The Minister of Health, Christian Dubé, wants to reduce the use of private personnel placement agencies in the public network. Since Tuesday, the CIUSSS and the CISSS in seven regions – including Montreal – must “impose” “unfavorable” shifts (evenings, nights and weekends) on the independent workforce. However, at the CIUSSS de l’Est-de-l’Île-de-Montréal, 76% of the hours worked in 2021 by private nurses were during the day, learned the To have to.
The newspaper obtained data on the hours worked by nurses of private agencies in nine health establishments, thanks to the Law on access to documents of public bodies. Only the CIUSSS de l’Est-de-l’Île-de-Montréal, the CISSS de la Montérégie-Center and the Center hospitalier universitaire (CHU) Sainte-Justine provided the figures based on work shifts (day, evening and night), as requested.
We can see that over the past three years, nurses from private agencies have worked mostly during the day at the CIUSSS de l’Est-de-l’Île-de-Montréal. The phenomenon has become more pronounced over the years: the proportion of daytime hours worked was 65% in 2018-2019, 68% in 2019-2020 and 72% in 2020-2021. As for the other shifts, the share of hours worked at night was greater than that of evening.
The situation is different at the CISSS de la Montérégie-Center. In 2019-2020, 40% of hours worked were during the day. This figure rises to 38% in 2020-2021 and 47% for the financial year 2021-2022, still ongoing.
The use of agencies has exploded in many establishments during the pandemic. At the CISSS de l’Outaouais and the CIUSSS de l’Est-de-l’Île-de-Montréal, the number of hours doubled between 2018-2019 and 2020-2021. He quintupled at the CISSS des Îles-de-la-Madeleine. At the CISSS de la Mauricie-et-du-Center-du-Québec, private nurses worked 5,729 hours in 2018-2019, compared to 53,714 in 2020-2021.
The Center hospitalier universitaire de Montréal (CHUM), for its part, affirms that it does not at all use private employment agencies for the nursing workforce. The CHU Sainte-Justine did not use it in 2020-2021, according to the documents obtained.
Measures in seven regions
The new measures announced Tuesday by Christian Dubé – offering “favorable” shifts to staff in the public network and “unfavorable” shifts to private workers – currently only apply to Montreal, Laval, the Montérégie, the Laurentians, Lanaudière, the Capitale-Nationale and Chaudière-Appalaches.
However, the minister asked all CEOs of health establishments to present to him, by 1er December, a “transition plan” aimed at “freeing yourself” from private employment agencies. It has not determined a ratio as to the personnel of the private sector who can work in the public network. Some regions, such as Abitibi-Témiscamingue and the Côte-Nord, depend more on employment agencies, he said at a press briefing.
“I told the CEOs […] get back to me with a suggestion [de ratio], indicated Christian Dubé. But before signing a six month renewal [avec une agence], I want to know why you justify such ratio in your region. “
For the CIUSSS de l’Est-de-l’Île-de-Montréal, this ministerial directive calls for a 180-degree turn. The duty wanted to know how he would get there. The establishment responded by email.
Describing the minister’s announcement “excellent”, the CIUSSS referred to the “difficult vicious circle” in which it finds itself. “The staff leave the establishment to go to work elsewhere, thus forcing the employer to have recourse to MOI [main-d’œuvre indépendante], we write. Staff from agencies frequently refuse to work on unfavorable shifts, which puts pressure on our employees to make themselves available to cover those shifts. Over time, they too eventually quit, which creates the situation we are in. “
Hélène Gravel, president of the association Private companies of nursing personnel of Quebec, considers “excessively high” the number of day shifts offered by the CIUSSS de l’Est-de-l’Île-de-Montréal to the workforce. independent nursing work. She ensures that her firm, based in Estrie and which does business with remote regions, is already filling the evening, night and weekend shifts.
“We don’t choose our shifts,” she says. They come from the network. We respond to requests. We don’t call a CIUSSS to say, “I will answer your requests, just if it’s daytime”. “She finds” completely normal “that the government imposes unfavorable shifts on the agencies, since their mission is to make” repairs “.
A “public” agency
At a press briefing, Minister Christian Dubé also announced his intention to transform the Jecontribue platform into a public human resources agency “which would be flexible for our health network”.
The Deputy CEO of the CIUSSS du Center-Ouest-de-l’Île-de-Montréal, Francine Dupuis, believes that a public agency could be useful in home care services, where the “hours” of work are “broken”. “You have to get people up in the morning, give them their breakfast,” she describes. After that, you leave and you come back in the evening to put them to bed. “
According to Francine Dupuis, this work could be provided by “public labor” which would “increase the volume through the establishments”, such as the five CIUSSS of Montreal.
Damien Contandriopoulos, professor at the School of Nursing at the University of Victoria, thinks the idea of a public agency is “good”. But it would not be necessary, he underlines, that nurses holding a regular position in the public network leave their employment to carry out only replacements in this agency. “It’s going to cause the same damage as private agencies,” he says.
In British Columbia, a platform allows nurses in the network to help out during unfilled shifts, at a “double or triple time” salary, indicates Damien Contandriopoulos. “But this bank is exclusively for nurses who have a stable position,” he says.
The model worked “very well” before COVID-19, he said. “But there are no more nurses who want to do another 12 hour shift after four exhausting days,” he says.