SA hospital locum costs soar up to $3000 a day

The cost of fill-in doctors to help meet the pressures of the pandemic in rural SA hospitals has soared with one country town using locums on 4638 days in 2020-21.

Fill-in doctors at rural hospitals are earning up to $3000 a day as locum costs soared by 50 per cent to almost $31m a year under the pressure of the pandemic.

Some local health networks have seen their costs more than double while the cost of a locum has jumped about 15 per cent.

At rural hospitals, the shortage has seen the use of locums increase to the equivalent of 12 doctors a day.

Mount Gambier had the biggest usage, with 4638 locum days in 2020-21, followed by Port Lincoln at 1470 and Berri with 1058, while seven other hospitals had the equivalent of a locum every day during the year.

SA Health data reveals that total costs have blown out by $9m in 2020-21 compared to 2018-19.

It also shows there were hospitals with no on-call doctor or even a locum at times during the 12-month period. Naracoorte had 27 days with no on-call doctor, followed by Penola on 21, Bordertown 4.5 and Booleroo Centre District Hospital and Balaklava Soldiers’ Memorial District Hospital with two days.

Rural Doctors Association of SA president Peter Rischbieth. Picture: Tait Schmaal

The Advertiser has previously reported the long list of country hospitals advertising for emergency department doctors, offering lucrative day rates.

Last month, the government entered a landmark agreement with rural GPs, investing an estimated $188m over two years to help attract GPs to regional South Australia.

This includes a sign-up bonus of up to $50,000 for a doctor to work in remote areas and the option for doctors to work for an hourly rate in hospitals or to remain with a fee-for-service structure.

The government is also rolling out its Rural Medical Workforce Plan expanding rural medical training positions and tripling full-time rural medical intern positions, providing 50 rural rotation opportunities for metropolitan-based interns and offering 17 advanced skill registrar positions.

Health and Wellbeing Minister Stephen Wade said the ability to recruit rural GPs was one of the most significant challenges facing the health system – and they had been exacerbated by the pandemic.

Riverland General Hospital, Berri

“While training and funding of rural GPs is primarily a matter for the federal government, most South Australian country hospitals rely on local GPs to provide medical services,” he said.

“As we have said repeatedly, this government will invest whatever it takes to ensure South Australians receive the care they need, when they need it. If that means employing locums to fill healthcare gaps in our regional areas, that’s what we will do.

“Locums have been used to fill shifts in South Australian regional hospitals for more than a decade.

“Generally, the daily rates sought by locums increased during the pandemic. The average daily rate for locums across all regions has increased by 10 to 15 per cent since early 2020 and some locums are receiving daily rates as high as $3000 a day.”

Mr Wade stressed the government was committed to recruiting and retraining skilled doctors in the regions to lessen the reliance on locums into the future.

Opposition health spokesman Chris Picton said the cost blowout over 12 months was a “sign of complete crisis in our regional hospitals”.

“Locums are about plugging the gaps, but the gaps are turning into chasms,” he said.

“This locum expenditure is a sign that country doctors have been leaving the system in droves over the past three years.

Health minister Stephen Wade. Picture: Emma Brasier

Opposition health spokesman Chris Picton. Picture: Naomi Jellicoe

“There’s too many hospitals that are now completely reliant upon locum doctors – that’s not only bad for patients, it’s also more expensive for taxpayers.

“Many regional hospitals in fact have been so desperately short-staffed, they have been without any locum coverage at all, diverting patients away who need medical attention.

“This has an effect across the system, with patients diverted to Adelaide and only increasing the record ramping crisis.

“We need urgent action to work with regional GPs to address these shortages, not Band-Aid solutions like we’ve had for the past four years.”

Rural Doctors Association of SA president Dr Peter Rischbeith said there was a “critical” workforce shortage in rural areas, particularly on the West Coast.

He said the recent industrial agreement with the state government would help.

“It will go a long way toward engaging more local doctors back into the system to provide services,” he said, noting Covid had stopped recruitment of doctors from interstate and overseas.

He said local GPs who opted to be on-call for local hospitals tended to be involved in the community, knew patients and helped with training – unlike locums.

“A $9m increase (in locum costs) in a couple of years is massive,” he said.

Originally published as SA hospital locum costs soar up to $3000 a day