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Health Services Daily: Solution to costly locum doctors ignored for 15 years

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Amanda Cohn
NSW Greens MP
12 July 2023

Fifteen years after the Garling report and NSW Health still has casual doctor supply problems. 

NSW Health minister Ryan Park has ordered a special inquiry into health spending that will cost nearly $16 million and take up to two years but an earlier recommendation could solve the expensive locum doctor issue. 

Some locum doctors are receiving up to $4000 per day to service needy regional areas and in 2021-22, NSW spent $1 billion on visiting medical officers, a Sydney Morning Herald story reported yesterday. Dr Amanda Cohn, NSW Greens MP, said a state-run workforce registry would be a much cheaper solution and be “extraordinarily beneficial for the health system”. 

“It’s such low-hanging fruit for NSW Health which will address both continuity of care for patients and recoup enormous savings from the inefficiency that we can reinvest into the health system. It’s also something that’s quite achievable to change in a short amount of time,” Dr Cohn told Health Services Daily. 

Dr Cohn moved a motion in parliament in June, that using for-profit recruitment agencies to fill roster gaps in hospitals was “inefficient and expensive” adding that she was not the first to suggest a centralised register of casual doctors.  

She referred to Justice Peter Garling SC’s 2008 Special Commission of Inquiry Acute Care Services in NSW Public Hospitals, which advised NSW Health to create a  healthcare worker register for causal vacancies. 

Fifteen years later the recommendation remains unactioned which Dr Cohn said is possibly partly due to 12 years of a Liberal National Government in NSW. 

“The former government had a track record of privatising essential assets and services. So, ideologically and politically, with the previous government, it may not have been in keeping with their agenda,” she said. 

However, if the Labor government of 2008 had followed the Garling report recommendations, a centralised casual doctor workforce registry would have been created within 12 months. 

Dr Cohn said a lot has changed since 2008 and that she is not opposed to the new government doing another special commission of inquiry.  

“However, I would urge them not to wait for the results of another inquiry to start making some of these very obvious changes,” she said. 

Dr Cohn also told parliament that harmonising the onboarding and credentialing of doctors between local health districts would enable a more efficient and timely flow of human resources.  

When Dr Cohn worked as a locum in regional NSW she regularly had to undertake online onboarding training, including modules such as hand washing procedures and using electronic health records. 

“One placement asked that I undertake 15 hours of online training modules. It’s a real barrier to the deployment of health workers temporarily from one LHD to another,” she said. 

Dr Cohn said the different onboarding requirements between LHDs was also “a real bugbear” for local doctors to take a placement in new LHD especially given that the online training was usually expected to be completed unpaid. 

Dr Cohn’s motion to NSW parliament received support across party lines.  


Source: Health Services Daily at 

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Amanda Cohn
NSW Greens MP
12 July 2023


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