Western Isles health board paid an agency doctor over £19,000 to work just one week.
The bill for the locum psychiatrist's 40 hours on duty plus the rest of the time on call at NHS Western Isles came to a total of £19,305. The final sum also includes 20% vat.
A health board spokesperson said: "During a period of extended sickness absence in 2013, a consultant psychiatrist was hired from an agency to cover one week’s annual leave for the remaining consultant.
"The locum consultant undertook 40 normal working hours and provided 128 hours on call for which the cost to the Board was £19,305.22.
"This figure is the gross total paid to the agency and includes 20% VAT. "
NHS Western Isles spending on temporary agency consultants rose from £452,000 in 2012 to £1.2 million in 2014.
The number of temporary agency consultants hired decreased from 43 in 2012 to 36 in 2014. However, the duration of locum placements varies considerably.
NHS Western Isles said it only uses agency staff when it has exhausted all other means of obtaining staff to maintain a safe service.
If a locum cannot be found from a list of contracted agencies with nationally agree rates then cover must be sought from another agency regardless of their fees.
The spokesperson said: "Medical cover is required 24/7 and therefore staff are required not only during normal working hours but must also be available to be called upon out of hours in an emergency situation, and we have to pay an availability allowance for this whether or not staff are called out.
Cover has to be put in place immediately urgently when the regular consultant is unexpectedly absence such as for illness.
The spokesperson stressed: "This can mean that the cost is high, but there is no other option if we are to maintain safe levels of medical cover.
"This is not an experience peculiar to the Western Isles."
Western Isles NHS pays agency doctor £19,000 for week's work
3 July 2015