Experts are warning a significant health workforce burden looms if the Government does not urgently loosen its criteria for critical migrant workers to enter New Zealand.
Since New Zealand closed its borders, on March 25, hundreds of migrant healthcare workers have been allowed to enter the country under the critical workers exemption.
The Ministry of Health says they are needed to "cover the gaps caused by Covid-19" and
the Ministry of Business, Employment and Innovation (MBIE) say they are needed to "minimise the disruption to the health workforce".
But experts across the health sector told the Herald the process was too strict, the $3100 quarantine cost on employers was not sustainable and soon patients and aged-care residents would start to feel the brunt of the "extremely concerning issue".
GPs call for loosening critical worker exemption restrictions
New Zealand Medical Association chair Dr Kate Baddock, who also runs a GP clinic in Warkworth, said already patient consults were getting delayed and wait times were worsening due to the lack of GPs - a problem that had snowballed due to Covid-19, particularly in rural areas.
She said rural GP clinics were dependent on locum doctors from overseas but the process to get them here was difficult.
Before Covid-19, it used to take between three to six months and now with border restrictions it takes six to 12 months, Baddock said.
"For many New Zealand GP graduates, it just wasn't appealing to work in rural clinics," Baddock said.
Close to 47 per cent of GPs were expected to retire in the next 10 years, the Royal New Zealand College of General Practitioners estimated three years ago.
Baddock said employers couldn't afford to keep covering the quarantine costs.
"We will be pushing the Government to waive this fee for critical workers because it's not sustainable and they are helping save lives."
A New Zealand Rural General Practice Network (NZRGPN) chief executive Grant Davidson said no overseas doctors could even apply for a visa if their contract start date was beyond December 31.
"This is the date that current exemptions of critical health professionals from exclusion to NZ ends," Davidson said.
He said NZRGPN had written an urgent letter to Minister of Immigration Kris Faafoi asking for this date to be extended but were yet to get a response.
"Our NZ locums recruitment team are still receiving significant levels of interest from overseas doctors who are interested in moving to New Zealand and we have continued to recruit and place them.
"However, we are concerned that border and immigration restrictions will cause delays in placing these essential health workers in jobs beyond December 2020."
Faafoi responded to the Herald saying: "The Government will review the category to ensure any exception continues to meet the necessary objectives. Any decisions will be made before the end-of-year expiry date."
Aged-care sector: A particular concern
Multiple experts said the aged-care sector was of particular concern, as it was heavily reliant on migrant caregivers and nurses.
Of the 5000 registered aged-care nurses in New Zealand, half are from overseas. And one in four aged-care caregivers (20,000 in total) are international, Simon Wallace - chief executive of New Zealand Aged Care Association said.
"Our international workforce has dried up fast and it's a extremely concerning issue what the future could bring."
MBIE data showed in January, there were 378 internationally qualified nurses who arrived in New Zealand. In September there were six.
Wallace said it was good that the Government extended international caregivers and nurses' visas by 12 months but the long-term impacts were a serious worry.
The reality is next year, when those visas run out, we could be in a crisis and there has been no commitment from the Government about how long-term New Zealand plans to tackle the issue, he said.
Wallace said the positive was locals had become more interested in stepping into caregiving after losing their job in hospitality or other sectors.
"Many people are seeing caregiving as a stable job because the one good thing that's come out of Covid, is that people are realising how important it is that we look after our elderly."
Wallace said further work was needed to make caregiving and aged-care nursing more attractive to locals. One way was by streamlining the process to progress from caregiving to nursing, he said.
Nurses outside of the aged-care sector:
David Wills, Nurses Society of New Zealand director, echoed concerns by Wallace but said nurses working at DHBs had not been hit as hard as the aged-care sector that relied more on migrant workers.
He said the union did not have any statistics on numbers of New Zealand nurses going overseas this year since Covid-19 but anecdotally he suspected it was very low.
"At this point think the numbers coming in are very low and likely to remain low. Border controls and Covid-19 issues being the main issue.
"That said anecdotally we are hearing suggestions that given our good Covid-19 response we might see more nurses moving here from North America, UK and other parts of Europe. We have had a few some inquiries."
Andrew Craig, Immigration Policy Manager at MBIE, said: "The exception for critical health workers was created in March 2020 to facilitate our health system's response to Covid-19 and minimise the disruption to the health workforce."
In response to calls about making the critical workers exemption process easier and waiving quarantine fees, Craig said: "The border is open to critical health workers. Critical health workers get invoiced after they leave managed isolation, it is then up to the person to arrange payment with their employer."
MBIE data showed 314 overseas health workers have been allowed to enter New Zealand between August 10 and October 18. A MBIE spokesperson said data before August was not accurately available.
"We are unable to provide the data request as this information is not recorded in an easily reportable format."