A WATCHDOG probe carried out in hospitals in England last year found that locum doctors rates were excessive.
While the financial regulator - known as NHS Improvement - accepted that temporary medical cover was necessary to plug short-term gaps, it concluded the rates being charged by private recruitment agencies were too high.
Concerns around the "unfairness" of a system were also raised, where a permanent NHS doctor works alongside stand-in colleagues earning three times their salary.
The issue of inflated locum pay rates in Northern Ireland hospitals came to a head in August this year when the Department of Health ordered that £70 million in cuts was to made across the north's trusts to balance the books.
Chief among a raft of controversial "saving plans" was the slashing of medical and nursing locums - a move that trusts acknowledged would have a significant impact due to the sector's heavy reliance on them.
Read more: Paying locum A&E consultants £300k a year to cover NHS rota gaps questioned by top medic
An eleventh-hour bailout led to the shelving of most of the cash-saving plans, a development welcomed by one Northern Ireland hospital that has spent more than £1 million in the past year covering just three temporary A&E positions to keep its service safe.
The situation the Northern health trust has found itself in is not of its own making, as there have been repeated attempts to recruit new consultants to the Causeway hospital in Coleraine over the past two years.
What is significant however is that the 'temporary' doctors they have employed have worked there for a considerable period, with one stand-in consultant based in the Coleraine unit for two years.
With annual salaries in the region of £300k after the recruitment agency fee, the trust's own medical director concedes that a "market has been created for doctors to make a lot of money."
Dr Seamus O'Reilly is the first senior health manager in the north to openly express his frustration at the situation.
The highly respected medic, who spent 20 years working on the hospital floor as an A&E consultant in the Ulster, also makes the central point that a lack of regional workforce planning - which is the Department's remit - has led to the crisis.
With the Bengoa reforms to overhaul the north's health service now a year old and behind-the-scenes 'preparatory work' reportedly apace, the next year will be critical in reshaping the face of the sector and reducing its chronic dependency on costly temporary staff.
