In the public health system, demand for nurses far exceeds supply. This is a business person’s dream. So why blame nursing agencies for taking advantage of these market forces to make some money?
Those who manage nursing agencies understand how a healthcare ‘market-place’ works. In particular, they recognise that there is a shortage of nurses, particularly specialist nurses. In such an environment, the market sorts out what is a reasonable price. This is how all free markets work. But do we want healthcare handed over to market forces?
Current healthcare policies support a range of entrepreneurial activity in the healthcare ‘industry’. This indicates that healthcare is fast becoming a commodity in a free market. We see this in the growth of nursing agencies and money-making medical clinics.
So why does the government support money-making medical clinics and object to money-making nursing agencies? The government needs to make up its mind. If it objects to one group of healthcare professionals operating in the free market, it must surely object to others.
The chronic shortage of experience and qualified nurses working in the public hospital system was caused by a complex range of factors, including a remarkable lack of vision by policy makers. Rather than take some responsibility for the shortage, the government chooses to play political football by shifting our attention towards greedy nursing agencies. Making nursing agencies scapegoats is no substitute for a responsible healthcare policy. The government objects to the fees the nursing agencies charge public hospitals. Yes it is not only the $1 million a week that worries the government. It is also concerned that nursing agencies, not bedside nurses, are taking a large percentage of the exorbitant fee. Would the government feel better about the fee if bedside nurses receive the lot? Or perhaps they would prefer the agencies to run as cooperatives, with nurses sharing the profits.
The government’s response to nursing agencies perhaps reflects the common view that nursing is a caring, not a money-making, profession. We accept a bill for $100 for a 10 minute appointment with the specialist doctor. Why should we object to a specialist bedside nurse earning $80 an hour on weekends?
Do policymakers have any idea what a bedside nurse does during a shift? Those who manage nursing agencies do. They are often nurses themselves. They understand the demands on nurses at the bedside.
As such, agency nurses are employed with attractive work conditions including salaries according to skill and experience, flexible hours, ongoing education and supportive packages. Given the state of our underfunded public system, is it surprising that so many nurses choose to work for nursing agencies?
The growth of nursing agencies over the past decade coincides with the increase of medical manages in the healthcare system. As nursing agencies become more corporate, they inevitably focus on business indicators such as outputs and deliverables. This shift makes nursing agencies no different from other businesses, including corporate medical clinics.
If the government is serious in his objections to corporate health care, it must focus on the healthcare system in general, not merely a few nurses who have shown business acumen. After all, nursing agencies are merely working in the current healthcare environment that is supported by current government policies.
To demonstrate its commitment to both patient care and the healthcare professionals who work in the public health care system, the government must address systemic issues. In particular, it must ask fundamental questions about the underlying causes for the nursing shortage.
Providing attractive work conditions helps nursing agencies to recruit staff. Maybe attractive work conditions would also help public hospitals to attract new graduates and retain experienced nurses. Public hospitals need to value nurses. Otherwise both patient care and hospital budgets will continue to suffer.
First published in The Age on 11 October 2002