Review of the National Rural Locum Program - Final Report - April 2011

Efficiency of the NRLP

Page last updated: 04 July 2012

Inputs/outputs

Reporting requirements to the Department of Health and Ageing have been streamlined and agreed over time with the administering bodies. None of the schemes reported these to be significant or onerous.

Administrative costs

There is a significant level of overhead cost being incurred with the scheme being administered by separate agencies. This is especially so for RGPLP, which has two layers of administration within its structure.

It is clear that SOLS is performing well and with total secretariat costs at 16% it is difficult to argue for any changes to the administrative structure of the program.

GPALS, on the other hand, has had unacceptably high administrative costs per placement. With low requests for placement and low locum numbers, it is difficult to argue that GPALS should continue to be administered by a separate organisation. Options for amalgamation with SOLS or RGPLP should be considered. Alternatively, the program could be discontinued altogether, however, it is recognised that there is a continuing need for anaesthetists to be available to support obstetricians in the surgical component of their work, which in turn benefits the rural community.

Secretariat expenses for RHWA, together with the administration fee for RWA totals administration expenses at 29.7% of the total budget for the funding period. It is acknowledged that the administrative costs for a new program are always higher in the initial set up phase and it is anticipated that the costs for the period 1 July 2010 to 30 June 2011 will be slightly lower at 26.7%.

Of the RHWA secretariat expenses for the current funding period, 20% is budgeted for marketing and promotion and website and database development. It is likely that these costs will be reduced in the next funding period now that much of the establishment of the program has been completed.

Clearly the efficiency of the program in terms of administration costs is affected by the two layers of administration in RHWA and the RWAs.

However, the value of an overarching coordinating body can be argued, particularly in the set up phase of a new national program such as the RGPLP. RHWA:

  • has enabled the development of a national database of locums so that the RWAs have access to a larger supply of locums than just those registered with their agency
  • has played an important role in delivering a national marketing program and developing program guidelines and materials
  • as a national body can vary the target placements across the states and Northern Territory and can provide a more targeted approach to the areas of most need
  • has developed a good platform for the RGPLP with which other locum programs and Government initiatives draw linkages
  • has provided a means of networking and sharing information between the RWAs
  • collates and reports on the national performance of the RGPLP.

The role of the RHWA in going forward must be evaluated and defined. It is now well positioned to play a more strategic role in improving locum supply overall and to better target the provision of locum and subsidy relief. However, there is a need to monitor the administrative costs of the RGPLP and to ensure the role of the RHWA continues to provide value to the program.

Clearly, there are opportunities to streamline the administrative structure of the NRLP and improve the overall efficiency of the program. Options to amalgamate some or all of the programs should be considered.