Rural medicine school well intended but misplaced

National’s election announcement of funding to establish a new school of rural medicine is well intended but misplaced, according to Auckland University of Technology Dean of Health and Environmental Sciences Professor Max Abbott.

“The good news is that government recognises the major challenge facing rural health services. The bad news is that it appears to believe the solution is to produce another 60 medical graduates a year. This is misguided and will not meet urgent health needs in rural New Zealand. We need a rural health school that includes doctors, not another medical school.”

Professor Abbott said within two years existing medical schools will produce around 570 medical graduates a year, an increase of over a third in a decade. Rather than a shortage, New Zealand may soon face an oversupply and the problem is one of distribution, not overall numbers. The issue is due to a shortage of training places for general practitioners and low interest in rural practice.

“We don’t just need more doctors in rural practice. We need to expand the number of nurses, paramedics, midwives, pharmacists, psychologists, physiotherapists and a range of other health professionals who play critical roles in providing comprehensive health care. There is huge potential to extend the scopes of practice of nurses and other health professionals. We can get better health outcomes with collaborative interdisciplinary teams. We don’t need more of the same. We need to do things differently and better.”

“A new medical school would take a decade to have graduates in independent practice and there is no guarantee that they would choose to live in rural communities. We have to start doing more, immediately, with medical and other health science graduates to attract them to rural health services, and retain them there.”

Professor Abbott said there are serious downsides to overproducing doctors. This includes the high cost of training and employing them and the potential of this to inhibit innovation in the deployment of health professionals and health service delivery.

“A national approach is required to meet pressing rural health workforce needs, involving the major universities that provide medical and other health science education programmes and research.

“Otago, Auckland and AUT are working together and with rural health providers on a proposal to extend their existing involvements in rural health. We are welcome to working with other health education providers.”

Professor Abbott said AUT welcomes the opportunity to explore with government and other stakeholders how best to meet rural health challenges and improve health outcomes.

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