Introduction
Scottish opposition leaders are condemning government ministers for gross mismanagement of the health service after it emerged that £130m has been paid out for temporary psychiatrists in the last five years. This has resulted in what opponents term ‘jaw-dropping’ costs and has instigated a political furor around locum psychiatrists being unaffordable and detrimental to the health sector.
Why Are NHS Boards Spending Millions on Locum Psychiatrists?
Data has emerged that Scottish NHS boards must spend as much as £837 per hour to source locum psychiatrists through agencies because the country is experiencing a permanent consultant shortage. Such spending is mainly incurred for primary psychiatric care, and many boards have become reliant on emergency temporary staffing.
According to the finding, the Scottish Liberal Democrats, Labour, and the Conservatives said they would confront health ministers this week. They ask why the health service has had to spend so much money on recruitment agencies instead of staffing for the long term.
What Are Opposition Leaders Saying About the Rising Costs?
Scottish Liberal Democrat leader Jo’s ideas found the situation as financially irresponsible.
“These are jaw-dropping figures,” Cole-Hamilton said. ‘I expect the average Scot will be shocked to learn that millions of pounds are being spent on recruitment agencies which charge hundreds per hour instead of recruiting and training its permanent health board staff.’ At best, it is almost the definition of what Australians call a false economy.”
Paul Sweeney, Scottish Labour’s spokesperson for mental health, reiterated these sentiments while adding that a long-term perspective would look at the consequences if this spending rate is continued.
“The NHS is being held to ransom by years of SNP failure to recruit and retain staff,” Sweeney said. “Given that many workers in the NHS are complaining of burnout, and with more pressure on hospitals than ever before, the Scottish National Party needs to start enhancing the terms and conditions of employees so that a career in the NHS is the pinnacle for employees.”
How Much Are the Costs Rising?
Figures from the 14 NHSScotland boards reveal £19.5m was spent on private providers for locum psychiatrists between 2019 and 2023. For that reason, some boards set their staff to work for themselves as locums, offering them an extra amount of cash to cover extra working hours or weekends. Nonetheless, over a third of the total spending, £134m, has been paid to other private organisations for short-term coverage.
This emergency cover has been so expensive in the past few years. An exceptional £14, 847,000 was spent in the financial year 2023 on locum contracts, despite ministers’ move to bar routine use in May 2023.
Which NHS Areas Are Facing the Worst Crisis?
Chronic areas of use are confirmed by the figures representing the realised spending of the districts: NHS Tayside used a total of £30.5m for employing locum psychiatrists on a long-term and emergency basis. This figure reached a record of £ 7.7 million for last year only. NHS Fife had the same issue; they increased their costs to £29.5 million during the same period, with £9.5 million during 2023 alone.
The professional regulatory body, the Royal College of Psychiatrists, has pointed out that some locum psychiatrists for these schemes must be adequately qualified. Occasionally, these locums were not even members of the Royal College of Psychiatrists and issued their reports while working off-shore from Scotland.
How Are Patients Affected by the Use of Locums?
The over-reliance on locum psychiatrists has also been seen to have affected patient outcomes in a big way. The remote and Rural Patients Survey to get feedback was organised by Vox Scotland, a patient advocacy campaign; according to this, nearly 500 patients participated, and half of them expressed their discontent with the treatment given by locums. Some levelled serious accusations: too many temporary doctors and patients received inconsistent, fragmented, or poor-quality care, with different doctors providing different diagnoses or recommending different medications.
Participants stated that they felt that they were shifting from one doctor to another, with different treatment methods recommended to them, but for one to see if they work, the doctor is transferred elsewhere.
Why Do Locum Agencies Defend Their Role?
Nevertheless, locum agencies explain that they are necessary for the NHS, especially when there is a high workload or staff turnover. Currently, many doctors opt for locum work because of the flexibility in the working hours and conditions of service offered, thus making it almost impossible to secure permanent workers.
Kate Shoesmith, the Deputy Chief Executive of the Recruitment and Employment Confederation, came in defence of locum psychiatrists.
The quickest way to deliver sustainable and affirmative change in health staffing is to follow Shoesmith’s suggestion of developing a strategy that recognizes and provides for substantive, bank, and agency workers across the board. ‘This approach will no longer allow constant expensive changes at the last minute that may compromise the harmony of a functional agency model’.
How Does the Government Justify the Use of Locums?
However, Maree Todd, Scotland’s Mental Wellbeing Minister, said that the spending is minimal, as it constitutes a drop in the NHS Scotland staffing pay bill, which is over nine billion pounds annually.
“Current NHS Scotland staffing pay bill is more than £9 billion per annum and what we spend on locum psychiatrists is just a drop in the ocean of this amount,” said Todd. She clarified that the Scottish Government believes that ‘Off-framework agency spending’ should be kept to a bare minimum to guarantee that essential services are delivered during unanticipated staff absence, sickness, or unpredicted high activity level.
What Is the Way Forward?
With NHS staff shortages emerging as a significant concern in Scotland, leaders of the opposition parties are calling for structural changes to make the system sustainable. Bear in mind that the cost of hiring locum psychiatrists increases yearly, making staff recruitment and retention more acute, as does the need to offer patients stable, effective psychiatric care.
Add a Comment