The highest paid employee in New Zealand's public hospital system could be working at Wanganui Hospital.
The hospital's sole radiologist is doing the equivalent work of 3 specialists to earn his $600,000-plus salary noted in the Whanganui District Health Board's 2009 annual report.
But board CEO Julie Patterson says she is not happy with that level of salary being paid to a specialist.
The report also shows that 35 employees earned $200,000 or more but only one of them - Mrs Patterson - is not a clinician.
She told the Chronicle that the radiologist was working well in excess of 40 hours each week and as the sole radiologist was on call every second day.
"If we followed the [medical] college guidelines about the number of readings a full-time radiologist should do in a year, we would need to have 3.4 FTE [full-time equivalent] radiologists to do the level of readings this radiologist is doing," she said.
Asked if patient safety was compromised, Mrs Patterson acknowledged there was some risk.
"This is a risk we face when we don't have staff with a good work-life balance. Obviously, we monitor the performance and do not have any concerns at present, but definitely acknowledge the risk," she said.
Mrs Patterson said efforts were being made to address the staff shortage.
"Previous recruitment activities have not been successful [and] at the moment we are actively participating in a central region project which is looking at the sustainability of the radiology services across our region.
"I am expecting that the outcome of the project [with MidCentral DHB] will provide us with the opportunity for change."
Mrs Patterson said salaries of any senior medical officer were set by the multi-employer collective agreement between the union and the DHBs collectively.
"When senior medical officers [SMO] are in sole positions, with onerous on-call requirements, an estimate of the level of their workload is done against [the Medical] College guidelines and a salary negotiated accordingly."
She said the agreements were usually arrived at between the department manager and the SMO.
But she said that in any future negotiations for those positions she would be involved and would take responsibility for signing off the agreement. This particular salary was set before Mrs Patterson arrived as CEO.
"Having said that, my view is these arrangements in sole practitioner specialities are not desirable for the organisation and certainly not desirable for the individual in terms of work-life balance.
"I personally do not agree with any public servant being paid this level of salary, but I can understand the circumstances at the time this agreement was reached, and acknowledge that the alternatives even at this time would cost the DHB more - that is, if we were able to recruit other specialists."
Board member Clive Solomon said he had issues with the amount being paid to the individual.
Mr Solomon said he was astounded that he was not aware such a contract existed.
"I am concerned that any service in our hospital would be paying such an amount to any single employee," he said.
He said "such stunning expenditure" had no place in a small regional hospital such as Wanganui.
Hospital specialist earns $600,000
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