The Government has launched a major plan to plug significant healthcare worker shortages that are currently forecast to see nearly 13,000 extra nurses and over 5000 doctors needed within a decade.
Overall the health system currently has about 8000 vacancies, and based on current population growth an extra 1600 workers will be needed a year out to 2032, meaning if nothing changes the gap could grow to 25,000 healthcare professionals.
There are currently about 250,000 people employed in the sector, including 90,000 for Te Whatu Ora/Health NZ and 160,000 elsewhere.
The plan comes after reports of increasing pressure on the health system, exacerbated by the pandemic.
Health Minister Ayesha Verrall said while the extent of some of the gaps was “confronting” they had to know where they were so they could address them.
“This problem has been decades in the making. And we’ve heard from our health workforce, that they’re under pressure. So no, I’m not surprised.”
The plan would bring together education and immigration settings to not only grow the workforce but reduce attrition, she said.
Initiatives include “earn-as-you-learn” programmes, targeted rural programmes and funding for 50 new medical school places.
It also included improved working conditions and support for healthcare workers, such as reintroducing free meals and a Health Workforce Wellbeing Hub, including an occupational health and wellbeing service.
“We want our workers to be better supported,” Verrall said.
The Opposition meanwhile has criticised the Government, National’s health spokesman Dr Shane Reti saying its six years in power had led to the current situation.
“The Government chose to focus on the bureaucracy, rather than the frontline. And with the workforce now in crisis, Labour is desperate to make it look like they’re doing something but it’s all too little, too late.”
The Health Workforce Plan was developed under the new health entities Te Whatu Ora (Health NZ) and Te Aka Whai Ora (Māori Health Authority) with the clinical workforce, professional bodies, unions and Government input.
New data released today showed current gaps in the health workforce, based on vacancy rates, with estimates out to 2032 based on projected population growth.
They included:
Despite the shortages, data in the plan showed New Zealand actually had more health workers now than in recent decades.
In 2000, there was one doctor for every 450 New Zealanders - it was now one for every 275 New Zealanders.
Verrall said under this term of Government there had been a 16 per cent growth in nurses and doctors.
“However, it’s not enough to keep up with the population, the aging population and the new demands.
“When I came into the portfolio, I saw how much the professions have grown. And yet, I was hearing stories about all of the shortages. That’s why we did the modelling.”
The plan included six broader priority areas to support and retain the workforce, growing pathways for Māori and Pacific communities in health, driving locally-led innovation in training and bolstering priority workforce groups.
Māori make up just 9 per cent of the overall health workforce, despite making up 19 per cent of the population. This proportion drops to just 7.3 per cent of nurses and 4.4 per cent of the medical workforce (such as doctors).
Pacific are also underrepresented, at just five per cent of the health workforce compared to 10 per cent of the population. This drops to 3.6 per cent of nurses and 2.1 per cent of medical workforce.
To make up the identified gaps would involve a mix of increased domestic training, improving working conditions to reduce attrition rates and international recruitment.
New Zealand currently has among the highest rates of foreign-trained medical staff in the OECD - it has the highest rate of foreign-trained nurses and the second-highest rate of foreign-trained doctors.
While this declined during Covid, since the borders re-opened workforce shortages are largely being made up through international recruitment. Of the roughly 8000 new nurses registered in 2022, 6000 were from overseas.
The plan estimated these rates would need to continue for another two years to address current nursing shortages.
Alongside this, reducing attrition was identified as a major way to increase the workforce. Close to one in three nurses don’t complete their training, with higher rates for Māori and Pacific students. Reducing attrition by 20 per cent would see over 3000 extra nurses in the workforce by 2032.
Similar issues existed in the medical workforce, where the focus would be on immigration, retaining staff and scaling up medical training.
Verrall said there had already been “significant progress” over the past 12 months.
This included more than 8000 nurses registered for the first time in the 2022/23 registration year, up from around 5000 registered for the first time in 2021/22.
Approved funding was in place to enable 50 additional medical student places for the 2024 intake and 34,000 nurses, enrolled nurses and healthcare assistants had been awarded significant pay uplifts, increasing pay for most nurses by more than 14 per cent.
“We now have the roadmap to build on this to further retain, grow and recruit our health workers,” Verrall said.
“Today’s plan also signals bigger shifts needed over time to make our health workforce sustainable. Those are focused on reducing reliance on the global market, growing our own rural health teams and building a workforce representative of communities across New Zealand.”
Global workforce shortages and long-term under-investment have put a lot of pressure on our dedicated health workers and these challenges aren’t unique to New Zealand, Verrall said.
“Over the next year, stabilising our domestic workforce and supporting them to manage the day-to-day pressures will be a key focus. Our healthcare workforce spans across a variety of practices, and each of these workers is vital.
“It will take time for the actions we’re taking to be fully realised, however we are laying the foundations for much-needed fundamental change in how we regulate, train, invest and recruit for the future.
“This requires partnership and drive from other parts of our health system, and across government. It must be a key focus for all our health agencies over the next year.”
Reti said National’s plan would deliver more nurses and midwives by paying student loan repayments if they enter a bonding agreement of five years, and make New Zealand a more attractive destination for international nurses.
Act Party leader David Seymour said the current workforce shortages were driven by more attractive offers overseas and restrictions on immigration through the pandemic.
Earlier, Immigration Minister Andrew Little said the Accredited Employer Work Visa scheme and the Green List Straight to Residence pathways - launched a year ago - had attracted more than 6300 overseas health workers.
“This includes 2,500 nurses, and more than 2300 workers in the aged care, disabled and personal care sectors,” he said.
There is now a total of 48 health sector roles on the Green List all of which are on the Straight to Residence pathway.
The participant's death was unrelated to the pilot, according to Oranga Tamariki.