that not only has agency nursing continued — it has intensified.
That contradiction has placed the province in a precarious fiscal position. On paper, agency nurses are a stopgap, brought in to plug short-term scheduling gaps. In practice, they are now embedded in daily operations across emergency rooms, acute care wards, and long-term facilities. With their services costing significantly more than unionized staff, and their contracts flowing through for-profit intermediaries, British Columbia has created a parallel workforce it can barely afford and cannot function without.
The province has attempted to address the issue through GoHealthBC, a public travel-nurse program launched in 2023 under Northern Health. The initiative was designed to deploy the equivalent of 530 full-time nurses across 40 rural and remote communities, to replace agency deployments with unionized, provincially controlled staffing. While the program remains operational, it has not meaningfully slowed the financial outflow to private firms.
International recruitment and billions in federal funding
In addition to deploying programs like GoHealthBC, the province has also tried to address the nursing shortage through international recruitment. In April 2022, under former Premier John Horgan, the province announced a set of reforms aimed at making it easier for internationally educated nurses to get licensed and registered.
At the time, then-Health Minister Adrian Dix described the process for foreign-trained nurses as complex, expensive, and often taking years. The changes were supported by the BC College of Nurses and Midwives, the Nursing Community Assessment Service, and Health Match BC.
The province allocated $12 million to the initiative, including funding for bursaries, a streamlined application process, and a marketing campaign to position BC as a “desirable” destination for healthcare workers.
Nearly a year later, Health Canada and the provincial government announced a new funding agreement, with more than $27 billion allocated to BC over ten years. This includes $3.32 billion through a bilateral deal targeting shared healthcare priorities and $273 million in a one-time top-up for urgent system needs. The funding forms part of a broader federal investment of $198 billion over a decade to stabilize healthcare across the country.
Despite these efforts and funding, publicly available workforce data shows that BC’s nursing vacancy crisis is deepening. According to Statistics Canada, the province had 5,080 open nursing positions as of spring 2024, placing more strain on scheduling and further justifying the use of temporary labour. But this shortfall doesn’t just stem from training capacity. A major factor is attrition.
‘What was once a contingency plan has become a budget line’
A province-wide survey conducted by the BC Nurses’ Union in May 2024 revealed a bleak portrait of working conditions. Over 80 percent of nurses reported monthly exposure to verbal or emotional abuse. Half said they were short-staffed every single day. One in three were actively planning to leave the profession. The conditions were consistent across every health authority in the province, with particularly high rates of reported short-staffing in places like Island Health and Fraser Health, where more than 95 percent of nurses said they worked short-staffed at least once a month.
(Courtesy of CPN Union)
The Ministry of Health has repeatedly pointed to investments in international recruitment, increased training seats, and expansion of the Employed Student Nurse program as signs of progress. But these efforts have not yet shifted the province’s financial dependency on agencies, nor addressed the environmental conditions driving nurses away from permanent public roles.
As BC runs a record provincial deficit, spending half a billion dollars on agency nurses reflects a broken system. With that money, the province could have hired and retained thousands of permanent nurses. Instead, it has paid premiums to staffing companies — a short-term fix that now looks permanent.
What was once a contingency plan has become a budget line.
