National price for locums ‘won’t fix workforce problems’

3 minute read

NSW is investigating a plan to centrally manage locum allocation and develop a national price, ringing alarm bells.

Suggestions of a national locum price from NSW’s Health Minister have raised concerns from a workforce already “running on fumes” and will likely be “ineffective” if rural work is not suitably incentivised, says the AMA.

In May 2022, the NSW government was issued a scathing report of the state of health services in rural, regional and remote areas, with an unsurprising takeaway: the problem lies with workforce shortages.

As the rollout of the state’s 2022-2032 workforce plan – which was released in May 2022 – continues, NSW Health Minister Ryan Park is promising to make workforce a priority.

“We’re not going to be able to build our way out of this with new facilities and new services,” Mr Park told the ABC last week.

“We have to focus on developing, retaining and attracting the workforce.”

However, one of the state’s proposed initiatives is raising concerns among doctors: a national price for locums.

Mr Park told the broadcaster that NSW Health secretary Susan Pearce was spearheading a program to investigating a national price for locum doctors.

Mr Ryan said the move might manage the “distortion” of locum fees.

Locum agencies have long received criticism for using GP labour shortages to drive up prices.

NSW Health did not reply to The Medical Republic’s questions regarding whether national pricing may impact locum GPs before deadline.

Mr Ryan told the ABC that a “definitive decision” had not yet been made about the proposal.

But the idea is already raising alarm bells for some doctors.

In an open letter to Mr Park and the NSW health secretary, published on LinkedIn yesterday, Dr Josh Case – a locum doctor who has mostly worked in hospitals across southeast Queensland and NSW – raised “great concerns” over the proposal.

“Instituting a ‘national price’ for urgent healthcare vacancies is a short-sighted approach that will accelerate the collapse of our workforce in the long term,” he said.

“You can only ask your workforce to do more work for less pay for so long before you force them to move overseas or exit the healthcare industry altogether.

“Our public health systems have depended on the goodwill of the individuals who work in them for too long.

“And now they’re running on fumes.”

Dr Case labelled any wage-restriction move by the state’s biggest healthcare employer as “grossly anticompetitive” and said it would not be tolerated in any other sector.

Dr Case flagged unpaid overtime, wage theft, workplace bullying, “the rampant credentials arms-race to bypass training bottlenecks” and lack of flexibility as more pressing issues deserving funding.

“If all of our hospitals offered flexible, safe and well-supported employment, perhaps we wouldn’t have to spend a fortune to convince someone to work there in the first place,” he said.

“Particularly for doctors, who are at the mercy of hospitals administrations and specialist colleges, who conspire to dictate when, where and how they work.”

When asked about national pricing for locum doctors by TMR, a spokesperson for the AMA said that while the association “supports mechanisms to address locum arrangements … without addressing the factors driving doctors to become locums, these measures are unlikely to be effective”.

“Workforce is a critical issue for health services.

“There is a need to address the terms and conditions to make it more attractive for doctors to choose to live and work in rural and regional areas.

“This includes not only remuneration but ensuring that doctors are valued.”

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