Health Reforms Raise Fears Of Two-Tier System And Workforce Shortages
Dr Graham Roper, chair of ANZCAs New Zealand National Committee, says the outsourcing plans will negatively affect the training of anaesthetists, who are critical for operations to proceed, and see existing specialists move from public hospitals to …
Moves by Health NZ to outsource elective operations to the private hospital sector increase the risk of a two-tier health system and will worsen the medical workforce shortage, a leading medical college has warned.
The Australian and New Zealand College of Anaesthetists (ANZCA) is one of the largest specialist medical colleges in Australia and New Zealand and the region's leading authority on anaesthesia, pain medicine and perioperative medicine.
Dr Graham Roper, chair of ANZCA's New Zealand National Committee, says the outsourcing plans will negatively affect the training of anaesthetists, who are critical for operations to proceed, and see existing specialists move from public hospitals to the private sector.
'Trainees' practical experience will be impacted, with a loss of exposure to outsourced clinical cases, and skewed amounts of urgent and complex work. It will take longer for trainees to get their required experience, delaying their entry into the workforce. Anaesthesia training will become less desirable, threatening the ability to produce much-needed specialists.
'Anaesthetists are a central part of both the hospital and the surgical team – without them, operations simply can't go ahead.'
Dr Roper says the changes will lead to public system specialists facing a large amount of complex and urgent patients, requiring the highest level of care with extended hours of work. This would lead to specialists choosing to move to the private sector, further increasing the strain on the public system.
He is also questioning the ability of some private facilities to provide the required level of care and training opportunities.
'Not all private facilities are set up to deliver the same level of clinical care as the public system. Private providers do not take on the same complexity of work in the same volumes as the public system, and may not provide high-dependency care, intensive care, acute pain services, pre-admission clinics and access to urgent investigations. Any significant complications during or after surgery will see the patient transferred to the public system for ongoing care.
'Many private facilities do not have on-site medical cover overnight and have a limited ability to respond to medical emergencies,' Dr Roper says.
'Our Māori and Pacific peoples, with increased complexity of health needs, are unlikely to benefit from this outsourcing model. In addition, our rural and remote communities may not be well served with this change.
'People living in rural areas are not always close to a private provider, can have transport difficulties, and lose family and whānau support if they have to travel long distances for surgery.'
Dr Roper says ANZCA is willing to be involved in finding solutions to the unmet need of elective surgery across Aotearoa New Zealand.
'The provision of high-quality safe and equitable care for our community remains the core aim of our profession and the New Zealand public should expect that access to anaesthesia and surgery is future-proofed.'
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
1News
3 days ago
- 1News
Former Black Fern fundraising after shock cancer diagnosis
Cheryl Waaka, a former Black Fern and a māmā to two teenagers, is now facing her toughest opponent yet, stage 4 bowel cancer. She was a fit and strong wāhine Māori hailing from Ngāpuhi and Ngāti Kahungunu, she's won two World Cups in the black jersey and is still dedicated to the game — but her diagnosis in June has left her stricken with sadness. "I was healthy, running around, doing my everyday job. It was King's birthday weekend. There was a Johnny Isaacs Māori tournament in Kaikohe. I was running the line, AR-ing, and three days later, I'm on the floor in excruciating pain." She remembers the day her life was changed forever. "I got my brother to get me to the GP in Kaikohe. Ambulance to Kawakawa. Ambulance to Whangārei and then that night, broke the news that I have a tumour in my bowel and I need to have emergency surgery. ADVERTISEMENT "I suppose I'm very lucky to my surgeon. He got the tumour, but unfortunately, it spread to my liver. In March, Health Minister Simeon Brown announced the National Bowel Screening Age would be lowered for all New Zealanders from 60 to 58, a step he said would save hundreds of lives. The "redirected" funding was previously set aside for a pilot programme that allowed Māori and Pacific people to access bowel cancer screening starting at age 50. While Brown said the age of eligibility for free bowel screening was projected to prevent an additional 771 bowel cancers and an additional 566 bowel cancer deaths over the next 25 years, advocates called the move "institutionalised racism" as half of bowel cancers in Māori occurred before the age of 60. Waaka, who was up to date on all her health checks, said if the screening age was lowered to 50, her diagnosis would not have been stage 4. "If it didn't happen now, would [the tumor] have been still sitting there, and by the time I got to 58, if I got to 58, it might have been too late. "You look at me, strong, fit, healthy. It can happen to anyone. And I don't want it to happen to anyone." ADVERTISEMENT (Source: Photosport) And the effect ripples to her whānau, she recalled the moment she had to break the news to her two children. "I wouldn't like to wish that on anybody. Just myself to be told, and then to actually tell the kids. "I was trying to hold myself to be strong, as we do as wāhine. So that was one of the hardest moments of my life. I wouldn't wish that." The rates of early onset colorectal cancer have risen by 26% per decade on average over the past 20 years, according to University of Otago researcher Dr Oliver Waddell. Researchers and Māori health practitioners have called for the age to be lowered to 45 as it was in many other countries. "If we had [earlier] screening, I most probably wouldn't be costing the country money. ADVERTISEMENT "That's how I'm looking at it. If I was able to get screened at a younger age, you just imagine how much money this government will be saving in health costs," Waaka said. Bowel cancer treatment costs depended on when it was found — stage 1 being the cheapest and stage 4 is the most expensive. For Waaka, her bowel cancer has got into her liver and aside from rounds of chemotherapy, the non-funded drug she needs comes at a cost of $30,000. To start her first round of treatment on August 11, she is having to fundraise to survive. But Waaka said it's a big ask to turn to the community for funds. (Source: Photosport) "Life is hard, people are struggling and for me, I feel like I'm taken from the whānau. "And everyone said, you know, you've given so much, it's our time, but deep inside you know everyone's struggling to survive out there, and I'm just so grateful that people are willing to help me to survive and for me to fight this fight... which I'm going to do." ADVERTISEMENT She wanted her off-the-field legacy to be remembered as much as her on-the-field career. "I'm never one to ask for help, but I'm always giving. So for me, my legacy will be that I've given everything that I can, and hope I've just left something that will remind people of me." By Mihingarangi Forbes of
Otago Daily Times
3 days ago
- Otago Daily Times
Less than half of recent nursing graduates employed by Heath NZ
Nursing students and recent graduates say they are being "failed" by Health NZ, which has employed just 45% of mid-year graduates. Health NZ figures show just 323 of 722 applicants have got jobs in hospitals through its Advanced Choice of Employment Mid-Year matching process. Co-president of the Nurses Organisation student unit, Bianca Grimmer - who is set to graduate at the end of the year - said it was "really discouraging". "It's certainly affecting all of our cohorts from year one to year three, lot of uncertainty and students wondering if they continue with their degree or look at finding a job somewhere else. "Te Whatu Ora used to hire 80-90% of all graduates. We were blindsided this time last year when only three in every five mid-year graduates were hired. This year is even worse." Health NZ said for the mid-year matching process, there were 173 applications from graduates who were still looking for jobs after graduating at the end of last year. National Chief Nurse Nadine Gray said those who did not get hospital jobs were placed in the talent pool, which was open to all registered employers across the health sector. In recent years, the majority of initially unmatched applicants had successfully secured positions from the talent pool with about 84% of nurses eventually finding roles in both 2023 and 2024. "Graduate RNs [registered nurses] often look to hospitals for their first role, and while we are working to employ as many graduate RNs as possible, I want to encourage students to look right across the health system when looking for their first job." The government was investing in expanding and strengthening the nursing workforce in primary and community care, Gray said. The investment includes: $30 million over five years to fund 400 graduate nurses into primary and community care each year, with providers receiving $15,000 for employing a nurse in an urban setting and $20,000 in a rural setting. $34.2 million over five years to fund 120 nurse practitioner training places in primary care each year from 2026. An additional $21.6 million over four years to accelerate advanced tertiary education for up to 120 primary care registered nurses annually. The Nurses Organisation said a recent survey of 1246 nursing students found 62% would consider seeking a nursing job overseas if they were unable to get a new graduate job in Aotearoa New Zealand. This increased to 73% for Māori students. Bianca Grimmer said nursing students recently attended a jobs expo where Australian recruiters were offering graduates better wages and conditions. "We have a health system in crisis and desperately need more homegrown nurses. With 30,000 Kiwis leaving for Australia in the past year, this short-sighted decision by Te Whatu Ora will see more graduate nurses packing their bags." About 36,000 of NZNO's Te Whatu Ora members are preparing for a 24-hour national strike on July 30 after Collective Agreement negotiations stalled. The union said Health NZ's "refusal to commit to its obligation to employ new graduates" was one of the sticking points.
RNZ News
3 days ago
- RNZ News
Nursing students, graduates say they are being 'failed' by Health NZ
National Chief Nurse Nadine Gray says those who do not get hospital jobs are placed in the talent pool. Photo: 123RF Nursing students and recent graduates say they are being "failed" by Health NZ, which has employed just 45 percent of mid-year graduates. Health NZ figures show just 323 of 722 applicants have got jobs in hospitals through its Advanced Choice of Employment Mid-Year matching process. Co-president of the Nurses Organisation student unit, Bianca Grimmer - who is set to graduate at the end of the year - said it was "really discouraging". "It's certainly affecting all of our cohorts from year one to year three, lot of uncertainty and students wondering if they continue with their degree or look at finding a job somewhere else. "Te Whatu Ora used to hire 80-90 percent of all graduates. We were blindsided this time last year when only three in every five mid-year graduates were hired. This year is even worse." Health NZ said for the mid-year matching process, there were 173 applications from graduates who were still looking for jobs after graduating at the end of last year. National Chief Nurse Nadine Gray said those who did not get hospital jobs were placed in the talent pool, which was open to all registered employers across the health sector. In recent years, the majority of initially unmatched applicants had successfully secured positions from the talent pool with about 84 percent of nurses eventually finding roles in both 2023 and 2024. "Graduate RNs [registered nurses] often look to hospitals for their first role, and while we are working to employ as many graduate RNs as possible, I want to encourage students to look right across the health system when looking for their first job." The government was investing in expanding and strengthening the nursing workforce in primary and community care, Gray said. The Nurses Organisation said a recent survey of 1246 nursing students found 62 percent would consider seeking a nursing job overseas if they were unable to get a new graduate job in Aotearoa New Zealand. This increased to 73 percent for Māori students. Bianca Grimmer said nursing students recently attended a jobs expo where Australian recruiters were offering graduates better wages and conditions. "We have a health system in crisis and desperately need more homegrown nurses. With 30,000 Kiwis leaving for Australia in the past year, this short-sighted decision by Te Whatu Ora will see more graduate nurses packing their bags." About 36,000 of NZNO's Te Whatu Ora members are preparing for a 24-hour national strike on 30 July after Collective Agreement negotiations stalled. The union said Health NZ's "refusal to commit to its obligation to employ new graduates" was one of the sticking points. Sign up for Ngā Pitopito Kōrero , a daily newsletter curated by our editors and delivered straight to your inbox every weekday.
