Two announcements in two days, both with specific actions targeted at rural health workforce solutions, are seen as
signalling hope for a rural health workforce in extremis.
Yesterday Te Whatu Ora and Te Aka Whai Ora released their Health Workforce Plan that, for the first time, included data
that estimates the current workforce gap and show how that gap will widen even further by 2032 if nothing different is
done. The plan acknowledges that the rural workforce needs special attention, which is a relief to see, as the rural
primary care and hospital teams are at breaking point.
The plan includes a 365-day funded action list that proposes scaling existing training initiatives in rural areas that
are seen to be producing good outcomes. This is to more rapidly grow rural primary care teams that include doctors,
nurses, midwives, and others supported and trained to work in rural communities.
The plan also proposes developing a nationwide framework to coordinate rural workforce data, pathways, and student
placements. This will certainly improve our understanding of what the rural health workforce needs now and help plan and
prepare for what is needed in the future.
Dr Davidson, Hauora Taiwhenua CE, commented, “For a very long time, we have been strongly advocating for innovative new training initiatives based on proven overseas
research that shows if you train rural people, in rural areas using rural health professionals, graduates are more
likely to stay practicing in those rural communities. We are so pleased to see that the plan reflects our thinking.”
Bold and innovative actions such as developing a national rural training system, and local earn-as-you-learn schemes,
are what are desperately needed in addressing the massive workforce gap estimated at 4800 nurses, 1700 doctors and 1050
midwives. Adding estimates of the number of allied health vacancies compounds this and confirms these approaches are
crucial to a sustainable, capacity building rural health workforce model.
With only the first year of the plan currently funded, much of the plan’s anticipated gains are reliant on successful
future year budget bids.
This announcement was followed today with the National Party committing to a third new medical school at Waikato,
specifically targeted at rural GP training. This will commence with 120 new medical trainees who will all have
previously completed an undergraduate degree. This will allow a shorter, four-year medical training programme, with much
of it delivered in rural and regional areas. 50 extra medical training positions, in addition to the 50 already
announced by Minister Verrall this week, will also be offered to Auckland and Otago Universities.
Dr Davidson commented that “this is a potential game changer. We have a party committing to significant ongoing funding to train the many hundreds
more doctors needed across the country. More importantly, they are prepared to fund a new approach that will
specifically deal with the rural GP shortage. The Network has been promoting this dispersed rural training model for
many years and to date been ignored. To finally see a commitment to funded action is exciting. It will provide our
sector with hope at last.”
None of this deals with the harsh reality that pay and working conditions of primary care nurses, doctors and others
trail their peers in Te Whatu Ora hospital settings and overseas markets. With the announced initiatives we need to
prioritise the retention of existing staff while, at the same time, working quickly to increase the number in the rural
health workforce of the future. Failing to do so risks the gains from any new training initiatives being undone by
people “walking” to other jobs, often in other countries, to get better pay and work conditions.
“That our ideas for the building of a strong rural workforce are reflected in the Health Workforce Plan, and in the
opposition health manifesto, means that there is finally a real opportunity for improvement.
We stand with our members, willing and ready to help Te Whatu Ora and Te Aka Whai Ora implement the Plan under any
future Government and get those actions moving, for the greatest outcome for the health and well-being of rural
communities,” says Dr Davidson.