KEY POINTS:
Hospitals in Auckland are headed for another winter of discontent, with one in 10 junior doctor positions vacant.
That is expected to worsen to 14 per cent by August, predicts the Auckland Regional Resident Medical Officers Service, the agency set up by the three Auckland district health boards to employ and train junior doctors.
General manager Peter Guthrie could not rule out another winter shortage like last year, when one in five house officer positions went unfilled. The vacancy rate for house officers - medical graduates in their first or second year of practice - has traditionally been 0 per cent.
"It's very hard to predict. Last year was a very exceptional year."
The shortage sparked a bidding war for casual fill-ins, or locums, in order to ensure safe staffing levels. A locum could expect to earn $60 an hour, but the rate shot up to $85 to $100 an hour on short notice.
But the shortage became so acute that the three health boards in September raised the fill-in rate to $150 an hour - more than what a senior doctor under their collective contract gets when called in to perform junior doctor duties.
Documents obtained by the Herald through the Official Information Act reveal that the Auckland DHB, paid one locum $2700 for a nine-hour shift. That was a one-off, with the board's average spend being $604 a shift.
The documents also show that by October, spending on locums by the three boards last year had surpassed the entire 2006 spend of $4.3 million.
Mr Guthrie said the agency will be recruiting in London in March and October this year to try to fill the shortage. It was also working with the union on better defining the career paths of junior doctors.
The annual winter shortage has traditionally been caused by an exodus of junior doctors to the UK to gain overseas experience.
The collaboration with the union, said Mr Guthrie, is intended to make staying in the Auckland region an attractive option.
Dr Stephen Child, a member of the District Health Boards of NZ medical workforce strategy group, believes shortages are going to be high this winter.
"The vacancy rates are continuing to increase. The primary problem is that we are creating more jobs than we are graduating people. So we've created 350 to 500 new jobs in the last five years and the medical school output hasn't matched that."
The number of overseas doctors applying to come to New Zealand has also fallen away.
Dr Child said there needed to be a rethink about how staff were deployed.
"At the moment we have the same system that we've been using for over 150 years. We have a new generation, we have new demands, we have new technology and yet we're still using the same system."
* THE NUMBERS
Auckland region's junior doctor shortages:
Current shortage: 35 vacancies (10.1 per cent) out of 345 house officer positions.
By February 25, 40 vacancies (11.6 per cent).
By May 26, 44 vacancies (12.8 per cent).
By August 25, 48 vacancies (13.9 per cent).
Source: Auckland Regional Resident Medical Officers Service
