Rural health issues demand a rational response
The Vice-Chancellor of the University of Auckland has called on the Government to ignore the hype around the Waikato bid for a third medical school and make decisions that will benefit all rural New Zealanders.
Professor Stuart McCutcheon says: “This Government prides itself on astute financial management. It now has the opportunity to demonstrate that in considering how best to meet the health needs of rural New Zealand.”
“A third medical school, originally touted for Wellington and now being proposed for the Waikato, is about the least efficient way imaginable of providing more rural health professionals.
“It would require several hundred millions of investment in a university that - unlike the world-class medical schools we already have at Auckland and Otago – has no medically related subjects ranked in the top 500 in the world. Yet the Government has turned down previous requests for capital investment other than in relation to the Canterbury earthquakes.”
Professor McCutcheon says: “The issue for New Zealand is not the number of medical graduates but rather where they practise. Setting up a new medical programme, especially a postgraduate programme, would be an extremely expensive way of addressing this issue.”
The country’s two existing medical schools are already responding to the country’s increased demand for doctors. “By 2020 we will be producing 570 medical graduates each year, 200 more than in 2008. The scale of these increases was agreed with the Government and the health sector, but will be jeopardised if the Waikato proposal goes ahead because the Waikato DHB has already said that it will reduce our clinical placements.”
Both the Auckland and Otago medical schools have extensive programmes to encourage their graduates to practise in the rural and regional areas. These programmes operate nationwide, not just in one region.
Professor McCutcheon says: “The University of Auckland has trained doctors and nurses in regional and rural based programmes for decades. We have established specialist hubs for rural training in Northland and Bay of Plenty, and will open another one next year in Taranaki. Otago University also has several hubs.”
Professor McCutcheon says that Auckland and Otago, together with AUT and the College of General Practitioners, have provided the Government with a proposal that could see 10 rural training hubs established across the country over the next five years. Each hub would be based around a rural hospital, with over 100 health trainees - junior doctors gaining rural community experience, general practitioner and rural hospital medicine vocational trainees, nurse practitioners and registered nurse prescribers – working in each hub.
“We have offered the Government a way of having 1000 students per year living and learning in rural communities. International experience shows that these schemes lead to many of those trainees returning to work in those communities, and it could be delivered before a third medical school even got off the ground.”