Calls for stronger regulation of travel nursing agencies are growing as concerns about rising costs, limited oversight and inconsistent practices continue across Canada. Joan Almost, a nursing professor at Queen’s University, says the current system operates like the “wild west,” with agencies charging dramatically different rates and offering little transparency about how public money is spent.
Almost recently completed a 2024 report on private staffing agencies but believes the available data still does not show the full picture. She says there is no consistent national system for tracking how these agencies operate or how much they charge. Without that information, governments cannot compare spending between provinces or understand how much of each contract actually goes to nurses versus the agency.
Some agencies cover travel costs, accommodation or parking for nurses, while others pass those expenses on to the health authority. Almost says this inconsistency makes it hard for governments to monitor spending or assess the true cost of agency nursing.
She argues that provinces need to work together on a national plan for regulation of travel nursing agencies. Governments, she says, must know who these agencies are, what services they provide and how they set their rates.
The use of private agencies has increased sharply. One Quebec health authority worked with at least 262 agencies in 2023–24, a dramatic rise linked to staffing shortages and high demand. Almost says the profit potential is now so high that almost anyone can start an agency.
In Prince Edward Island, unions have raised similar concerns about transparency. Both the PEI Nurses Union (PEINU) and the Union of Public Sector Employees (UPSE) say they struggle to access the same data used by Health PEI. PEINU president Barbara Brookins says the province often fails to share spreadsheets that should be provided under the collective agreement, which requires timely access to staffing reports.
Goodwill Staffing and Recruitment, the agency receiving the most money from Health PEI, did not provide a spokesperson for an interview. Northern Medical Connections also did not respond to a request for comment.
