Some NSW Health employees are earning excessive overtime and call-back pay of more than $150,000 a year, raising patient safety issues, the Auditor-General has found.
In a report on the financial performance of state government health agencies, NSW Auditor-General Grant Hehir also found 10 of the 17 local health districts and speciality networks did not meet their budgets in 2012-13.
The largest overruns were recorded by Northern Sydney ($32.4 million), Western Sydney ($23.2 million) and Western NSW ($18.9 million).
His report also highlighted excessive annual leave balances and found many employees were paid without supervisors approving time sheets.
The report, released yesterday, found total overtime was falling overall in the NSW Health workforce, along with the frequency of workplace injuries.
"While overtime payments reduced from $390 million in 2011-12 to $370 million in 2012-13, some employees continue to earn more than $150,000 in overtime and call-backs a year," the report said.
Mr Hehir recommended agencies identify the top 1 per cent overtime and call-back earners and investigate whether "excessive reliance on these employees represents value for money or compromises patient safety".
It was feared excessive overtime by medical staff could lead to excessive tiredness and mistakes being made that put patients at risk.
Identifying top overtime earners could lead to identifying smarter and possibly cheaper rostering and operational practices, Mr Hehir said.
The report found in some cases up to 30 per cent of employees were paid without a supervisor approving time sheets and sick leave was well above the ministry's 50-hour annual target for full-time workers.
The main reasons for the budget overruns were higher-than-predicted in-patient activity, higher-than-budgeted visiting medical officer expenses and increased bad-debt write-offs. AAP