Doctors being offered $4k a day to work in Western Australia

Written by Michael Bennet for the Australian Financial Review?

In regional Western Australia, doctors are being offered bumper pay packets after Premier Mark McGowan’s axing of the state’s border reopening.

Even for a state used to big pay packets at the mines, it’s big money – up to $4000 a day – with interstate doctors now being enticed with pay while they serve out their enforced quarantine.

One email from a major healthcare recruiter sent to doctors around Australia last week, seen by AFR Weekend, advertised a range of locum jobs, including emergency department specialists, ED general practitioners, surgeons, anaesthetists, paediatric consultants and psychiatrists.

Many roles offer an “increased rate”, most between $2000-$3450 a day, often for around a month of work.

With regional areas already crying out for medical workers before the indefinite border closure, ED locum jobs in Geraldton and Kalgoorlie are now going for $4025 a day.

“It’s desperate,” says one veteran healthcare recruiter who declined to be named, adding there’s never been more jobs on offer. “And what they’re doing is upping the rates, but it’s not really the rates that’s the issue, it’s the supply and if people don’t want to come over here and sit in hotel rooms (to quarantine), then they’re not going to. “The rates are huge compared to anywhere else (around Australia). It is massive money. It’s probably gone up $700 a day in the last six months.”

The hot demand and big money on offer is an apt symptom of Mr McGowan’s divisive border stance.

While the Premier has claimed the health system was “strong and ready” for the reopening and spruiked higher spending since coming to power five years ago, medical lobby groups and unions say hospitals, particularly emergency departments, are stretched even before COVID-19 takes off, especially in regional areas.

With a tight election looming and several WA seats under threat, Prime Minister Scott Morrison this week backed Mr McGowan’s dumping of the state’s reopening but suggested he should more aggressively use the state’s budget surplus to ensure the health system can cope when it eventually opens up.

An AMA WA survey last month of 1500 members revealed about half opposed Mr McGowan’s border backflip and wanted a new reopening date set. However, around 78 per cent of Perth respondents believed the state was not ready to deal with the inevitable omicron outbreak if the February 5 reopening went ahead. In the regions, 85 per cent of members held this view, reflecting the greater labour shortages.

Perth doctors told AFR Weekend that while good money has always been offered for locum work – particularly in emergency departments – in the regions due to difficulties attracting permanent staff, it’s become more lucrative in recent times.

“I can’t imagine the border closures have helped things,” one GP said.

Another specialist doctor, who also declined to be named, added the mines can offer similar daily rates, but only some have jobs on site or may prefer occupational physicians who specialise in work-related issues. The remoteness of some towns, undesirable weather and added stress were also cited as turnoffs.

Still, assuming a specialist doctor takes locum jobs paying $3000 a day and takes four weeks leave, they could theoretically make around $700,000 a year, plus the perks such as free accommodation, rental cars and travel costs.

While recruiters say some doctors from interstate have taken locum jobs and done hotel quarantine “once or twice”, most weren’t interested and Mr McGowan’s scrapping of his planned reopening this Saturday was a further blow.

Australian Medical Association WA President Dr Mark Duncan-Smith tells AFR Weekend the big money on offer in the regions reflected “chronic problems” that have been amplified by the closed borders.

A critical one, he says, was doctors not viewing the government’s WA Country Health Service (WACHS) as a “preferred employer”. He adds a broader problem was the lack of permanent employment, which sees medical workers employed on five year contracts, which causes job “insecurity” and fears of speaking out.

“I see the large amounts being paid for locums ... as crisis management for a chronic problem of WACHS not being a preferred employer,” he says. “And there’s a real danger that when the borders do eventually open, we could actually lose medical workforce to other states. This egocentric assumption of WA Health and the government that as soon as the borders open that doctors are going to flood in here is not necessarily valid.”

Outside the hospital system, it’s a similar but different situation.

Tim Shackleton, chief executive of Rural Health West, a not-for-profit that specialises in GPs, practice nurses and allied health, says demand for locum GPs has increased this financial year amid lower availability, receiving requests for 3999 days of cover, or the equivalent of about 20 full-time doctors.

But he says wage inflation hasn’t been the same as in hospitals.

He adds that the daily rates being offered to locum specialists may sit outside the sector’s standard enterprise bargaining agreements under so-called contracted, or “visiting”, medical practitioners arrangements.

“It is unviable for small country general practices to pay significantly inflated rates to secure locum GPs,” Shackleton says. “On the occasions where general practices cannot secure locum cover, they may close for a short period of time or divert patients to nearby practices.”

As for permanent positions, Rural Health West’s GP vacancies have remained fairly stable – up since July when WA’s border rules tightened, but down compared to a year ago. But Mr Shackleton says vacancies for NMDAH (nursing, midwifery, dentistry and allied health) professionals have increased significantly in the past year across WA.

He says it was partly due to interstate and international professionals returning home because of the border rules and difficulty attracting them, but it wasn’t the only issue.

“There’s a variety of reasons for the overall workforce shortage, including global, national and local factors,” he says.

Amid the skills’ shortage, the government has continued to run its $2m “Belong” ad campaign to try to attract healthcare workers to the state, despite its January 20 dumping of the reopening that has left businesses and the public in limbo.

Responding to questions about the campaign’s success, Health Minister Amber-Jade Sanderson says the chief health officer “received, processed and approved” more than 130 applications from interstate and overseas healthcare workers in January, but couldn’t provide overall figures since its launch in October.

She added all hospitals were also actively recruiting, with an additional 1259 nurses and midwives employed in 2021 and WA Health adding another 892 in 2022. She said almost 600 doctors were employed in 2021, including 261 from UK and Ireland.

In WA, healthcare workers from overseas are allowed into the state above the international arrivals cap, and they’re offered “up to $8000 to cover flight and quarantine costs”. From February 5, interstate workers will be able to work after seven days home quarantine.

But it’s still proven tough to satiate demand. The Department of Health’s website has 441 healthcare/medical jobs advertised, while the WACHS has a range of jobs going, including permanent roles offering packages north of $500,000. In the background, WA’s net overseas migration has been negative since the pandemic began after years of growth.

“The state government understands and appreciates that it is a difficult time for West Australians who currently reside elsewhere, but healthcare workers are critical to the functioning of our world-class health system,” Ms Sanderson said, adding she was confident the public “understands the importance” of trying to attract health workers despite the borders being closed for others.

Wesfarmers chief Rob Scott last week revealed he’d had enough and would move to Melbourne to run one of WA’s biggest companies, followed soon after by Richard Goyder going public with similar plans. Anecdotal evidence suggests migrant doctors are doing the same, while several specialists, led by Perth Dr Luke Torre, have publicly slammed the Premier’s decision, arguing now was the ideal time to reopen ahead of winter and the hospital system would never be perfectly prepared.

Still, the supply demand imbalance may be improving.

Data from the Australian Bureau of Statistics show the numbers of healthcare and social assistance workers in WA fell from more than 205,000 in February 2021 to 184,700 in August, before bouncing back to 192,100 in November.

But in the regions, it appears doctors will likely enjoy the prospect of earning up to $4000 a day to work in regional WA until the borders come down.

Although, it appears that at a time when freedom of movement has never been more valuable, big money isn’t always enough.