Lucrative "crisis rates" are being offered to private doctors and consultants in an attempt to mitigate a potential health catastrophe triggered by a mass exodus of nearly 200 public sector psychiatrists in NSW.
About 198 the state's 295 staff specialist psychiatrists so far have tendered their resignation over an ongoing — and increasingly bitter — industrial dispute with the Minns government.
Such a walkout, planned for January 21, would be unprecedented in Australia's medical sector and if it proceeds could wreak havoc across NSW's public hospital, social services, and criminal justice systems — all sectors that require the work of qualified psychiatrists to function.
In response to the looming crisis, the government as part of its contingency plan has engaged several locum agencies — which recruit qualified medical specialists to fill temporary roles — to help plug the hole left by any mass vacancies.
Proposed pay rise for public psychiatrists unaffordable, says premier
For doctors, locum roles can be significantly profitable — often paying more than 300 per cent more for the same hours worked, but with less responsibilities and additional allowances for accommodation.
On Monday, NSW Premier Chris Minns said the proposed pay increase was more than the state could afford. (Pexels: Alex Green)
Public psychiatrists in NSW have demanded a 25 per cent pay increase, arguing they are paid 30 per cent less than their interstate counterparts.
This has caused many to flee to the private sector for better opportunities.
During a Monday press conference, NSW Premier Chris Minns gave no indication that the government would be backing down, saying the proposed increase was "way more than we can afford".
"A 30 per cent pay increase, forever, is more than the contingency plan we put in place for Q1 next year," he said.
"In those circumstances, if the choice is between the government signing a blank cheque or being reasonable around the negotiating table, I think they [the average citizen] would expect us to protect the budget bottom line."
Locum agencies advise of 'influx' of opportunities at 'crisis rates'
After negotiations between the government and psychiatrists further deteriorated last week after the Industrial Relations Commission (IRC) got involved, locum agencies have been on an advertising blitz.
Since the mass resignation of psychiatrists working in NSW's public health sector, locum agencies have begun contacting private health workers nationwide. (ABC News: Luke Bowden)
Many have sent recruitment and marketing communications to medical specialists across the country, flagging workers of an increased demand in NSW.
"As you're probably aware by now NSW Health has received 100's of resignations from psychiatrists across the state," said one recruitment agency on Friday and in an email seen by the ABC.
"We have been chosen as one of the few agencies to back-fill these roles with our pool of locums. As you can imagine, they are offering increased 'crisis' rates along with accommodation and travel allowances."
One agency said private psychiatrists and consults should expect an "influx" of opportunities to be available next month, while another agency in an email stated that any psychiatrists who resigned from the public sector would still be eligible to locum back within the NSW system.
Frontline psychiatrists told the ABC this means that a staff specialist who resigns next month may end up returning to the same hospital for increased pay.
To reduce cost blowouts, chief executives of local health districts across the state were directed last week to cap locum daily rates.
In an email seen by ABC News, NSW Health Secretary Susan Pearce said all psychiatrist locum vacancies could not be advertised for more than $3,050 a day unless authorised by the health department.
Ms Pearce said the health department would create a "central coordination team" to liaise with locum agencies (of which there are more than 50 used by the NSW government) for a period of eight weeks starting from January 13.
"This team will take responsibility from that date for all negotiation rates on behalf of the system," she said.
NSW Health Secretary Susan Pearce said the most income that a psychiatrist locum vacancies could be advertised for was $3,050 a day. (AAP: Bianca De Marchi)
Concerns raised over locum solution
Psychiatrists said the over reliance on locums is unsustainable.
Pramudie Gunaratne, the NSW chair of the Royal Australian and New Zealand College of Psychiatrists (RANZCP), said even with increased spending on locums around a third of current psychiatry staff specialist roles remain unfilled.
"If we're not still not able to fill that with locums, the chances of being able to fill a significantly larger gap in January [onwards] is unrealistic," she said.
Pramudie Gunaratne warned that the reliance of locums would not be enough to fill all psychiatrist vacancies across the NSW's public hospital sector. (ABC News: Berge Breiland )
Ian Korbel, a forensic psychiatrist of 20 years and one of the 198 workers who is resigning, said dozens of locum offers were already being sent out every week before the proposed mass walkout.
"If they can't fill them now, they can't fill them in January," he said.
Dr Korbel added that the focus of locums is on patient care and unlike staff psychiatrists, they don't oversee training of staff, quality assurance or the improvement of a hospital's systems.
Despite this, Mr Minns said the government would be pushing ahead, arguing it would be cheaper than raising public psychiatrists wages.
"A permanent [25] per cent pay increase, it's not a one off it's forever," he said on Tuesday.
"The locum costs in that emergency period are part of our contingencies and we're putting them in place for however long the dispute goes on for."
Mr Minns said the government would be pushing ahead with their locum plan, despite the costs associated. (AAP: Dan Himbrechts)
Government offer insulting, psychiatrists say
The government has offered a 10.5 per cent increase to medical specialists — not just psychiatrists — over three years, which it said is the largest pay increase for psychiatry staff in more than a decade.
This offer was overwhelmingly rejected by Australian Salaried Medical Officers' Federation (ASMOF) members.
Psychiatrists who spoke with ABC News said the figure was insulting, not only because it would still leave NSW public psychiatrists 20 per cent worse off than their interstate counterparts but because it does not address systemic issues.
A spokesman for the Minister for Mental Health Rose Jackson said the health department was continuing to work to "ensure services and vital mental health support are not impacted" by the collective resignations.
"We are exploring every single option to ensure people get the care they need, including finding staff to help plug any gaps," she said.