Dr James Irwin recently resigned as the last fulltime permanent gastro specialist at Palmerston North Hospital, a service now staffed by locums and fill-ins from other districts.<\/p>\n
He\u2019s seen the positive and negative side of using locums.<\/p>\n
\u201cIn a department, where you\u2019ve got a full department and then someone is sick or goes away for a period of time, getting a locum is great because it helps fill holes and helps get work done.<\/p>\n
\u201cYou have an expectation that you\u2019re going to have a full department going forward to deal with all of the long-term stuff and all of the departmental planning, and so forth.\u201d<\/p>\n
Reliance on them, however, was less satisfactory when it became more of a medium-term arrangement, or longer.<\/p>\n
\u201cAs a longer-term employee you\u2019re then the one that\u2019s dealing with all of the chronic disease management and planning for the department.\u201d<\/p>\n
This happened to Irwin.<\/p>\n
In the 2025-26 financial year, Health NZ spent about $220m on locums, up from about $208m in 2024-25 and $209m in 2023-24. The bill was $168m in 2022-23, Health NZ\u2019s first year of operation.<\/p>\n
Irwin said constantly changing faces had an effect on continuity of care for patients too.<\/p>\n
\u201cIt\u2019s a consequence of the transactional model of healthcare.<\/p>\n
\u201cIf you employ a locum and pay them money to do something for six weeks, they come and do that, but they\u2019re not going to want to take on additional responsibility that continues after they finish,\u201d Irwin said.<\/p>\n
\u201cYou need to be employing people in a situation where it\u2019s clear that they\u2019re going to be providing long-term care. That requires a long-term appointment.\u201d<\/p>\n
He said that\u2019s why permanent appointments were needed.<\/p>\n
Budget trimmed after spend increases<\/p>\n
Health NZ national director of people, culture, health and safety Robyn Shearer said the organisation was recruiting overseas and working with medical schools to get more doctors long term.<\/p>\n
\u201cIt\u2019s a global challenge. It is hard to get all the doctors we need,\u201d she said.<\/p>\n
\u201cLocums play a really important role for us in maintaining continuity of care and staffing, particularly in specialities and regions which are harder for us to staff.<\/p>\n
\u201cThey\u2019re an important part of how we fill and manage short-term gaps in our rosters and provide cover for our permanent doctors, in particular, to take a break.\u201d<\/p>\n
New Zealand was competing against other countries for specialists, so Health NZ worked hard to promote the country as a great destination.<\/p>\n
\u201cWe are in a competitive market, there\u2019s no doubt about it, and we have to be prudent financially,\u201d Shearer said.<\/p>\n
\u201cThere is always a balance around what we offer, but we do look at, certainly, what New Zealand has to offer, and you\u2019ll have probably seen we\u2019ve had an influx of doctors in the South Island from America who are promoting New Zealand as a great place to work and live.\u201d<\/p>\n
She said health authorities had always used locums, but more were required as the demand for health services increased, putting pressure on the workforce.<\/p>\n
However, Health NZ was looking to bring the cost under control, cutting the budget for the 2026-27 year to $179m.<\/p>\n
\u201cWe are deliberately looking to have a decrease in our spend. What we are supporting districts and regions with is how we can give them information so they have more awareness of locum use and spend.\u201d<\/p>\n
Shearer said Health NZ regions could look at alternatives, drive recruitment and look at \u201calternate workforce ways of working\u201d such as using nurse practitioners.<\/p>\n
Minister orders reliance to end<\/p>\n
Executive director of senior doctors\u2019 union, the Association of Salaried Medical Specialists Sarah Dalton said locums did quality work, but permanent staff provided better value.<\/p>\n
\u201cWhen you\u2019re relying on locums to help run a service, anything from the complete collapse of the gastroenterology service in Palmerston North through to another service in another part of the country that needs locums on a regular basis to fill gaps in rosters, it is a cost to patients and to colleagues.\u201d<\/p>\n
Patient Voice Aotearoa\u2019s Malcolm Mulholland had another idea to try to hold on to doctors, rather than use more expensive locums.<\/p>\n
\u201cI do not for the life of me know why Health NZ aren\u2019t coming up with a better plan \u2013 something along the lines of getting our best and brightest when they graduate from med school and bonding them in hard-to-staff areas.<\/p>\n
\u201c[Health NZ] could say as part of that bonding, \u2018We\u2019re also going to take care of your student loan.\u2019<\/p>\n
\u201cTo my mind it would still be a cheaper option than looking to employ locums left, right and centre.\u201d<\/p>\n
Health Minister Simeon Brown has written to Health NZ\u2019s chairperson, saying he expects the organisation to move away from depending on locums.<\/p>\n
\u201cAs a priority I expect you to monitor and prioritise shifting away from dependence on locums to recruiting permanent senior medical officers to vacancies \u2013 with an initial focus on regions that have high dependency on locums,\u201d he wrote.<\/p>\n
The minister\u2019s office told RNZ locums would always play a role, as the minister\u2019s priority was to make sure patients received the care they needed, when and where they needed it.<\/p>\n
\u201cHowever, the long-term goal is to build a stronger, more stable workforce, with more permanent staff delivering care across the country, and the minister has made that expectation clear to Health New Zealand.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"Dr James Irwin recently resigned as the last fulltime permanent gastro specialist at Palmerston North Hospital, a service…\n","protected":false},"author":2,"featured_media":536608,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[88140,1975,3528,33912,134,527,2959,4508,1736,222776,1132,117,111,139,69,90,8262],"class_list":["post-536607","post","type-post","status-publish","format-standard","has-post-thumbnail","category-healthcare","tag-88140","tag-at","tag-doctors","tag-ellingham","tag-health","tag-healthcare","tag-high","tag-hits","tag-jimmy","tag-locum","tag-million","tag-new","tag-new-zealand","tag-newzealand","tag-nz","tag-on","tag-spending"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/536607","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/comments?post=536607"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/536607\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media\/536608"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media?parent=536607"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/categories?post=536607"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/tags?post=536607"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}