Meet NZ needs first, say doctors

Medical leaders want foreign-student places at New Zealand medical schools given to New Zealanders, to help fix the country's chronic shortage of doctors.

The country is short of specialists in many disciplines, including psychiatry, pathology and, in some localities, general practice.

Shortages of health workers are global and the pressures will only worsen with an ageing population, an increasing range of treatments and the reduction in doctors' working hours in Europe.

The senior doctors' union blames the New Zealand shortages for 25,000 non-urgent public hospital patients being forced to wait longer than the intended maximum of six months to see a specialist.

Higher pay overseas is a commonly cited reason for New Zealand's hard-to-fill vacancies.

A third of the country's 8400 doctors were trained overseas.

Among junior doctors, the percentage who remain registered in New Zealand is declining slightly. About a quarter are no longer registered in the country by the third year after graduating.

Nearly half of first-year doctors said in a survey they were considering going overseas because of their debts, and the Medical Students Association urges reducing medical school fees - now $11,000 a year for New Zealand students - to help reduce the loss of junior doctors.

Senior doctors' union president Dr Jeff Brown said that since medical school places were limited, "why would we bring overseas students to New Zealand to lose them [once they graduate]. Why not have those places for New Zealanders, who are more likely to want to stay in New Zealand."

He said initiatives such as the new requirement in the senior doctors' collective contract for health boards to include them in planning of staffing levels, and the Government's revival of health workforce planning - dispensed with in the 1990s market reforms in health - would help to fix the shortages.

But this would take at least a decade, since the training for many specialists took 14 years or more.

The Government, which pays two-thirds of the cost of New Zealanders' undergraduate medical education, has capped the number of places for Kiwis at the two medical schools at 325 each year.

The Auckland University intake this year had 135 places for New Zealanders - and six for foreigners paying full fees, plus 40 fourth-year places for Malaysians. Otago University took 190 New Zealanders and 50 foreign students.

"Should we be using such a proportion of our medical school places for training overseas students when we are facing workforce shortages ourselves," said Medical Council chairman Professor John Campbell, the dean of the Otago school.

The council carefully checked the credentials of foreign-trained doctors wanting to work in New Zealand, and medical staff choosing to work in different countries benefited healthcare, but the developed world had become over-reliant on doctors trained in the Third World, which was unfair on those countries.

"As a First World country we do have an obligation to meet our own medical workforce needs."

The Auckland school's dean, Professor Peter Smith, called for the training of more New Zealand doctors and his university would, if the Government lifted the cap.

Health Minister Annette King would not be interviewed yesterday, but through a spokesman listed actions to address doctor shortages and said: "This Government takes this issue seriously. It has increased the number of doctors in training by 40 a year ... the first such increase since 1981."

Doctors needed

Shortages exist in many areas, including:

* General practice in some rural and poorer urban areas
* Pathology
* Psychiatry
* Cancer treatment
* Children's health