Failure to fund, plan, and build capacity in health sector workforce training

The crisis in the New Zealand health sector is longstanding. The comments of the Health Minister's task force in 2009 reviewing how the training of the New Zealand health workforce is planned and funded were prescient: 

"New Zealand has significant problems in recruiting, training and retaining adequate numbers of appropriate health and disability services workers. This is most likely to worsen.
The planning and funding of the training of the New Zealand health and disability services workforce is iterative, ad hoc and poorly coordinated."

In 2009, the New Zealand health workforce situation was considered to be that of a crisis. New Zealand is the most reliant country in the OECD group on overseas trained doctors and nurses (>40% for doctors).

In 2004, a NZEIR report, Ageing New Zealand and Health and Disability Services, Demand Projections and Workforce Implications, 2001-2021, predicted that population ageing will increase the demand for health and disability services labour by between 2.5 and 4.3 times the rate of increase in the population as a whole. 

Simply put, New Zealand has not, and does not train enough health and disability workers to cope with attrition, population growth or increased demand due to an ageing population with complex needs.  Thirteen years later, this lack of planning and reliance on overseas trained practitioners has left the sector weakened and precarious.  It remains to be seen if the newly restructured institutions with the same people that brought us to this nexus will deliver different and appropriate solutions. 

As per the task force's recommendation, a single agency, which has a whole of health and disability services workforce and a whole of educational continuum responsibility, is needed if New Zealand is to have an affordable and fit-for-purpose health and disability services workforce.

A foundational requirement for health workforce planning is the resumption of health profession surveys that characterise the age, sex, ethnicity, work setting, work type, and work intentions of their members. In some instances this information has not been collected for 15 years for some professions and is not reported by many of the regulatory authorities. 

Increased flexibility of education delivery 
The Productivity Commission's 2017 report raised this issue, that tertiary education is typically delivered on-campus, to school leavers in full-time programmes disadvantaging many groups in accessing tertiary education which is the gateway to training to be a healthcare professional in most instances. If Covid showed us anything it is that other modes of educational delivery are possible. 
Yet, to look at the approval process to establish a new programme and a new PTO to deliver it yields a bureaucratic structure geared toward a bricks and mortar, whiteboard delivery model. The crumbling of the university and polytechnic sectors dictates an urgent review of the delivery and funding models, for the sake of the healthcare sector and professions that require it to deliver services to meet population needs.