Information received under the Official Information Act shows Te Whatu Ora Lakes spent $5,092,110.94 last year on outsourced/locum medical specialists. Photo / Andrew Warner
Information received under the Official Information Act shows Te Whatu Ora Lakes spent $5,092,110.94 last year on outsourced/locum medical specialists. Photo / Andrew Warner
More than $5 million was spent on outsourced/locum medical specialists in Te Whatu Ora Health NZ Lakes hospitals last year, records shows.
“With so many vacancies, Te Whatu Orais reliant on locums. To attract locums, Te Whatu Ora has to pay higher rates,” Association of Salaried Medical Specialists executive director Sarah Dalton said.
She said there would be “real financial benefits” if Te Whatu Ora employed a full roster of doctors and was not “reliant on paying locum rates and additional duty rates to cover gaps”.
Te Whatu Ora said locums have been used “for decades” to fill service gaps, cover sickness and leave, and reduce surgery wait times.
Initiatives to grow the medical workforce included adding medical school places, creating immigration hubs overseas to help recruit specialists and helping more junior doctors train faster for specialist roles.
Which department received the most money for locums?
Records released under the Official Information Act showed Te Whatu Ora Lakes spent just over $5m last year on outsourced/locum medical specialists at Rotorua and Taupō Hospitals.
The department recording the highest spend was the mental health department, where just over $1.5m was spent.
This was followed by medical physicians, who received just under $950,000, and emergency physicians who received about $725,000.
Te Whatu Ora was asked for the number of outsourced/locum medical specialists it employed last year, however, the request was refused under section 18(f) of the act, for reasons of “substantial collation and research” being required to gather the information.
Dalton said the data showed the cost of the shortage of senior medical officers in New Zealand and the need to train and retain its medical workforce.
She said locums were used when there were not enough employed specialists to cover staffing gaps.
Dalton said Te Whatu Ora had 738 vacant positions for senior medical officers in November.
Association of Salaried Medical Specialists executive director Sarah Dalton.
She said there were also unadvertised vacancies and “many services and departments” that did not have the staffing to provide the expected level of service.
“Reliance on locums also carries other costs, such as less ability to train and support resident medical officers.”
Dalton said many locums were already employed in other parts of the health system and performed locum duties on top of their workload. She said doctors recognised staffing gaps would cause patients to suffer.
“They undertake locum work and additional duties to minimise the disruption in their care. But this comes at the risk of fatigue and burnout and contributes to their inability to take leave.”
Dalton said the union’s collective agreement with Te Whatu Ora had annual salaries for members between $185,380 and $267,980.
Te Whatu Ora responds
In a statement, Health New Zealand Te Whatu Ora chief people officer Andrew Slater said the agency knew its medical workforce across the board was under pressure and addressing it was a “top priority”.
Slater said its senior medical officer workforce grew in the 12 months to December 2023 by 207 full-time equivalents to 5359.
“Our vacancy rate has continued to trend downwards.
“While we have more doctors per person than ever before, we’re still well short of the number and diversity needed to provide everyone with exceptional care, especially in rural areas.”
This meant, from “time to time”, it needed to use temporary and locum staff to fill gaps to ensure service continuity or reduce surgery wait times, Slater said.
“This is something the health system has done for decades.
“Our absolute preference is to have permanent staff performing these duties wherever possible, noting it takes many years to train our medical workforce and we face global competition for staff.”
Permanent staff were better placed to offer continuity of care, knew their community, and strengthened local services.
Initiatives under way to grow the medical workforce included adding 50 new medical school places from this year and two pilots run to help a further 20 overseas-qualified doctors practice in New Zealand each year.
There is also a commitment to launching physical immigration hubs in key places overseas to recruit specialists and working to establish more training and fellowship roles to help more junior doctors train faster for specialist roles.
Slater said locums were used for a range of reasons and varied from area to area, often driven by the size of the local team.
Reasons for employing a locum included staffing gaps due to sickness, leave or unfilled posts. Locums are most often required for weekend and acute calls, he said.
“At times locums can also be employed to address surges in demand or reduce numbers of people waiting.”
Decisions about locum use were made locally based on the ability to staff a service, the cover available from local staff, and workload.
Locum availability was also an increasing factor behind when they were used. While a locum may be considered necessary, their services could not always be secured, Slater said.
In the neighbouring Bay of Plenty region, $8,633,384 was spent on outsourced/locum medical specialists last year.
Megan Wilson is a health and general news reporter for the Bay of Plenty Times and Rotorua Daily Post. She has been a journalist since 2021.
