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NZ Herald
21 hours ago
- NZ Herald
Waikato med school business case beats Auckland and Otago
Option 2 was a specialist medical training programme focused on rural health run by those two universities and was estimated to cost $10.2b, while option 3, the new medical school at Waikato, was estimated to cost $9.1b, making it the cheapest overall – although the University of Auckland has criticised the assumptions behind this costing. Director-General of Health Dr Diana Sarfati and University of Waikato vice-chancellor Professor Neil Quigley, watched by Health Minister at the time, Shane Reti, and Prime Minister Christopher Luxon, signing the Memorandum of Understanding for a third medical school in 2024. Photo / Mark Mitchell The Waikato medical school was also estimated to deliver greater benefits, leading to a benefit-cost ratio of 1.99, meaning each dollar spent on the school produced $1.99 in benefit. Option 1 and 2 had a ratio of 1.5 and 1.8 – placing them only narrowly behind Waikato. Health Minister Simeon Brown told the Herald the school was a 'game-changer for the long-term growth of our medical workforce in New Zealand'. 'Cabinet agreed to this proposal following the Ministry of Health undertaking a business case and a cost-benefit analysis which demonstrated this proposal would be the most effective at building this critical health workforce for New Zealand,' he said. The University of Auckland's Dean of Medical and Health Sciences Professor Warwick Bagg told the Herald he was 'deeply concerned' by the business case, which seemed to have a predetermined outcome: to favour the Waikato medical school the National Party took to the last election. He said the assumptions of the report were flawed. The capital cost for the new school at Waikato of $232 million was far greater than the other two options, which had costs of $49m and $81.5m respectively. The ongoing operational costs racked up over the years 2026 to 2042 were higher for the first two options, at $513.6m and $508m compared with $361.6m at Waikato. Bagg said this modelling made unfair and inaccurate assumptions about the existing two medical schools that put them at a disadvantage. For example, the business case said that it is 'more certain that Option 3, the Waikato school, has a lower operating cost … simply due to it being a shorter programme'. While it is correct that the Waikato Medical School is a shorter programme, tailored to just graduates, the students admitted the school will still have to offer an undergraduate programme somewhere, probably in New Zealand, which the Government will have to subsidise. Bagg said the cost of turning Waikato's students into graduates who can be admitted into the school isn't reflected in the business case. Lifting those costs out of the business case made Waikato look better overall. 'They are focused on the four-year graduate programme … they haven't focused on the three years that they'll have to do to get into that medical school,' he said. He said another way the high capital costs for Waikato have been 'offset' is the business case has found 'more benefits for the Waikato medical school'. The business case is particularly reliant on the assumption that far more Waikato graduates will go on to be GPs – and GPs who work rurally – than graduates of other schools. The business case found increasing capacity at the existing medical schools would result in just 23% of those graduates staying on to become GPs, while the joint rural training programme would result in 33% of its graduates becoming GPs. In the Waikato medical school's case, 38% of its graduates would become GPs. The business case notes that having a higher number of GPs in the community increases people's health. The fact the Waikato school provides the greatest number of GPs therefore weighs heavily in its favour. Benefits and costs of the three options analysed. Table / Ministry of Health Bagg said Sapere, who provided cost-benefit analysis for the business case, 'haven't used the data we provided them' to calculate the GP figure for the option of increasing capacity at Auckland And Otago. He said 'about 35%' of graduates from Auckland and Otago medical schools are working as GPs eight years after graduating – a far higher figure than the 23% quoted in the business case. He said this lower figure came from a survey of graduates' intentions when they graduated, not what they actually ended up doing. 'We told Sapere this assumption was incorrect,' he said. The assumptions for the number of GPs graduating from Waikato were based on figures from Australia's University of Wollongong Graduate School of Medicine, which will be a model for the Waikato school. Brown defended the modelling behind the business case. He said the school will 'offer a post-graduate medical qualification based on similar successful programmes in Australia'. 'These programmes include a year-long primary care placement and encourage students to work in primary care settings following graduation. The selection criteria of students alongside their long-term placements in primary care will both support a higher degree of these medical students to work in primary care after graduation,' he said. No expectation of ratepayer funding for med school – Brown Brown poured cold water on concerns councils could be asked to stump up for the new school. Brown's Cabinet paper suggested territorial authorities – local councils – are being lined up for a contribution to the school. A paragraph from the Cabinet paper progressing the school, which will be joint-funded by the Crown, the university and philanthropists, noted, '[t]he University of Waikato has identified $151.859 million which they will ... contribute towards the new medical school costs'. 'This contribution shows significant support for a new medical school from a range of stakeholders from private trusts and foundations, individuals, and territorial authorities'. But Brown told the Herald, 'as Minister of Health, I have no expectation that councils will financially contribute to the new Waikato Medical School'. University of Waikato vice-chancellor Neil Quigley told the Herald earlier this week about half of the university's $150m share of the school could come from donations. 'At the moment, we're well on the way to the 50% of donations just with a relatively small number of large trusts and very wealthy individuals so we don't see that as particularly challenging,' he said. Brown defends information release Labour's health spokeswoman Ayesha Verrall called for the business case to be published on Monday to show the assumptions underlying Cabinet's decision to proceed with the school. 'Treasury has raised concerns about this project. Decisions about the future of NZ's medical workforce are critical and must be transparent. The Government needs to release the costings quickly,' Verrall said. The business case was published by the Ministry of Health about 6pm on Friday, a time often associated with the Government trying to bury information because people are enjoying their weekend. Brown defended the timing of the release, saying: 'Cabinet made the decision to progress with the third medical school on Monday with officials tasked with preparing material for proactive release following this decision. 'Normally Cabinet decisions and supporting information are required to be proactively released 30 days following a decision, however due to the significant interest in this decision, this was sped up to ensure the information could be made available as quickly as possible.'
RNZ News
4 days ago
- RNZ News
Kids and smartphones
Owning a smartphone before age 13 is associated with poorer mind health and wellbeing in early adulthood, according to a global study of more than 100,000 young people. The study was published earlier this week in the peer-reviewed Journal of Human Development and Capabilities, and found that 18- to 24-year-olds who had received their first smartphone at age 12 or younger were more likely to report suicidal thoughts, aggression, detachment from reality, poorer emotional regulation, and low self-worth. OECD data in 2018 showed that New Zealand youth used digital devices 42 hours per week on average, compared to 35 hours globally, and studies have shown that children's screen use has increased since then. So how can parents and caregivers manage screen time? Kathryn speaks with Jackie Riach, psychologist and country lead for Triple P New Zealand which provides parenting programmes nationwide. To embed this content on your own webpage, cut and paste the following: See terms of use.
Otago Daily Times
4 days ago
- Otago Daily Times
Telehealth launch criticised
A local primary health organisation has criticised recent announcements about the launch of telehealth services. Minister of Health Simeon Brown recently announced a new 24/7 digital health service offering virtual consultations with New Zealand-registered doctors and nurses "anytime, anywhere". The service connects patients to clinicians through trusted providers using secure digital technology. Doctors and nurse practitioners will be able to assess symptoms, diagnose conditions, prescribe medications and provide referrals — all from wherever the patient is. "This is about making sure Kiwis can get the medical help they need when they need it, especially when they can't get a timely appointment with their regular general practitioner, or outside normal clinic hours," Mr Brown said. "It also helps ease pressure on emergency departments by treating non-urgent issues earlier and in the right setting." It would ensure care was available when and where it was needed, helping to bridge the gap when traditional access to a general practitioner was not possible, he said. The digital service gave people greater access to the care they needed, but did not replace the critical role of general practitioners, who were responsible for their patients' continuity of care. "That is why providers will be required to send clinical notes back to a patient's GP after an appointment. "At the same time, we are backing GPs with a record up-to-14% funding boost this year to support the critical work they do in our communities," Mr Brown said. WellSouth chief executive Andrew Swanson-Dobbs said primary care was in crisis in many parts of the Southern region and across the country. "We continue to hear about clinicians working unpaid, about doctors unable to retire as there is no replacement." "This is compounded in our rural parts," Mr Swanson-Dobbs said. About half of the general practices in Otago and Southland are rural or at least a 50-minute drive from a hospital. Existing services had been undermined, both clinically and financially, by telehealth providers, he said. "Investment is shifted to a service that effectively takes patients away from their own GPs. "To make matters worse, telemedicine is pulling GPs and nurses from practices for these telehealth roles." Telehealth was contributing to the issue and should not be seen as an alternative to a superior face-to-face service, he said. "If you want to reverse the trend of too few GPs, hire more GPs, fund the existing GPs adequately." As the primary health organisation for Otago and Southland, WellSouth had always maintained that investment in primary care should first and foremost support the workforce on the ground in existing general practices. "Our rural communities especially need clinicians to keep their practices sustainable." While telemedicine was an important part of primary care, more investment in people was needed, he said. "That is why at WellSouth, we are investing in building and sustaining our local general practice workforce, through new investment in training and supporting our GP registrars and new nurse practitioners, in addition to our existing nursing workforce and healthcare assistants." Mr Brown said that, as minister of health, his priority was to ensure all New Zealanders had access to timely, quality healthcare. "That is why the government has invested a record $16.68 billion in health over three budgets to bring down wait lists, employ more frontline health workers and ensure we have the health infrastructure Kiwis need. "This government has been clear that we want to see more healthcare delivered in the community and ensure that hospitals have capacity to provide planned treatments and emergency procedures. "To do this, we need greater funding of primary and community healthcare." The recent announcement of an agreement between the government and the University of Waikato to establish a new medical school may provide some welcome news. WellSouth clinical director Dr Carol Atmore said training doctors with a focus on primary care and rural health was important for the country. "The evidence shows that if you train people from rural backgrounds in rural settings both at undergraduate level and once qualified as doctors, those doctors are much more likely to settle and work in rural communities in the longer term. "Nearly half of our communities in Otago and Southland are rural and this is where the biggest workforce issues sit across the country." While there was no guarantee the graduates would end up working in the South, it was hopeful that having about 120 graduates going through the new primary care and rurally focused training programme at the University of Waikato might help alleviate some of those workforce pressures for Otago and Southland in the long term, Dr Atmore said.
