"Critical" gaps in mental health and addiction services in Northland are revealed in a new report as health authorities move to fill almost 40 jobs across the region.
Northland District Health Board has outlined through a mental health and addiction services workforce status report how it was advertising to fill 28.5 full-time equivalent (FTE) roles, made up of 24 full-time positions and seven part-time positions.
This figure did not include a further 7.6 FTE jobs in the interview process, three FTE jobs which started employment in October and one FTE, a doctor, starting in December.
Those additional roles would take the current number of vacancies to 39.1 FTE jobs.
"I am surprised by those numbers," Dr Shane Reti, a former NDHB board member and recently ousted Whangārei MP, said.
Reti, also the National Party health spokesman, said he was sure the DHB prioritised a stable workforce but had to contend with a historical underdevelopment in mental health training.
He believed the consequence of an overstretched mental health sector was dire.
"The concern is that we will get to [patients] late and that their mental illness will progress to a position where they are harming themselves or others."
Reti, whose daughter was a primary care nurse in Auckland, said any shortcomings in DHB mental health services would result in an increased workload for primary care operators such as general practitioners.
Of the advertised vacancies, 5.3 FTE were classed as "medical" roles. These were made up of 2.3 psychiatrist positions in Whangārei, two senior medical officer positions in Whangārei and one psychiatrist position in the Far North.
The remaining 23.2 FTE vacant roles comprised 11 in nursing, 0.8 in management/administration and 11.4 in allied staff - which included occupational therapists, clinical psychologists and various health clinicians.
The report said the majority of the medical vacancies were being covered by locum doctors - physicians working on a temporary basis taking the place of an absent doctor.
The Northland DHB (NDHB) confirmed the average monthly cost to employ locums in the mental health services for the 2019-20 financial year was $73,265 - an annual bill of $879,180.
The report, prepared by NDHB mental health and addiction services general manager Ian McKenzie, stated there were "critical/essential service gaps currently", largely across Whangārei's inpatient unit and community-based services.
Speaking to the Northern Advocate after the report's release, McKenzie said increased need for Whangārei staff was due to the pressures of working in a "high acute" setting with the complexity and demands of acute mental health patients.
"These are areas requiring 24/7 cover and many staff prefer the option of Monday-to-Friday work within office-like hours as they are perceived as being more whānau-friendly," he said.
Regarding locums, McKenzie accepted staff wellbeing could be affected and patient outcomes could be compromised without the long-term employment of medical staff.
"Staff wellbeing can be affected with short-term locums due to staff shortages, however, a lot of our locums are long-term locums so we have seen some consistency there.
"Patient outcomes and experience can be compromised with short-term locums due to people needing to see different doctors rather than building a therapeutic relationship with a permanent doctor."
However, McKenzie said there was no concern in the DHB's ability to deliver its mental health and addiction services due to the vacancies.
He said a high level of vacancies in mental health services was not uncommon and it required a collaborative approach from primary healthcare operators to establish an adequate workforce.
George Riley, of Te Rarawa Social Services in Kaitaia, said it was important to grow the mental health workforce, considering the shortage he saw in Far North services.
While he believed patients would have varying reactions to having multiple doctors treating them, Riley said the efforts made by current staff were well recognised.
"All whānau up here appreciate that the staff inside the hospital in particular are fantastic."