Saturday, March 30, 2024

First step to boost rural health

Neal Wallace
A tentative step has been taken toward alleviating a looming rural health professional crisis, Rural General Practice Network chief executive Dalton Kelly says.
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The National Interprofessional School of Rural Health, an initiative by the country’s medical schools, will create a rural training and research structure to help health professionals develop careers and do research.

But more action is needed to stem the existing shortage of health professionals that will worsen with pending retirements.

A quarter of the country’s 200 rural health practices have vacancies for doctors, nurses and other health professionals but within a decade half the country’s GPs intended retiring.

It is similar for rural nurses with many nearing retirement.

“This retirement wave which New Zealand is facing will inconvenience urban communities where there is a choice of health providers.

“In rural NZ, however, this will result in a healthcare crisis of significant scale if it is not addressed now,” Kelly said.

That burgeoning crisis is being plugged by recruiting doctors from overseas and Kelly says about 14 a month are being introduced to life in rural NZ.

The latest intake is about to embark on an orientation tour of NZ and an introduction to job vacancies.

His organisation attends recruitment fairs around the world and Kelly says there is plenty of interest but doctors moving to NZ need to stay in a practice for at least 12 months.

Importing health professionals is not a permanent solution to the rural health crisis and NZ needs to grow its own supply.

For the new health professional to stay the community needs to make them feel welcome.

The school is an initiative by Otago and Auckland Universities, the College of General Practitioners, the network and Auckland University of Technology.

It establishes a nationwide network where rural health professionals use virtual campuses to extend teaching of rural medical staff and for the research of health issues.

The new entity is based on successful Australian models and lets rural health professionals combine academic roles with active rural clinical practice.

Kelly says training is needed for a wide range of health professionals directly embedded in rural communities and to allow rural health research.

Otago University associate rural dean Dr Garry Nixon said the training is based around nodes established in rural towns throughout the country and integrated with local health services.

“Sharing human, physical and other resources will permit these institutions to educate students and undertake research in rural communities in ways currently not possible.

“It will create a community of health professional teachers and researchers in rural areas,” he says.

There are three proven ways to encourage health professionals to work in rural areas: select students with a rural background, provide students with high-quality experience in rural practices during their under graduate years or provide specific post graduate training dedicated to rural practice.

“This initiative supports all of that,” he says.

Nixon said health professionals often reach a stage in their career where they want to move to another area of practice or advance their career but to do so means further education.

The proposal provides that and is proven overseas.

“It is important university medical schools come up with ideas and evidence-based solutions from overseas and this is what this is all about.”

Whether it progresses is up to the Government but Nixon said it will potentially solve a shortage of health professionals such as doctors, nurses, chemists, physiotherapists and mental health workers.

Waikato Univeristy  vice-chancellor Professor Neil Quigley says a decision on its proposed new medical school specialising in rural health rests with the Government.

“The need for a third medical school of this nature is widely acknowledged and its relevance continues to grow as pressure mounts on the country’s medical services and practitioners.”

He describes the school as commendable for recognising the shortage of trained doctors because the primary care needs of provincial and rural communities are not being met.

“However, the evidence from the international medical education literature is that if we want to produce doctors who will in much higher proportions choose to work in rural and provincial areas we need to adopt a completely different student selection and medical education model such as that proposed for the Waikato Medical School.

“It is unlikely that incremental changes to the existing programmes can achieve the substantial change in health workforce outcomes that is needed to meet the needs of provincial and rural NZ”

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