Cost of young doctors filling workplace shortage doubles in a year

The cost of young doctors working overtime to cover labor shortages has soared to more than $70 million a year.

Costs for 2022-23 were more than double the previous year, when they were $33 million, figures generated for RNZ by Te Whatu Ora show.

They were also 2.6 times higher than the $23 million paid in 2020, when doctors worked long hours to deal with the Covid pandemic.

Health NZ was forced, due to large roster gaps, to virtually double the rate it paid per shift in June 2022.

“My reaction when I saw the numbers was, ‘Wow, it really is that bad,'” said Resident Doctors Association (RDA) national secretary Dr. Deborah Powell.

“For me they were new figures, but with 400-500 vacant positions for resident doctors they were not a surprise either.”

Health NZ agreed to pay almost double per hour in mid-2022 for “additional duties” in which junior doctors performed evening, night and weekend shifts in addition to their normal working hours, as well as a much smaller amount for ” cross coverage”. “work to fill gaps in daytime shifts.

These higher rates were due to stop last month, but they continued.

“There are still gaps as some shifts and services have not been able to fill them,” Health NZ said in the OIA provided to RNZ.

Historically, after-hours shifts have been difficult to fill.

“The enhanced payments were to recognize that we needed coverage for those changes.”

Powell said it was a “vicious cycle”, with closing gaps at high cost taking money away from the regular pay rises needed to help retain staff.

“It took an increase in rates to get them to cover the coverage,” he said.

“But they don’t want to. They already work 60 hours a week… they don’t want to suffer the consequences of being tired and making a mistake.”

He said young doctors were not taking advantage of the system. “No, the residents (junior doctors) know that we have to cover the shifts, otherwise there will be no doctor.”

It took Health NZ more than a year to provide the junior doctor’s information to RNZ; By law, it should take five weeks.

“I am very sorry for the delay,” wrote Sasha Wood, head of government services.

The high costs increased pressure on districts that were ordered by the government last month to save $105 million on staff by the end of June.

“The higher fees are higher than budgeted, which will impact outcomes,” Whanganui District said of junior doctors’ fees.

The 2,500 junior doctors of the Resident Doctors Association are striking over pay issues.

Tuesday’s strike will be followed by another two-day strike starting next Thursday morning. Senior doctors have often had to cover for them.

Most have been offered a 20 percent pay rise, but not all: others would get a 12 percent pay cut, creating a division that has motivated strikers.

“We are such an undervalued but integral part of the hospital,” a Waikato Hospital medical registrar told a picket line.

OIA figures show some districts paid more than double between the 2021-22 and 2022-23 financial years. Northland paid almost four times as much ($3.2 million versus $840,000), Waikato paid 3.3 times as much and MidCentral’s costs were 2.6 times as much.

Capital and Costa paid 2.3 times more, and also exceeded the total costs in additional rights and cross coverage of any district: $13.4 million, an increase of $7 million in just 12 months.

This was well ahead of Canterbury ($10 million) and Auckland ($8.7 million).

The embattled Southern District had to find an additional $2.27 million to cover extra pay for junior doctors that it had not budgeted for.

While higher rates had helped close the gaps, “manpower shortages” and higher rates of unplanned leave for both junior doctors and senior doctors had had an opposite effect, the OIA showed.

This was reflected in the Hutt, Capital Coast and Wairarapa districts by stating: “While these fees add to the district’s overall salary costs, this is offset by the districts’ RMO (resident medical officer) vacancy rates” .

Vacancies were the problem, Powell said.

“If we can solve our retention problems, we will not need to pay this money.

“An investment in getting retention right will pay off by not having to pay this money and overall we will be in a much better financial situation and have enough doctors to care for our patients.”

Health NZ chief people officer Andrew Slater said in a statement that work pressures were being felt on the frontline “and these shortages are having an impact on our people”.

“We recognize your contribution and commitment to serving your patients and communities,” he said.

“We can’t fix that shortage quickly.”

An additional 50 new places will be opened in medical schools from this year as a “first step” to boost local training, and a support service for young doctors is being developed, Slater said.

At the OIA, Te Whatu Ora said there was no evidence that junior doctors were cheating the system, such as using replacement days with the agreement that a colleague would work for them and charging the highest additional duty payment, and then requesting your own replacement day. .

A joint agency-union group met to ensure that any violations were clamped down on and that “neither party raised it as a concern or witnessed practice.”