The Minister of Health and Social Services, Christian Dubé, wants to reduce the use of private personnel placement agencies in the public network. It has asked the CIUSSSs and CISSSs of the greater Montreal and Quebec City regions to submit plans to achieve this in December. The duty learned that healthcare institutions aim to return to their lowest rate of use of freelance workers since 2019, then to reduce this by 25% by September and 50% by September 31 March 2023.
The duty obtained plans to reduce the use of independent labor in four healthcare establishments, thanks to the Act respecting access to documents held by public bodies. The CIUSSS du Centre-Sud-de-l’Île-de-Montréal indicates in its own that it intends to increase its rate of hours worked by agency staff by 7.59% (figure dating from last November) to 4.14% (the lowest rate recorded between 2019-2020 or 2020-2021), then to 3.11% by the 1er September and 2.07% by March 31, 2023.
Goals jeopardized by successive waves of COVID-19? The duty was unable to obtain an interview from the CIUSSS du Centre-Sud-de-l’Île-de-Montréal, nor from the three other health establishments cited in the text. However, the CIUSSS specified that its rate of recourse to independent labor was 5.66% for the period from January 2 to 29. In an email, the organization points out that the Omicron wave “has slowed down [sa] ability to highlight [son] plan to reduce the use of independent labour”.
At the worst of the crisis, in January, “nearly 2,000 employees were absent,” it says.
“The current lull allows us to invest even more energy in recruiting personnel. Managers were invited to solicit agency staff who work in their department at [se] join [aux] CIUSSS teams. An “accelerated recruitment process” enabled the hiring of about fifteen people from agencies.
According to the Union of Health Care Professionals of Centre-Sud-de-l’Île-de-Montréal, affiliated with the FIQ, reaching the target of 2.07% within a year is unrealistic. “We are in shortage of nurses, says its interim president, Denis Joubert. It is missing everywhere, even with [la présence de] independent labor. »
Many agency nurses remain in the field, he says. Many, however, were transferred to unfavorable shifts (evening and night), as requested by Quebec. “I saw it in the emergency room of Notre-Dame hospital and at the Mental Health and Dependency Department,” says Denis Joubert.
Unequal overtime
The 25% and 50% reduction targets also appear in the CISSS de la Montérégie-Centre plan. The health establishments of the Greater Montreal area worked together, as evidenced by the “514-450 initiative” seal affixed to this plan as well as to that of the CIUSSS du Centre-Sud-de-l’Île-de-Montréal.
For its part, the CISSS de Laval wants to achieve a rate of recourse to independent labor of 1.67% in 2022-2023. In an email, the organization claims to have also “slowed down the implementation of certain measures provided for in the plan” during the fifth wave. Contrary to what is advocated in its plan, new agency staff have been directed to replace caregivers absent due to Omicron, recognizes the CISSS.
“With the current period of calm, the CISSS has resumed the implementation of all the measures provided for in the plan,” we wrote in an email. No new contract has been signed with an agency. More than a hundred employees in nursing and cardiorespiratory care have been hired thanks to a recent recruitment campaign, underlines the establishment.
The Union of Nurses, Respiratory Therapists and Auxiliary Nurses of Laval (CSQ) deplores the fact that independent workers are not subject to mandatory overtime (TSO). In its plan, the CISSS cites among its measures the introduction of “the application of the TSO for personnel coming from agencies”. “Members often tell us: ‘Oh well, I stayed in TSO, and the agency employee was able to leave,’” relates Déreck Cyr, interim president of the union.
At the CISSS de Chaudière-Appalaches, it is confirmed that the 20% reduction target, set in its plan, was not reached in March as planned due to the fifth wave. The file is however in “active development”. “The establishments of the Quebec region and Chaudière-Appalaches create a pole so that they all adopt concerted measures”, one writes.
According to Hélène Gravel, president of the Association of private healthcare personnel in Quebec, the rate of recourse to independent labor in the province is generally around 3%. “It was higher in times of pandemic because we were really active for vaccination,” she said. It reports that its members have not seen a “major change” since the CIUSSS and CISSS plans were filed with the Ministry of Health and Social Services in December 2021.
The association will closely follow the presentation on Tuesday morning of Minister Dubé’s plan to modernize the health system. “It is supposed to give space to the private sector, says Hélène Gravel. How will it be? She says she is “totally in agreement” with there being a “supervision of the independent workforce”.