Andrew Dickens: We need more doctors, but is a third school the solution?

We all know we need more doctors. A lot more. Considering how long it takes to train a doctor, this is something that someone should have probably thought about 20 or 30 years ago. New Zealand's population has doubled since the last med school was opened, so you can see how far behind we are. 

But now we have a proposed new medical school in the Waikato. 

This was dreamed up last electoral cycle by the University with the help of a report and analysis by Stephen Joyce with his consultation hat on. Shane Reti was heavily involved with the university. The University called the school a present for National's second term. 

Low and behold, it became National’s policy at the last election, and it seemed a vote winner. After all, we know we need more doctors 

But then it all got sticky with bureaucrats and coalition partners suggesting the idea might not fly. 

Now it’s back with a miraculous cut in budgeted costs and a substantial expectation that generous benefactors would make up any underfunding from the government. And if they didn't, the University had the means to cover any shortfall. 

The two universities that already have medical schools don’t support it. They say just give us more money and we’ll make more doctors. A PWC report last year said a school was duplicative and expensive. 

And with the need for doctors so urgent there’s the time factor – to get a school up and running takes a while. You need all sorts of specialised spaces. The Waikato Graduate School of Medicine is scheduled to open in 2028 —three years from now— versus two schools who claim they could grow intake from next year. 

The whole thing seems a bit rife of political necessity.  They promised it, so it has to happen whether it's a good idea or not. It reeks of wasteful government spending as a payback to loyal supporters. It preys on the largesse of the wealthy. Is it a good idea? 

If it was a good idea why has not been part of our long-term planning for longer? Training to become a doctor in New Zealand typically takes 12 to 17 years, depending on the chosen specialty. 

But a third school has suddenly landed in our lap. I'm not against Waikato having a medical school in the future – health experts have said rural-origin students who train in rural areas and are trained by rural health professionals are six times more likely to work in those rural areas post-graduation. Now Hamilton is quite rural, but frankly so is Otago so I'm not sure that's a reason to have a school there. But right now, it seems a bit rushed and political.  

So do you support the establishment of a school in Hamilton? 

And then there's all the other issues around medical staff. 

The proposal to date aims to produce proportionately more rural and primary care doctors via a four-year graduate programme, largely based in the community and the wider region’s general practices, yet drawing also on the many excellent clinicians at Waikato and other regional hospitals, so that graduates (as at Otago and Auckland) are equipped to go into any area of medicine. 

Many in the medical sphere say the real problem in banging out doctors is not in the number of places at a school, but where they go to get on-the-job training – placements 

So to train more doctors we need more doctors to train more doctors.  And this school does nothing to solve that problem. 

Once they're trained in theory, how do we train them practically? Once they are trained, how do we pay them properly, and then how do we keep them from disappearing overseas? 

And then there's the question of where we find people with the ability and desire to go through the arduous process of training to be a doctor. 

Because doctors don't grow on trees.  

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Episode Transcript

Speaker 1 (00:06):
You're listening to the Kerry Wood of Morning's podcast from
News Talks, he'd be.

Speaker 2 (00:11):
We all know we need more doctors, a lot more
considering just how long it takes to train a doctor.
This is something that someone should have probably thought about
twenty or thirty years ago. New Zealand's population has doubled
since the last med school was opened, so you can
see exactly how far behind we are now. But now

(00:33):
we have a proposed new medical school in the Whitecado.
Actually it's not proposed, they've approved it. It was proposed
during the last election, but now apparently it's going to happen.
It was all dreamed up last electoral cycle by the
university with the help of Shame Retty and also with
the help of a report and analysis by communication expert
Stephen Joyce with his consultation hat On. The university called

(00:57):
their new medical school in the White Kado a present
for National second term, so there was a bit of
buttering up happening there. Yes, it became National's policy at
the last election and it seemed a bit of a
vote winner because as I said, we all know we
need more doctors, but they've got a bit sticky over

(01:18):
the last little bit with act saying this is too expensive.
They somehow claim they've cut eighty million dollars off it.
Bureaucrats were sitting there going not sure it's a good idea,
But now it's back with this miraculous cut and budgeted
costs and a substantial expectation that generous benefactors will make
up any underfunding from the government, and if they don't,

(01:40):
the university apparently has the means to cover any short form.
Heather last night said there's absolutely no way they can
build a school for what they're saying they're going to
build it for. It's going to blow out. But if
the government is going to limit it, it's a donation
towards this thing. Donation that's the wrong word. Their contribution
towards this whole thing, Our money, our contribution towards this

(02:02):
whole thing. And then it blows out. Well, that means
the university is going to have to cover it, and
is that going to criple them? But anyway, they know
their business, they know what they can do. Now. The
two schools and the two universities that are already doing
this job, they don't support it at all. They've always

(02:22):
said just give us more money and we'll make more doctors.
And a PwC report last year said a new school
was duplicative and expensive, doubling up on the stuff we're
already doing, building buildings we already have, and with the
need for doctors so urgent, there's also the time factor.

(02:43):
To get a school up and running takes a while.
You need all sorts of specialized spaces and of course trainers.
The White Cato Graduate School of Medicine is scheduled to
open in twenty twenty eight. That's three years from now,
versus two schools who claim that they could possibly grow
intake from next year, but certainly a lot quicker than
three years. The whole thing seems a little bit political,

(03:06):
don't you think They promised it would happen at the
last election, so therefore it has to happen. Whether it's
a good idea or not. It has the possibility of
being wasteful government spending, but at the same time it's
a payback to loyal supporters within the University of Whitkato community.
It prays on the largesse of the wealthy. So my

(03:27):
question for you is is this a good idea? Full stop?
After all? It's your money, it's being spent on a
new school. And if it is such a good idea,
why has this not been part of our long term
planning for longer? Like I said right at the beginning,
our population has doubled since the last med school was opened.
Who's been thinking over the last thirty forty to fifty

(03:48):
years about when the next one would happen. I haven't
heard about this until the last election. Training to become
a doctor in New Zealand typically takes between twelve and
seventeen years, depending on the chosen specialty. I repeat, I repeat,
who was who was not thinking about this thirty years ago?

(04:08):
But there we go. A third school is suddenly landed
in our lap. And I'm not against Wai Katto having
a medical school in the future. I just wonder whether
it's being rushed now. The reason why why Katto might
be good is that health experts have said that rural
origin students who train in rural areas and are trained
by rural health professionals are six times more likely to

(04:31):
work in rural areas postgraduation. And they're saying that's why
we should have a school in the Waikato. Now Hamilton
how rural are you? I know you're surrounded by farms,
but frankly, you're a city these days, aren't you. And
I don't know if you've noticed, but Dunedin is surrounded
by farms and so it's deep in a rural area
as well. So I don't get that argument either. Maybe

(04:53):
you do, so as I said, it all seems a
bit rushed and a bit political. So the questions do
you support the establishment of a school in Hamilton? And
then there's the stuff that might got into this morning.
The propos today aims to produce more rural and primary
care doctors via a four year graduate program largely based
in the community and the wider regions. General practices all right,

(05:18):
so many in the medical sphere. So the real problem
and banging out doctors is not the number of places
at a school, but where they go to get on
the job training, you know, the general practice areas, et cetera.
You need doctors to train more doctors. I'm going to
do that sentence even more convolutedly to train more doctors.

(05:40):
We need more doctors to train more doctors, and this
school does nothing to solve that problem. And once they're
trained in theory. How do we train them practically, that's
the question. And once they're trained, how do we pay
them properly? And then how do we keep them from
disappearing overseas? And then there's the question of where do
we find these people with the ability and desire to
become a doctor. Because doctors don't grow on trees. The

(06:04):
thought is starting to rise that we should be heading
out there into the school systems and whatever and selecting
them and saying you, you have talent, you could be
a doctor. You can't tell people to be a GP,
as the University of Wycato Vice Chancellor Neil Quickly Tom
Mike this morning.

Speaker 3 (06:19):
People have tried bonding schemes and other places and things
like that, but they're really difficult to make work practically
and legally. What you have to do is select people
for the commitment that they show to being in general
practice and in primary care. And it's possible to design
your selection mechanisms so that you identify those characteristics and

(06:43):
people rather than just well well, because they will come
from places where you know there are shortages of doctors
and where they're committed to going back to those places
to practice, and will select them based on their demonstrated
involvement with the community rather than just the are academic

(07:06):
grades all right?

Speaker 2 (07:07):
So there's a whole lot to unpack in this and
that's what you're here for. The number de photos eight
hundred and eighty ten eighty. Is the medical school in
Wykatto a good idea? Or would you prefer the medical
schools in Otago and Auckland to be expanded? The second
thing is should we be selecting our doctors? Should we
be finding the kids who are actor good at this
and could be good at this? Because to be a doctor,
and certainly to be a surgeon, you need to be

(07:29):
an extraordinary individual. So do we wait for them to
voluntarily turn up? Then once we have trained them, how
do we keep them? Classical questions I know, but ones
we're still seeking an answer for, and one that you
might have the answer for me.

Speaker 1 (07:45):
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