Plans to make it easier for New Zealand doctors to work wherever they like in Australia are predicted to worsen this country's medical workforce crisis.
New Zealand is already short of doctors in many areas, and an easing of restrictions in Australia from April is likely to increase the attraction of its higher salaries.
"It's a threat to the whole medical profession in New Zealand," Association of Salaried Medical Specialists president Jeff Brown, a Palmerston North paediatrician, said yesterday.
"We would have major anxieties at the very time when we are trying to address our own workforce crisis, to suddenly have our near neighbours suck us dry potentially."
The crisis Dr Brown was referring to is hitting rural areas and provincial centres particularly hard. They are short of GPs and specialists, and hospitals in the main cities need more resident doctors and specialists.
In Auckland last year, more than a quarter of the 900 resident doctor positions in hospitals were vacant.
Australian laws on overseas-trained doctors, including New Zealanders, now allow the federal Government to control where GPs work.
They can generally be prevented from providing non-hospital health care funded by the Medicare insurance scheme for 10 years after becoming medically registered in Australia - but an exemption can be granted if they work in the Outback or other rural areas which have a shortage of GPs.
Australia's Health Minister, Nicola Roxon, said the exemption enabled the Government to influence the distribution of the medical workforce in rural and remote areas of Australia, giving those affected by shortages access to medical services.
But a bill to become law in April will lift these restrictions on New Zealand citizens and permanent resident doctors who gain their first medical degree from a New Zealand or Australian university.
"It's one less barrier - or one more hurdle for us in retaining our own medical practitioners," said Dr Tim Malloy, of the New Zealand Rural General Practice Network.
Measures to keep doctors in rural New Zealand such as placing medical students in rural areas and the new voluntary bonding scheme "won't counter the promise of better pay and conditions in urban Australian centres".
Dr Brown agreed that lifting the Australian restrictions would undermine the voluntary bonding scheme, in which he understood more than 100 doctors had enrolled in return for having their student loans written off.
"This is going to run as a direct counter-magnet," he said.
"Certainly from a senior hospital doctors' perspective we'd see that as very frightening because Australia could soak up almost the entire New Zealand medical workforce to fill their vacancies."
He said the greatest threat would be of losing doctors doing their years of specialist training.
"Even just to lose one of those is one too many, and the earlier you lose them, the less likely they are to come back."
Resident Doctors Association secretary Deborah Powell said the Australian changes would give her members greater choices, but would deepen New Zealand's workforce crisis.
She understood the Australian Government agreed to lift the restrictions after coming under legal challenge from a New Zealand doctor who argued it was unfair that he could be forced to practise where directed for 10 years.
Dr Powell said many young doctors rushed over to Australia to get their feet in the door by registering to practise there, then spent the next 10 years moving between Australia and New Zealand filling lucrative short-term locum posts.
The changes meant they would be able to take their time about going to Australia, but there was a serious risk they would not come back.
* The numbers
Annual income for rural GPs:
NEW ZEALAND
About $150,000 for full-time GPs including some after-hours patient care.
AUSTRALIA
$200,000 to more than $400,000 for some of the more extreme Outback postings.
- ADDITIONAL REPORTING: Mathew Dearnaley
Australia opens door to NZ doctors
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