Health NZ's reliance on locum doctors has reached a critical juncture, with spending on temporary medical staff soaring to unprecedented heights. The latest figures reveal a staggering $220 million spent on locums in the 2025-26 financial year, a significant jump from the previous years. This trend has sparked intense debate within the healthcare sector, with experts weighing in on the implications and potential solutions. The question remains: How can New Zealand's healthcare system strike a balance between short-term staffing needs and long-term sustainability?
Locums play a crucial role in maintaining continuity of care and staffing, especially in specialties and regions that are challenging to staff. They provide a vital safety net during short-term gaps in rosters and cover for permanent doctors who need breaks. However, the constant reliance on locums raises concerns about the transactional nature of healthcare. As Dr. James Irwin, a former permanent gastro specialist, points out, locums may not be inclined to take on additional responsibilities that extend beyond their initial six-week contract. This transactional model can disrupt the long-term care and planning essential for effective healthcare management.
The rising costs of locum services are a cause for concern. Health NZ's budget for locums has increased year after year, reaching $220 million in the 2025-26 financial year. This surge in spending has prompted Health NZ to take action, cutting the budget for the 2026-27 year to $179 million. The organization is actively working on recruitment strategies, both domestically and internationally, to address the shortage of doctors. They are collaborating with medical schools and promoting New Zealand as an attractive destination for medical professionals.
Despite these efforts, the healthcare sector calls for more drastic measures. The Association of Salaried Medical Specialists' executive director, Sarah Dalton, emphasizes the value of permanent staff over locums. She argues that relying on locums can lead to service disruptions and increased costs for patients and colleagues. Malcolm Mulholland from Patient Voice Aotearoa suggests a novel approach: bonding graduating medical students to hard-to-staff areas with incentives like student loan repayment. This strategy could potentially reduce the reliance on locums and create a more stable workforce.
The health minister, Simeon Brown, has issued a directive to Health NZ, urging them to prioritize shifting away from locums. He expects the organization to focus on recruiting permanent senior medical officers, particularly in regions heavily dependent on locums. This move aligns with the long-term goal of building a stronger, more stable healthcare workforce. However, the minister's office clarifies that locums will continue to play a role in ensuring patients receive timely care.
In conclusion, the debate surrounding Health NZ's locum spending highlights the complexities of healthcare management. While locums provide essential support, the long-term sustainability of the healthcare system depends on a balanced approach. By investing in permanent staffing, implementing innovative recruitment strategies, and fostering a supportive work environment, New Zealand can strive to meet its healthcare needs without compromising the quality of care.
