Lucrative travel nurse contracts a breakdown in process, former N.B. health minister says

Former health minister Dorothy Shephard said a series of travel nurse contracts signed by New Brunswick in 2022 showed a concerning breakdown in normal processes.

“I think one of the biggest concerns with the auditor general’s report is that process failed,” she said.

“It didn’t just fail in one sector, it failed over three separate entities and that’s cause for a little bit of concern and maybe even more investigation.”

The legislature’s public accounts committee is holding three days of hearings to probe $173 million in travel nurse contracts signed by both regional health authorities (RHA) and the Department of Social Development, following an auditor general’s report that concluded the deals “were not reflective of best practices and did not demonstrate value for money.”

Shephard asked deputy health minister Eric Beaulieu to walk through the process for approving invoices, questioning why the AG found that in some cases invoices were being paid out without proper verification that services had been rendered.

Beaulieu said the AG report is a chance for government to address the issues raised, but stressed that the contracts were signed and executed at a time of crisis in the system as hospitals and long-term care facilities faced critical staffing shortages.

“The concerns in the system, whether it was the health system or long-term care system, were significant and obviously shortcuts were done,” he said.

“My point of thanking the auditor general for this work … is how do we improve it to ensure this does not happen again.”

But Shephard, who was shuffled out of the health portfolio shortly before Vitalité signed its first travel nurse contract in July of 2022, said she’s unsure how something as central as invoicing fell apart.

The latest health and medical news emailed to you every Sunday.

“I obviously understand the need to get bodies to the front line, that’s a really easy no-brainer,” she said.

“But the process for paying invoices is usually pretty much the same day in and day out, so that’s why I’m concerned about that failure of process.”

Beaulieu declined to speak with reporters during a break in Tuesday’s hearing.

Opposition parties spent much of their time with Beaulieu trying to determine when the department became aware of and concerned about lucrative contracts Vitalité signed with Canada Health Labs (CHL), which cost as much as $300 an hour for a registered nurse.

Beaulieu said he was aware the health authority was considering using travel nurses to avoid shutdowns of dialysis units and emergency rooms but advised then-trustee Gerald Richard in a fall 2022 meeting to ensure that the length of contracts was kept as short as possible. Health Minister Bruce Fitch was not present at that meeting and Beaulieu said it wasn’t until the spring of 2023 that Fitch and the department became aware of a pair of long-term deals signed with CHL that were causing significant cost overruns.

Vitalite had spent $123 million on travel nurses at the time of the AG’s audit, the majority awarded without requests for proposals to CHL. Vitalité has defended the decision, saying that CHL was one of the only agencies able to provide French language services, but the audit also found that there were minimal French language services required in the contracts.

Liberal health critic Rob McKee says Beaulieu’s story doesn’t quite make sense, when the department was also receiving monthly updates on the fiscal situation of both RHAs.

“For them to say that they weren’t aware of these overruns until later in the fiscal year, I don’t think it really jives,” he said.

“So it’s either them withholding information or government oversight is lacking.”

Green MLA Megan Mitton said she’s most disappointed that the government and RHAs didn’t look for ways to better retain the staff they did have.

“It’s frustrating that they knew these contracts were being signed and made the conscious decision to still not give retention bonuses to nurses even though they were clear calls for that and they had a clear HR issue,” she said.

Horizon CEO Margaret Melanson also appeared before the committee Tuesday. She stressed that the authority saw travel nurses as a short-term fix to deal with an exodus of nurses from the system, compounded by COVID-19 infections.

Melanson also told MLAs that during their request for proposals process, they did consider services from CHL, but opted against the company because it only offered long-term contracts. The average hourly rate for registered nurses sourced by Horizon was $146 an hour, far greater than normal rates, but well below what Vitalité has paid for nurses from CHL.

Horizon is still using about 30 travel nurses, Melanson says, mostly in the Miramichi region, but will permanently stop by the end of August.

CHL did not respond to an interview request.