The cost of locum medical staff is a "seeping sore" on the public health system, bleeding Waikato District Health Board alone of $6.4 million in the past year.
Board member Ewan Wilson says if the DHB had the right staffing levels, the need to spend millions on locums each year would disappear.
Mr Wilson questioned the cost during yesterday's monthly board meeting where the $6.4 million was noted as "unfavourable external personnel costs" for the financial year to date.
He said a large amount of the cost applied to Taumarunui, where recruitment of permanent medical staff had been difficult. It allowed some locums to take advantage of the situation.
"In fact, for some doctors, operating under the locum model has been highly profitable.
"Our solution to the ongoing problem has in itself become an attractive solution for some of the health professionals. There's very little incentive to fix the core problem."
Mr Wilson queried what the DHB was doing about attracting doctors and nurses from overseas.
"Despite the fact 20,000 health professionals in the United Kingdom alone are being made redundant as the nat-ional health system [there] contracts, we're still struggling to find people who'll move to these rural areas."
He said the need for locums had been ongoing for years and he wanted to know what strategy, if any, the DHB had planned to tackle the issue.
"Surely we must not be that unattractive an option, because we're paying copious amounts of money."
But Waikato DHB chief executive Craig Climo said the situation was not unique to New Zealand.
"Remote locations will always be difficult to recruit to. We're competing with Australia, which has endless money to throw at this, but they still have the same problems."
Health Waikato chief operating officer Jan Adams said the DHB had had a similar problem several years ago with recruiting to Thames. At the time, it worked with the district council to promote Thames as a lifestyle destination where staff could have the work-life balance people desire.
"It's not just about the money. It's about family, lifestyle and children."
She agreed the problem was consistent but what had changed was the rate paid to locums.
"The rates have gone up. And when we pay a locum fee and get a doctor from an agency, there's actually quite high agency fees included in that. They can be about 18 to 20 per cent."
Mrs Adams said part of the solution lay in figuring out an integrated healthcare system in rural towns and that process was already under way in Taumarunui, where there were a hospital and three medical centres catering to a greater population of 13,000.
"One of the things we're seeing in Taumarunui is there's a lack of GPs in the town but also getting permanent doctors to staff the hospital is of concern," Mrs Adams said.
"So what we will do as part of this integration project is look at how we can attract medical staff to the town to maybe work across both providers, between the hospital and GPs."
She added that the $6.4 million covered locums working in medical, nursing, allied health and management and administration roles.
Locums had been needed at Waikato Hospital, and for vacancies in mental health and nursing roles.