The Great Medical Staff Swap

The great medical staff swap

New Zealand Herald
5:00AM Saturday March 08, 2008

New Zealand now has the highest proportion of foreign-trained doctors in the developed world and the fourth-highest share of foreign-trained nurses.

A new report by the Organisation for Economic Co-operation and Development says New Zealand stands out from the other OECD countries in having high rates of both immigration and emigration of health professionals.

This makes it uniquely vulnerable to fluctuating markets.

Its analysis of data from the member nations has found 29 per cent of all New Zealand-born doctors, 25 per cent of NZ-born dentists and 23 per cent of NZ-born nurses are now living in other OECD countries, mainly Australia and Britain.

The emigration rate for nurses is higher than any other country except Ireland, and the rate for doctors higher than any except tiny Luxembourg.

Conversely, 47 per cent of doctors practising in New Zealand, 30 per cent of dentists and 23 per cent of nurses were born overseas. New Zealand's proportion of foreign-born doctors is the highest in the OECD, while only Switzerland, Luxembourg and Australia have slightly higher proportions of foreign-born nurses.

The number of NZ-born doctors living overseas (1904) is roughly half the number of foreign-born doctors in New Zealand (4212).

NZ-born nurses living overseas (7564) were almost exactly matched by foreign-born nurses in New Zealand (7698).

“In other words, one could argue that immigration replaces on a one-to-one basis the lost NZ-born nurses,” the report says.

Auckland University Associate Professor Nicola North said both emigration and immigration of nurses jumped suddenly in 2001, when Australian hospitals began active recruiting in New Zealand and New Zealand hospitals were forced to recruit in Australia, Britain, the Philippines and elsewhere.

Nursing Council figures show that the jump occurred in the mid-1990s, and the number of nurses registering from overseas has been more than the number of domestic New Zealand graduates in each of the past five years.

“Part of it is a global increase in migration. If you look at the UK and Ireland figures, there is a very similar phenomenon going on there,” North says.

In a recent paper she says many developed countries cut and reformed their health spending in the 1990s, causing nursing shortages almost everywhere a decade later.

New Zealand responded by raising nurses' pay rates by about 20 per cent in public hospitals after union action in 2005, but North says pay alone won't stop emigration.

“I think the high occupancy rates in many of our acute hospitals are an issue. Nurses describe themselves as being run off their feet,” North says.

“Flexibility of hours is also important. There are ways of making the shifts work for the individuals, and providing adequate childcare and even adequate parking.

“Many hospitals have childcare centres but they might not be available at all hours and for solo parents that makes a difference.”