Editor's Viewpoint: Cost of agency staff cannot be sustained
Last week this newspaper revealed that the NHS in Northern Ireland spent more than £200m last year on agency staff to plug gaps in the service. It is expected spending will rise to £230m in the current year.
These are mind-boggling figures and, given the billions spent on health, they are difficult to comprehend.
Today we break them down to make them more intelligible and the result is shocking.
The South Eastern Trust spent just over £1,600 on a single shift - more than many people's take home pay for a month. The Western Trust spent £155 a hour on a medical locum, while the Northern Trust paid £141 a hour on a locum consultant and the Southern Trust forked out £131 a hour on a specialist agency nurse.
At a time when the NHS in Northern Ireland is under severe strain, both financial and staffing, why are these huge amounts being spent? The examples given may be extreme but they make a point.
There are some 7,000 staff vacancies in the NHS here, some 3,000 of them nurses, and that is due to a combination of factors, including not training enough nurses in the past and being unable to recruit and retain staff at all levels. That leaves the NHS open to market forces and that is something which is never going to work out well.
Market forces and a caring ethos make very uncomfortable bed fellows and the agencies will take advantage of the need to charge exorbitant fees.
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As ever, Northern Ireland has shown a lack of foresight. Four years ago a system was introduced in England and Wales to bring an end to excessive charges by agencies but Northern Ireland's politicians did not set a cap on such fees and the results are blindingly obvious.
Without devolved government or any ministerial direction from Britain, the situation will simply continue.
The NHS has seen waiting list times lengthen constantly to unacceptable levels and it desperately needs agency staff to keep even a strained service operating. So it has to pay up, but that is draining badly needed funding from the service.
A blueprint to improve the NHS here, the Bengoa Report, was launched when we still had devolved government, but now there is no minister to sign it off.
The NHS here, like many on its waiting lists, is in ever more failing health and unless drastic action is taken soon its decline could be irreversible.