Don Simmers: Healthy development is vital

What a pity the concept of employing surgical technicians for routine operations has dominated discussion of the Medical Reference Group's consultation document Fit for purpose and for practice: a review of the medical workforce in New Zealand.

Reference to this concept has been made several times in the media but in the document itself it takes up less than one page, buried in the middle of 160 pages.

By contrast, the issue that occupied the most space was the need for this country's health system to actively embrace systematic workforce development.

Moreover, this issue's strategic positioning in no less than four different areas within the document rates a mention as well. It is listed in the document's immediate priorities for action.

The document defines workforce development, and paints a picture of this within the New Zealand context.

The potential players are identified along with the roles they could play in workforce development.

If this is still not enough, the document gives a history lesson on the previous efforts to institute work-force development over the past 30 years.

The Medical Reference Group's message is loud and clear.

There needs to be an immediate, concerted focus on the development of the medical workforce and the Ministry of Health needs to lead the way.

The lack of media focus on this key issue is perhaps understandable, as the need for workforce development was not well presented in the press release from the Ministry of Health that accompanied the discussion document.

It is hard to understand why the ministry would choose not to highlight the document's key message.

The general-practice workforce is the most immediate problem to be addressed.

The situation is becoming so bad that very soon New Zealanders will no longer be able to take for granted their right to visit a GP in a timely manner.

GPs are aging, and their numbers decreasing. Young doctors, many of whom have large student debt, do not see general practice as offering them a sound economic basis for their future practice.

It is little wonder only 9 per cent of first year doctors have indicated they would enter general practice. Traditionally, more than 50 per cent of medical graduates have done so.

Like every other Western nation, New Zealand has to face the problem of an aging population.

There will be increasing demands on the health system and there will be fewer working-age health professionals available for employment to meet these demands.

Fortunately, New Zealand's population will not age as quickly as other countries.

Therefore we can afford the luxury of not being first off the block in examining revolutionary ideas such as having technicians perform routine surgical procedures.

However, we cannot afford to continue to dither with what we want from our medical workforce.

Our young doctors are not getting enough support to ensure they will be available to meet New Zealand's healthcare needs.

If our health system continues to fail to meet the needs of young doctors, other countries will be only too willing to help.

* Don Simmers is the deputy chair of the Medical Association and chairs its workforce subcommittee. He is also a member of the Health Workforce Advisory Committee's Medical Reference Group.