Agency staff bill rockets in five years for NHS - with almost £350m spent on temporary workers

Locum or stand-in doctors are among those making up a massive multi-million spend by health trusts on temporary staff (posed picture)
Seanín Graham

ROCKETING spending on costly agency staff across the Northern Ireland health service has been exposed - with a bill of almost £350 million in just five years.

Stand-in doctors and dentists make up more than half the spend, which comes as the north faces its worst waiting list crisis in more than a decade.

Some locum hospital consultants can earn three times as much as an NHS staff doctors and have the potential to make thousands of pounds for several days' work.

The staggering bill equates to an almost 80 per cent rise over five years – from £43m in 2010/11 to £76.5 in 2014/15 – and has led to an Executive intervention, with high-level meetings taking place with health trust bosses to "review" the process, according to an independent report.

Chronic staff shortages have been linked to the total £346.5m pay-out.

It also comes six months after the Irish News revealed a leaked letter from the head of the Belfast Trust, Dr Michael McBride, warning his most senior directors to urgently curb spending on locum doctors.

The latest figures detail the cost of recruiting agency and locum workers across a wide range of specialites - including doctors, nurses, midwives, social workers, ambulance staff, administration and technical teams.

Spending on stand-in nurses has soared from £6.9m to £12m over the five year period.

Published by the UK Pay Review Body, the bill also reveals the north's five health trusts are on course to run up an ever higher spend for 2015/16 – as £40.2m was paid out to temporary staff in just six months alone between April and September last year.

Under the current system, health trusts have contracts with certain recruitment firms with agreed pay rates. However, they can also access private agencies which are free to charge what they want - a practice hugely discouraged.

The Pay Review body authors state in their February report: "The Northern Ireland Executive reported that work on the review of agency, locum and bank spend had commenced.

"It told us a meeting had taken place with all trusts and there was an agreed process around collecting and reporting data as well as clear definitions against what each area of expenditure related to."

The development comes four years after a scathing Stormont watchdog report warned that recruitment firms had the north's health service "over a barrel".

The Public Accounts Committee accused the firms of "creaming off substantial profits at the taxpayer’s expense by dictating inflated rates of pay for covering shifts".

Dr George O’Neill, a Belfast GP, said the spend was an indictment of the current hospital system, which has "too few doctors on too many sites".

He also pointed to some medics "taking advantage" of the higher rates they can earn as locums and said it was "human nature" to want to make more money.


"At the moment we have 10 acute hospital sites in Northern Ireland with many depending on locums to staff them…we have fewer doctors per head of population than the rest of Europe,” he said.

"This inflated spend merely reflects the inability of decision makers to reduce our number of hospitals to three or four - until someone grasps the nettle and makes that decision our skilled consultant cover will become diluted.

"Our system is obsolete and not fit for purpose."


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