Health of the Health Workforce 2015



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Ageing medical workforce


The medical workforce is ageing. A little over 40.1% of doctors were aged 50 or over in 2015, up from 35.3% in 2009. Six years ago the largest group of doctors was aged between 45 and 49. Since 2011 the largest age group has been 50–54-year-olds.4 Within the GP workforce the proportion of doctors aged 55 years or over rose from 27% in 2000 to 36% in 2013.
However, an ageing medical workforce is an international trend (see Figure 3), and New Zealand is better placed than many other OECD countries in terms of the number of doctors in the workforce aged 55 years and over.
Figure 3: Percentage of doctors aged 55+ in 29 OECD countries, 2000 and 2013

Source: OECD 2015


The gender gap in New Zealand’s medical workforce is closing. In 2013 women made up 41.7% of the workforce (39.1% in 2009) and outnumbered men among new doctors.5 Further:

45% of female doctors were under 40 years of age

28% of male doctors were under 40 years of age

57% of house officers6 and 50% of registrars7 were women.


Māori and Pacific peoples remain under-represented in the medical workforce (see Table 1). However, recent increases in the numbers of medical students from both groups indicate an emerging generation of Māori and Pacific doctors (Pacific Perspectives 2013).
Table 1: Medical workforce statistics

Medical workforce*

Size+

Age
50+
+

Gender split*

Ethnicity*

Main place of employment*

Qualified outside New Zealand+

14,678 (including 4592 working in general practice)

40.1%

Male 58.3%

Female 41.7%



European 68.3%

Indian 5.2%

Chinese 5.1%

Māori 5.1%

Pacific 1.8%

Other 16.9%



Public 54.4%

Private 35.3%

Other 10.3%


42.0%

+ Annual practising certificates as of 30 June 2015

* Medical Council New Zealand 2013 workforce survey



General practitioners


There were 84 doctors (76.9 FTEs) working as GPs per 100,000 New Zealanders in 2014. Auckland and Capital & Coast DHB geographical areas had the highest number of GPs per 100,000, while West Coast, MidCentral and Counties Manukau had the lowest.8 This data refers to all doctors working as GPs across New Zealand, including doctors who may work in general practice but who do not have vocational registration in general practice.
The trend is for GPs to work shorter hours. MCNZ’s 2014 workforce survey (providing the latest survey data) showed that GPs worked on average 36.8 hours a week (0.92 FTE based on a 40hour week), down from 38.1 in 2009. The average across all other specialties was 45 hours a week, down from 45.5 in 2009.
In 2009 vocationally registered GPs made up 37.5% of the total medical workforce, and this proportion has remained steady at 37.7% in 2015. However, in 2015 169 doctors entered general practice training, an increase of 45 on 2014. The number of doctors trained in other vocational specialties continues to grow at a similar rate to the number of doctors trained in general practice (see Figure 4.) The number of specialists (excluding general practice) went up from 4176 to 5362 between mid-2009 and mid-2015, a 28.4% increase.9
Figure 4: Trends in number of GPs and non-GP specialists



Managing the medical pipeline


A key objective of the Medical Workforce Taskforce (the Taskforce) is to ensure a continuum of training is available to new graduates and they are supported to make appropriate career choices and have opportunities for employment in New Zealand. HWNZ has collaborated with the medical colleges to bring together all the information that graduate doctors need in the form of career information specialty factsheets, published on www.kiwihealthjobs.com/rmo/fact-sheets.
More information about the Taskforce can be found in The Role of Health Workforce New Zealand.
Appendix 2 includes a graph showing each specialty’s ratio of postgraduate vocational trainees to specialists and the average age of these senior doctors. It indicates which specialties are considered likely to experience senior staff shortages in the future. A limitation of this information is that some specialties currently have insufficient senior doctors.
Prospects are particularly good for general practice, especially in rural areas, as New Zealand’s population grows and ages. General practice provides doctors with the opportunity of working with a wide variety of patients and being the first point of contact for health care. Working arrangements have changed, with most GPs now working as contractors or employees and often pursuing a portfolio-style career. For example, this might involve a combination of general practice, special interest practice, clinical governance and teaching.
New Zealand continues to employ overseas-trained doctors to address staff shortages. Such doctors accounted for 42.6% of the medical workforce as of mid-2015, compared to 43.7% in 2013.10 This is in part due to increased numbers of New Zealand-trained medical graduates, and fewer overseas-trained doctors coming to work in New Zealand.




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