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Te Whatu Ora launches strategy for health recruitment and retention

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RNZ

04 July 2023, 3:00 AM

Te Whatu Ora launches strategy for health recruitment and retentionHealth minister Ayesha Verrall. PHOTO: RNZ/Samuel Rillstone

New Zealand is estimated to need to increase recruitment by 8000 nurses and 3400 doctors on top of meeting current staffing levels to deal with demand out to 2033.


The government has released a strategy for making up the gaps in the health workforce, building on new data that estimates health need for the next decade.



The data suggests New Zealand will need to recruit or train another 1600 health professionals a year just to maintain current staffing levels relative to population growth - despite the number of new nurses registered in the

past year increasing to 8000, up from 5000 the previous year.


The agency estimated New Zealand was currently short by 4800 nurses, 1700 doctors, 1050 midwives, 220 dental or oral health practitioners, 200 anaesthetic technicians, 170 pharmacists, 120 sonographers, 30 radiation therapists and 30 clinical or cardiac physiologists.


However, Te Whatu Ora Health NZ estimated another 8000 nurses, 3400 doctors and 250 midwives would be needed to make up shortfalls in health demand out to 2033. That also excludes demand for other health professions, which the organisation was unable to estimate based on current data.


The modelling is also based on an assumption of no change to the efficiency of current systems - which the government also plans to improve.


Health Minister Ayesha Verrall announced the Government's plan to boost recruitment and retention at Parliament on Tuesday morning (July 4).


It targets six areas:

  • Māori health workforce recruitment and retention
  • Pacific health workforce recruitment and retention
  • Driving local-led innovation in training
  • Boosting recruitment in priority workforces
  • Retention, including through support
  • Developing clinical workers to become leaders


Specific initiatives include:

  • Growing rural and interdisciplinary training programmes to enable larger student intakes
  • Growing 'earn-as-you-learn' programmes across health professions
  • Creating 135 new training places a year for allied and scientific professionals, including paramedics, oral health therapists, radiation therapists and pharmacy prescribers and anaesthetic technicians
  • Seed funding for new programmes to grow these allied professions
  • Sustained investment in Return to Nursing and support for internationally-qualified nurses (IQNs) to get ready to practice in New Zealand
  • Launch of a Return to Health project focused on flexible opportunities for those with health qualifications to return to work
  • Expanding access to cultural and hardship support for Māori and Pacific students in training to minimise student attrition and grow workforces faster
  • Establishing funding for Māori providers to take more students on placement and to offer increased training and development roles


Verrall said the plan - developed by Te Whatu Ora and Te Aka Whai Ora - would make early differences to health workforces, and was aimed at making a difference to workforces within a year's time.


"Just like in medicine, you can't start the treatment until you've got the diagnosis right - so we need to know what our gaps are. Some of them are confronting but until we do that we can't make the progress we need to fill them," Verrall said.


"While the modelling in this plan might be confronting to some, I think it is important that Te Whatu Ora is clear on workforce shortages to enable action."


She said the problem had been decades in the making.


"The gaps have emerged over decades and we have grown the health workforce 16 percent in nurses, 16 percent growth in doctors, during the term of this government. However, it's not enough to keep up with the population, the ageing population, and the new demands we need, so we have to do more."


There was a focus on boosting Māori and Pacific workforces, and rolling out successful methods developed in the former DHBs to support health workers with things like pastoral and trauma care, and cultural competency.


The agency noted current staffing levels - 9 percent Māori and 5 percent Pacific - were falling well below the 19 percent and 10 percent proportions of the general population.


"A key thing is to make sure that we're building a pipeline all the way from high school, encouraging Māori and Pasifika students to study science subjects at high school so they have the background in order to do that in tertiary study," Verrall said.


Other initiatives would include things like scholarships; guaranteeing places in the national health workforce for those planning to go overseas and return; and making it easier for them to do so - or offering more international fellowships with the hopes they would remain in New Zealand.


A "boots on the ground" approach with staff based in overseas offices - including London - could also be taken to help boost international recruitment, although the plan in the long term aimed to lift domestic training rates so the system was relying less on foreign workers.


The voluntary bonding scheme would also be reviewed and reworked.


"In some cases, international experience is what we want from our health professionals. I did my fellowship in Singapore and sought to bring my experience back home but we need to join that up better. Currently, New

Zealanders returning to New Zealand can't access relocation costs - we need to fix that," Verrall said.


"It means everything from when you're on night duty, we'll now make sure that there is nutritious food available for you. It means that when something distressing happens at work, we need to be there with the approriate debrief."


She said no one had spoken to her back when she was a junior doctor and experienced her first patient death from an arrest.


"There was no one whose job it was to speak to me about that experience. Now, for some people that makes the difference between staying in the health sector or driving burnout and leaving. We want our workers to be better supported."


In a statement, National's health spokesperson Shane Reti said after six years of failure, the best Labour could offer was half-baked announcements.


"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," he said.


"National knows that workforce is one of the main issues facing the sector and we have a plan to 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."


National would announce further health policies ahead of the election, Reti said.


While research on health workforce gaps has been done in the past, this is the first time such estimates had been applied across the new national health agency.

Verrall pointed to the health reforms as a key part in making the plan possible.


"There are a number of actions we can take now that we couldn't take when we had 20 DHBs competing against each other for staff. In that old system it was nobody's responsibility to address the training pipeline, now we recognise that is the health system's responsibility and we're working hard on it - that led to the announcement of the 830 nursing placements yesterday."


Te Whatu Ora plans to continue to improve its data gathering for estimating workforce shortages and need, and produce reports and estimates on a regular basis into the future.


Te Whatu Ora's chief people office Andrew Slater said the research and plan had been pulled together as part of the annual Budget process.


"By bringing the 29 organisations together we've been able to take sort of a whole-of-system approach and as the largest employer of health workforce as well we're able to look at the really good practice we've got going across in certain areas and in certain hospitals.


"We've been able to evaluate some of the pilots, work out those ones that we need to scale, and then bring those through."