Late last month, New Zealand Health Minister Andrew Little stated what most who work in health already know.

Healthcare is all about people – the people being cared for and the people doing the caring.

Population growth, ageing and a pandemic mean there is no shortage of those needing care, but in New Zealand and globally, there is a chronic shortage of healthcare workers.

Little stopped short of calling it a crisis, but researchers and international agencies alike agree with a survey of New Zealand doctors that the health workforce is in crisis.

In 2016, the World Health Organisation (WHO) projected a global shortage of 18 million healthcare workers by 2030. That was before the covid-19 pandemic. Between 80,000 and 180,000 healthcare workers have died globally during the pandemic’s first 16 months, according to the WHO’s conservative estimate.

“Public statements from political leaders that there is ‘no crisis’ in the health system have seemed increasingly out of step with doctors’ experience over the past year” https://t.co/dXMhA38XIO

— Emma Espiner (@emmawehipeihana) July 11, 2022

Add to this the impact the pandemic has had on the mental health of frontline health staff, including reports of post-traumatic stress disorder (PTSD), and a healthcare workforce seven times more likely to have severe covid and now carrying the burden of long covid.

It’s clear healthcare is no longer the attractive sector it once was.

A highly mobile workforce and a global shortage
Like the cost-of-living crisis, the health workforce shortage is not unique to Aotearoa New Zealand.

This year’s budget included NZ$76 million for medical training and primary care specialists, but doctors who started training this year will not be specialists until 2034.

Meanwhile, Labour’s solution is to undertake an international recruitment drive. It is hailing New Zealand as one of the easiest places in the world for healthcare workers to come to. But are our newly opened borders attractive enough?

Overseas recruitment drive for nurses gains ‘good response’ https://t.co/RZrM4fW67L

— RNZ News (@rnz_news) July 13, 2022

In my health economics lectures I often use an anecdote about the Indian doctor who gets a job in the UK (colonial ties and a multicultural society), the British doctor who moves to Canada (less administration and more family friendly hours), the Canadian doctor who moves to the United States (specialists have much higher earning potential), and the US doctor who undertakes missionary work in India.

This highlights two issues: the health workforce is highly mobile and employment isn’t always about money. Aotearoa New Zealand is competing in a global health workforce market, and minister Little recently acknowledged the health sector as “fiercely competitive”.

But this isn’t a new phenomenon for New Zealand.

The health workforce in New Zealand has one of the largest shares of migrant workers, with 42 percent of doctors and almost 30 percent of nurses foreign-born (second only to Israel and Ireland, respectively). This is much higher than the aggregate estimates showing one in six doctors practicing in OECD countries studied overseas.

The OECD estimates the number of foreign-born doctors and nurses in OECD countries has increased by 20 percent, twice the growth rate of the overall increase across the workforce. This is what is most concerning.

The health workforce is not equally distributed. Migration of workers from low- and middle-income countries to high-income countries like Aotearoa New Zealand is a real threat to achieving universal health coverage and sustainable development goals.

New Zealand needs to be mindful that promoting our open borders is not at the expense of under-performing health systems with much greater need.

Losing healthcare workers to Australia
Outflow is also a problem in New Zealand, with New Zealand-trained doctors and nurses crossing the Tasman every year. Add to this the international recruits leaving New Zealand for Australia and there most definitely is a health workforce crisis.

As our nearest neighbour, Australia is aggressively recruiting staff. And like pavlova and Phar Lap they are happy to claim what is ours as theirs. An easier route to citizenship and voting rights will make Australia even more desirable.

How can New Zealand compete in this market? Minister Little refers to encouraging New Zealanders to return home, including lifting their pay. Research shows it’s not all about income. Location and professional development opportunities are important factors when choosing career moves.

The healthcare reforms helped tempt me back to New Zealand after 22 years away. Perhaps working in a system which has equity as its focus may encourage those who are clinically trained to return as well.

There is considerable research to inform policies around retention and recruitment. The New Zealand Ministry of Health may wish to look to the UK, which was historically dependent on EU health and care workers and now has a health workforce depleted by both Brexit and the pandemic.

In the recent LSE-Lancet Commission on the future of the NHS, British scholars argued a sustainable workforce needed integrated approaches to be developed alongside reforms to education and training that reflect changes in roles and the skill mix, and more multidisciplinary working.

The LSE-Lancet Commission authors flagged the need for better workforce planning. New Zealand’s approach to workforce forecasting has also been criticised previously.

Planning aside, a possible solution worthy of discussion is the required skill mix of the workforce, particularly with technological advancements and changing health needs. For example, the introduction of non-medical prescribers has improved job satisfaction, released clinical time and increased patient access.

New Zealand’s once-in-a-generation health reforms offer a logical time to undertake workforce reforms. We need to learn from our own historical mistakes and avoid disconnecting the workforce from the policy reforms.

If minister Little and the ministry are to solve this, he will first need to admit there is a health workforce crisis.

Aotearoa New Zealand is unfortunately not alone in its quest to adequately staff healthcare, but the transformation of the health sector to create a more equitable, accessible, cohesive and people-centred system means New Zealand is uniquely placed to put those people who deliver care at the centre.

Dr Paula Lorgelly is professor of health economics, University of Auckland. This article is republished from The Conversation under a Creative Commons licence. Read the original article.

Article by AsiaPacificReport.nz

Pacific Media Watch Newsdesk

Two New Zealand activists have raised thousands of dollars through crowdfunding after an Israeli court fined them for their role in singer Lorde cancelling her show in Tel Aviv, but they plan to donate the money to Gaza Mental Health Foundation instead, reports Al Jazeera.

Justine Sachs and Nadia Abu Shanab have rejected the legal action which ordered them to pay over $12,000 in damages for causing mental harm to three Israeli teenagers who had purchased tickets to the concert.

The duo turned to a crowdfunding website raising more than $33,000 with 705 donors by today.

READ MORE: NZ activists fined for Lorde cancellation raise funds for Gaza charity

The defendants wrote on Friday on fundraising website Give A Little that they had no intention of complying with the Israeli ruling.

“We will not be paying the court ordered amount. Instead, we would like to redirect the support extended to us back to Palestinians in need of mental health support,” they wrote, adding that the money would go to the Gaza Mental Health Foundation.

-Partners-

“Emotional distress is a lived reality for Palestinians in Gaza, where over half of children suffer PTSD as a result of Israeli military attacks,” the activists wrote.

Abu Shanab of Palestinian descent told RNZ that the pair were not prepared for the amount of international attention they would receive.

‘Sense of responsibility’
She said the pair had been “struck with a sense of responsibility”.

“Israel has chosen to make an example of us,” Abu Shanab said.

The lawsuit, filed in January, is the first ruling to cite a controversial 2011 Israeli anti-boycott law that allows civil action against entities who call for a boycott of the state as part of the Boycott, Divestment and Sanctions (BDS) movement.

Palestinians in Gaza face mounting mental health crisis

Activists behind the BDS movement say it is inspired by the campaign that targeted South Africa’s apartheid regime.

“Playing in Tel Aviv will be seen as giving support to the policies of the Israeli government, even if you make no comment on the political situation,” the activists wrote in their letter to Lorde in December.

The singer responded on Twitter, saying the concerns had been “Noted!”

Days later, the 21-year-old New Zealander cancelled the performance which was due to conclude her Melodrama world tour, saying she “didn’t make the right call” in her initial willingness to sing in Tel Aviv.

Israel sees BDS as a strategic threat and accuses it of anti-Semitism – a claim activists firmly deny, calling it an attempt to discredit them.

Artists who have participated in the cultural boycott of Israel through the Palestinian-led BDS movement include Brian Eno and Pink Floyd’s Roger Waters, writers Arundhati Roy and Eduardo Galeano, and filmmaker Ken Loach.

Article by AsiaPacificReport.nz