Latest news with #staffShortages
RNZ News
03-07-2025
- Health
- RNZ News
Money spent on locum doctors could be used to attract and retain permanent staff
Health NZ has spent almost $45m on locum doctors in the Midlands Te Manawa Taki region including Waikato, in less than a year. Photo: Supplied/ Waikato Hospital The amount of money Health New Zealand is spending each year on locum doctors to plug staff shortages is increasing by tens of millions of dollars a year, and could reach $200 million this year. RNZ has obtained figures that show the spend on fill-ins is rising fast, leading a frontline doctor and the senior doctors' union to voice frustration. Dr Ralston D'Souza is a rural hospital medicine specialist at Taupō Hospital, where a shortage of senior doctors means there's a revolving door of locums. "The frustration though is that we're being told constantly there's no money to improve recruitment and retention of our permanent staff in terms of any initiatives, but there's no limit, it seems, at spending money on locums." Health's a big-budget item. It's expected the government will spend $32.7 billion in the 2025-26 financial year. The figures RNZ has obtained show in the 2022-23 financial year, the cost of "outsourced specialist medical staffing" was more than $150 million. It was more than $183m in 2023-24 and for the nine months to March in the 2024-25 financial year it climbed over $155m, meaning it was on track to break $200m for the full year. Health NZ doesn't "hold records centrally" before its creation in July 2022, when locum spends were managed by district health boards. D'Souza wasn't surprised to see that growth. "We know on the ground that locums probably get paid three to four times more than a permanent staff member, but the locums don't actually do anything apart from service delivery. "They don't contribute to the training of the other staff, including resident [junior] doctors, and they don't improve the quality of the service in terms of quality-improvement initiatives." Health NZ won't release its full list of rates for locum work, but has given RNZ a summary, which shows junior doctors get between $55 and $130 an hour, and seniors between $1500 and $3000 a day. D'Souza wants officials to think about why it's so difficult to recruit and retain permanent specialists. "Health New Zealand seems to be spending a lot of resources on being reactive when a gap occurs, but they're not spending as much resource on being proactive - understanding why the gap has occurred in the first place." Health NZ's interim chief human resources officer Fiona McCarthy said although Health NZ would rather employ permanent medical specialists, locums had been used for decades. "Locums for specialist medical staffing are used for a diverse range of medical specialities, including general surgeons, anaesthetists, psychiatrists, sonographers, cardiologists amongst many others," she said. "Reasons for employing a locum can include staffing gaps due to sickness, leave or unfilled posts. "Locums are most often required for weekend and acute calls. At times locums can also be employed to address surges in demand or reduce waitlists." McCarthy said there were "long-standing workforce challenges" in some specialist areas, and officials were "working at pace to address this to ensure the needs of local communities continue to be prioritised". Health NZ grew its clinical workforce by 1689 full-time equivalent staff members in the 2024 calendar year, she said. The senior doctors' union head Sarah Dalton says there's a large number of locums working in New Zealand. Photo: LDR / Stuff / Kevin Stent Association of Salaried Medical Specialists executive director Sarah Dalton said the problem of specialist shortages was sizeable. "If you want to think about how many locums are being paid in a year to work in our system, we were looking at the numbers and thinking that's the equivalent of the entire medical staff of either Waikato or Waitematā districts." RNZ asked Health NZ for the number of locums it uses, but it said it didn't have that information, instead providing full-time equivalent figures that show 374 FTEs were used in the first nine months of the 2024-25 financial year, and 380 the previous year. It did, however, provide regional breakdowns, and in the 2024-25 year's first nine months the largest locum spend was in Te Manawa Taki Midlands region, at just under $45m. The region includes Waikato, Bay of Plenty, Lakes, Taranaki and Tairāwhiti. The central region, including Palmerston North, Whanganui and Wellington, spent just over $44m. RNZ also asked for a breakdown in figures by speciality, but was told this couldn't be done because the information "is not held in that form and would require considerable technical expertise to create". Sarah Dalton and the association, the senior doctors' union, were critical of this. Union officials knew, for example, of shortages in psychiatry, and had heard anecdotal evidence of psychiatrists giving up permanent work for locum jobs, but there were gaps in knowledge in other areas. "That's an endless bugbear for us, that they [Health NZ] aren't doing sufficient work on their workforce, current or future planning, to have an intelligent or informed conversation about the state of the problem," Dalton said. "But, what we can see from this data is they are spending more and more money on locums. It is a wildly expensive way to staff hospital." Settling senior doctors' collective agreement claims would cost less than a quarter of the annual outsourced specialist spend, she said. An over reliance on locums led to lower productivity, while permanent staff were burdened with doing the tough shifts temporary workers turned down. "It's incentivising our senior doctors to pick up locum work at the expense of a salaried job. "We really need to turn that around and that's what we've been trying to do by trying to look at improved conditions, recruitment and retention payments, and bonuses for people who choose to work only in public [hospitals]." Health Minister Simeon Brown said locums play an important role. Photo: Nathan Mckinnon / RNZ Patient Voice Aotearoa's Malcolm Mulholland has heard at the advocacy group's nationwide roadshows endless stories about how staff shortages are affecting patients and the health workforce. "The sad picture that it paints is that it's a horrific cost and one would have to think are these resources best allocated elsewhere in the health system? "I can't help but think that perhaps we need to bolster something like the bonding system in hard-to-staff areas, which is traditionally where locums are needed." Health Minister Simeon Brown said his priority was to make sure patients received the care they needed, where they needed it. "Locums play an important role in keeping services running, especially in hard-to-staff areas, but ultimately, we want more permanent staff delivering care across New Zealand," he said. "Since 2023, we've grown our health workforce, with over 1700 more nurses and more than 200 additional doctors employed by Health New Zealand as at December last year. "That's real progress, but there is more to do." Brown said the challenge wasn't unique to New Zealand and there was a "global war for talent in healthcare". Given the better pay rates and flexibility, even D'Souza had considered joining the army of temporary medical specialists. "I think that's definitely a thought that's occurred to all permanent staff and it goes back to that there's probably no great incentive to be permanently employed. "All of us are probably sticking at it because of the goodwill we have towards our community, towards our patients." Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
The Independent
04-06-2025
- Health
- The Independent
‘Postcode lottery' sees cancer patients face delays to treatment
A new report has revealed that cancer patients across the UK are experiencing "dangerous" delays in their care due to widespread staff shortages. The Royal College of Radiologists (RCR) has warned that these gaps in the cancer workforce are putting patient safety at risk. Despite some increases in staffing, the college asserts that these are not keeping pace with the growing demand from patients. The RCR has called on the government to take immediate action to address what it describes as a "ticking time bomb" for cancer patients. According to the RCR, pledges to reduce cancer waiting lists are unattainable without an increase in staff. Their reports on oncology and radiology staffing shortages highlight that these issues are creating a "postcode lottery" for patients, with smaller cancer centres more likely to report concerns over workforce shortages. The report on oncologists, or cancer doctors, indicates that 70 per cent of heads of service at cancer centres are worried about the impact of workforce shortages on patient safety. Furthermore, 23 per cent reported that they were unable to hire additional staff due to recruitment freezes. One consultant clinical oncologist told the RCR: 'Safe delivery of cancer treatment is becoming increasingly impossible.' Another said: 'Our waiting times for breast radiotherapy are now the worst I have ever known in 20 years. Patients are waiting over four weeks to be seen … and then another eight weeks to start radiotherapy.' Meanwhile, the report on radiologists – the specialists who use clinical images to diagnose, treat and manage medical conditions and diseases, including cancer – highlights how the radiology workforce grew by 4.7% in 2024, but demand for CT and MRI imaging grew by 8%. One consultant radiologist said: 'Patients are waiting longer than they should … and we have had several delayed cancer diagnoses as a result.' The RCR has predicted that by 2029 there will be a 39% shortfall in the number of radiologists in the UK, and there will be a 19% shortfall in oncologists. The college said workforce pressures are also forcing staff to take early retirement – the average age of radiologists leaving the NHS workforce is now just 50 years old, down from 55 in 2020, and the average age a consultant clinical oncologist leaves is now 54, from 59 in 2022. Dr Katharine Halliday, president of the Royal College of Radiologists, said: 'Patients are being failed by a chronic lack of radiologists and oncologists. 'Despite the best efforts of NHS staff, there aren't enough doctors to ensure prompt, safe and effective care – and the outlook is bleak. 'We are doing all we can to boost productivity, but there's a limit to how far we can go. The reality is we simply don't have enough staff. 'Any credible plan to cut waiting lists relies on having the headcount to meet the demand we face today, let alone tomorrow. 'The longer we delay action, the worse it gets. The government must train up more radiologists and oncologists to defuse this ticking time bomb for cancer diagnosis and treatment.' Commenting on the report, Genevieve Edwards, chief executive of Bowel Cancer UK, said: '(Bowel cancer) is treatable and curable if diagnosed early, but too many patients are facing long delays to start their treatment after going to their GP with symptoms. 'These delays may lead to the cancer spreading, making it harder to treat successfully. 'To fix this problem we must address the longstanding shortage of staff and equipment to deliver diagnostic and treatment services and meet the growing demand.' Chiara De Biase, from Prostate Cancer UK, added: 'These latest findings are extremely concerning. Prostate Cancer UK would urge the Government to look at the RCR's recommendations to ensure the workforce required to diagnose and treat the most common cancer in England are in post, trained and supported to execute their roles to best of their abilities.' Claire Rowney, chief executive at Breast Cancer Now, added: 'The worrying reality right now is that staff shortages continue to deny far too many people with breast cancer a timely diagnosis and quick access to potentially lifesaving treatments that they should be able to count on. 'Instead, they're facing long, anxious waits for this care. 'We recognise the intense challenges facing the health service, and the tireless efforts of its hard-working staff. 'However, this situation has to be addressed and the Government's upcoming national cancer plan for England offers a vital opportunity to bring about this much-needed change.' A Department of Health and Social Care spokesperson said: 'This Government inherited a broken NHS where too many cancer patients are waiting too long for treatment. But through our Plan for Change, we are determined to tackle delays, diagnose cancer earlier and treat it faster. 'We are delivering 40,000 more appointments every week, investing £1.5 billion in both new surgical hubs and AI scanners, rolling out cutting-edge radiotherapy machines to every region in the country, and backing our radiologists and oncologists with above-inflation pay rises for the second year in a row. 'Later this year we will also publish a refreshed workforce plan to ensure the NHS has the right people in the right places to deliver the care patients need.'
RNZ News
28-05-2025
- General
- RNZ News
Hundreds of Auckland nurses start on-call strike
Theatre nurses at Auckland City Hospital say there are chronic staff shortages in the city. File photo. Photo: RNZ / Marika Khabazi More than 370 theatre nurses at Auckland hospitals have begun a month-long on-call strike, in response to under-staffing concerns. Members of the New Zealand Nurses Organisation working at Auckland City Hospital, Starship Hospital and Greenlane Hospital are refusing to be on-call from now until 23 June. Starship nurse Haim Ainsworth said there were chronic and ongoing staff shortages in Auckland's hospitals. He said nurses were forced to work longer than they should, were not being paid properly for overtime, and patients were being put at risk. Te Whatu Ora has been approached for comment. Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
