Included in Thursday’s Government announcement was the rejection of two proposals to establish schools of rural medicine by Waikato University and a joint proposal from Otago and Auckland Universities.
Rural General Practice Network chief executive Dalton Kelly welcomes the Government’s recognition of what he calls a crisis in the delivery of health care in rural areas.
“In particular we welcome the Government’s acknowledgment that this is about the whole rural health workforce and that a multidisciplinary approach is needed.
“We need more doctors, nurses, midwives and physiotherapists in rural New Zealand and now we need to quickly develop a plan to deliver this.”
Kelly says a quarter of the country’s 200 rural health practices have vacancies for doctors, nurses and other health professionals but half the country’s GPs intend retiring within a decade.
It is a similar scenario for rural nurses with many nearing retirement.
“This retirement wave which NZ 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.”
The Government initiatives are similar to the National Interprofessional School of Rural Health proposal 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, a framework that has helped retain and recruit staff in rural Australia.
The initiative still has to be signed off by the Government and a spokesman for Health Minister David Clark said the announcement was not related to that earlier proposal and should not be seen as an an endorsement.
“Today’s statement does not relate to the National Interprofessional School of Rural Health initiative. It should not be seen as any sort of comment one way or the other on that.”
Clark also announced changes to the funding of training for GPs so a greater proportion of training places go to rural trainees.
He also proposes greater investment in professional development for rural primary health care nurses and midwives, extending rural professional education programmes and improving the use of technology for professional rural support.
Clark said these initiatives have proved successful in Australia but he has instructed the Health Ministry to look at longer term solutions.
“By itself, just training more undergraduate doctors is not the answer. We need a more comprehensive approach to attract, support and sustain the health professionals that care for rural people, he said.
Otago University associate rural dean Dr Garry Nixon said the National Interprofessional School of Rural Health proposal was based around training nodes in rural towns 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 undergraduate years or provide specific post-graduate training dedicated to rural practice.
“This initiative supports all of that,” he says.
Nixon says health professionals often reach a career stage where they want to move to another area of practice or advance their career but to do so means further education.
This proposal provides that training and opportunity.
“It is important university medical schools come up with ideas and evidence-based solutions from overseas and this is what this is all about.”
Nixon said it will potentially solve a shortage of health professionals such as doctors, nurses, chemists, physiotherapists and mental health workers.
Kelly said the crisis is being plugged by recruiting doctors from overseas and about 14 a month are being introduced to life in rural NZ.
But importing health professionals is not a permanent solution so NZ needs to grow its own supply or retain those already there.
“In particular, we want to see the training of a range of health professionals taking place inside rural communities so that students form relationships, become a part of the local community and experience everything that rural life has to offer.
“Embedding students, academics and rural health research programmes inside rural communities will see more of the health workforce choose to stay in rural NZ. It will better support and encourage rural kids seeing a viable pathway to a career in medicine and health within their own communities.”
