The Rural Health Alliance Aotearoa New Zealand described rural health services as inequitable compared to urban and with a quarter of rural practices looking for new doctors, services, especially emergency ones, needed to be brought “closer to home”.
The country’s two medical schools at Otago and Auckland universities have joined forces to create a new national School of Rural Health that aims to get more medical graduates working in rural communities but Waikato University, which wants to set up its own medical school, said it wouldn’t work.
The initiative would also see a broadening in the training of health professionals and the opportunity to do research while working in rural practices.
While working in rural areas, undergraduates and graduates would do multi-disciplinary training alongside other health professionals such as nurses and midwives.
Auckland University medical programme head Professor Warwick Bagg said increasing the number of rural GPs was a challenge but by exposing medical graduates to work and life in rural areas, research showed following that experience they were more likely to want to continue to work there.
The scheme established 20 sites around the country developed and governed by local communities through which health professionals across all medical disciplines could continue their training and do research.
“What we are trying to address is the issue of inequality of access to health care,” he said.
The proposal still required Government sign-off and funding though just how much was still to be finalised,
But it was cheaper than establishing a new medical school, Bagg said.
The proposal had been under consideration for several years and was developed out of targeted initiatives such as the Rural Immersion Programme and Pukewakawa in Northland.
“We think this is something rural people have been asking for for some time and this co-ordinated, national effort may provide a good solution.”
Waikato University vice-chancellor Professor Neil Quigley said the scheme was not the answer because the medical schools were not producing the required distribution of doctors across specialities and locations outside the main metropolitan areas.
The university was seeking Government approval to establish a graduate entry medical school, an entity Quigley said would offer a fundamental change in medical training to address workforce shortages.
“The Waikato proposal recognises that NZ is not training enough doctors to meet its health workforce needs and is too reliant on recruitment of trained doctors from overseas, an issue that the proposed new School of Rural Health does not address at all,” he said.
Rural General Practice Network chairwoman Sharon Hansen said the real benefit was having a specialist unit focused on rural health education and the training of health professionals.
“It means equity and access and that is what we haven’t got in the rural sector right now.”
Rural practices relied on staff with broad skills working together and she said the scheme would provide more people with greater skills to fill those gaps.
Hansen did not have an opinion whether the Waikato University proposal was superior to the scheme, saying her group wanted more professionals to meet the health needs of rural NZ.
Alliance chairman Martin London said the organisation was supportive of the scheme because it meant a greater number and more settled health professional workforce in rural areas.
London said he initially considered a similar model when doing a research project in 1992.
It was based on systems in parts of rural Canada and South Australia.
Fifth-year medical students at Otago University already spent a year in rural practices but the scheme went further.
“As well as that, undergraduates, interns, registrars will all get some experience in rural practice.
“To create a whole medical training course based on training in the context of rural communities is something we’ve dreamt about.”
London met politicians last week to push the case for better health services in rural areas and hoped to meet the ministers of health and primary industries soon.
Rural General Practice Network chief executive Dalton Kelly welcomed any change to how rural medical, nursing and allied health staff and students were trained.
He reiterated that early exposure to life and work in rural NZ would encourage people to move and make their careers there.
“There is overwhelming evidence that giving trainees exposure to good-quality rural medicine during their training means it is much more likely they will choose to work rurally once they graduate.”
