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Spend on locum doctors on target to reduce significantly

Friday, 22 December 2017

The Minister for Health and Social Care, Kate Beecroft MHK, has described comments made by Unite the Union’s regional officer Eric Holmes on locum doctors as “completely inaccurate and extremely unhelpful”. 

It comes as the Department of Health and Social Care (DHSC) forecasts spending on locum doctors to have decreased significantly by the end of the financial year (31 March 2018), if the current trend remains on track. 

The Minister said:

'It is highly concerning that Unite the Union is spreading false and deliberately provocative misinformation about the cost and governance of locum doctors working within our health service. Our health and social care professionals operate as one team. Unite’s comments are less than constructive at best and, at worst, irresponsible and toxic, with the potential to stir a completely unnecessary sense of conflict between doctors and other care professionals. 

'The DHSC is in complete control of the appointment and management of locum doctors which is subject to weekly scrutiny, with new locum appointments requiring the personal authorisation of the Director of Hospitals. 

'We have been exploring more creative solutions to address recruitment difficulties for doctors within particular specialties and I am pleased that we are beginning to reap the benefits of this.' 

Measures to reduce the cost of and reliance on locum doctors have included:

  • A renewed and concerted effort to recruit to vacancies and attract doctors to the Isle of Man, which has seen 14 appointments made in recent months
  • An increased reliance on a bank of on-Island locum doctors, with a significantly lower rate of pay compared to off-Island agency doctors
  • The re-grading of four vacant middle-grade doctor posts to consultant-grade, which are more senior but generally easier to recruit to. 

The recruitment of middle-grade doctors has been particularly challenging and makes up a significant proportion of doctor posts currently vacant at Noble’s Hospital, 20 out of 34. Middle-grade doctors are those who have completed their primary medical training and have begun to specialise, but who have not yet reached consultant grade. This is because an increasing number of doctors are choosing to delay progressing into a speciality, instead working at more junior grades. 

The Minister continued:

'Re-grading some of our vacant doctors posts up to consultant-level is actually more cost-effective for longstanding vacancies as the costs of a substantive consultant is less than the cost of a locum middle-grade doctor.  

'This approach has the added benefit of increasing the number of consultants on the Island, providing peer support for consultants who have been the sole specialists in their field locally. An example is ear, nose and throat; we have recently appointed a new consultant meaning the Island will have two ENT consultants for the first time, whilst reducing the overall wage bill. 

'This will help to reduce costs but more importantly it should help to address waiting times, meaning that patients are seen more quickly and by a more senior doctor.' 

The Minister concluded:

'Of course the number of vacancies is still higher than we would like.  We want our vacancies to be filled with high quality doctors who choose to be based here in the Isle of Man.  But we are making progress, and I am greatly encouraged by this. 

'We must be realistic, however, about the nature of the challenge. There continues to be a global shortage of doctors in many fields and without locums services simply could not function. Locum doctors are a necessity, not a luxury.  They keep vital services running. Hanging up a closed sign and telling patients ‘sorry, go away’ is simply not an option.'

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