The New Zealand-trained medical workforce is being boosted by an additional 200 government-funded medical student places, phased in between 2010 and 2018. This in turn means that more postgraduate year one (PGY1) employment positions are required in DHBs.
In 2013, for the first time, there were more applicants than PGY1 vacancies as increasing numbers of graduates entered the workforce. HWNZ and DHBs ensured that all New Zealand government-funded medical students who graduated in 2013, 2014 and 2015 received offers of employment. The Taskforce’s priority is to ensure this will continue in the years to come.
While the Taskforce initially focused on the immediate postgraduate period, a whole-of-career perspective has now been adopted. The most important issue is the impact of a prolonged period of medical labour market shortages on the workloads, wellbeing and productivity of DHB-employed senior doctors.
Other areas under consideration by the Taskforce include the distribution, long-term retention and retirement intentions of doctors trained in New Zealand and overseas. Leadership opportunities in systems improvement and innovation, consistent with the In Good Hands report on clinical leadership (Ministerial Task Group on Clinical Leadership 2009), are another focus for the Taskforce.
Of all overseas-trained doctors who work in New Zealand, those from the United States of America have the lowest retention rates, followed by doctors from the United Kingdom and Oceania. Overseas-trained doctors from North Africa and the Middle East have the highest retention rates, followed by those from sub-Saharan Africa and Asia.
Retention rates for all overseas-trained doctors level out at about 30% four years after registration, with only gradual decreases thereafter. This was a consistent annual trend between 2000 and 2013, the period examined by MCNZ’s analysis of its 2000 to 2014 workforce.
In 2014 there were 2173 dentists with annual practising certificates registered with the Dental Council of New Zealand (DCNZ). This had grown by 63 to 2236 on 31 March 2015.11 The number of practising dentists per 100,000 New Zealanders rose from 48.2 to 48.8 per 100,000 during this period.12,13 More than 80% of the dentist workforce is based in private practice. There are sufficient dentist numbers in New Zealand overall, but there remains a geographical maldistribution, particularly affecting rural areas. Distribution varies from 134 dentists per 100,000 people in Otago and 101 per 100,000 in Auckland, through to 30 per 100,000 in Tairāwhiti.
The 2010/11 workforce survey showed that 2.5% of dentists identified as Māori and 0.8% as Pacific people.14
New Zealand-trained dentists
New Zealand has one dental school (the Faculty of Dentistry at the University of Otago). Entry to the undergraduate Bachelor of Dental Surgery programme is highly competitive (in excess of 700 applications for the 60 places). Entry is via the prerequisite first year Health Science course, and this requires very high levels of academic achievement (grade averages within the top few percent).
The increase in the dentist workforce stems from both New Zealand graduates and overseas-trained dentists, both via the New Zealand Dental Registration Exam (NZDREX) process and individual reciprocal recognition registration.
In terms of workforce supply and sufficient employment, the New Zealand dental workforce is expecting to be affected by the four new dental schools recently established in Australia (giving a total of nine dental schools), which have led to an oversupply of dentists. This has substantially altered the availability of employment for young dentists in Australia. With Australian dentist graduates having automatic right to registration in New Zealand through the trans-Tasman Mutual Recognition Arrangement, this is expected to have an impact within New Zealand over the next few years.
For information on other professions that provide dental care, particularly to children and young people, see the ‘Allied health, science and technical professions’ section of this report.
The nursing workforce has grown steadily over the past six years. There were 52,729 nurses with annual practising certificates registered with the Nursing Council New Zealand (NCNZ) as of 31 March 2015, including:15
145 nurse practitioners
49,769 registered nurses
2815 enrolled nurses.
This represents an increase of 6764 nurses since 2009, when there were 45,965 practising nurses, and an increase of 4202 since 2011 (48,527).16 Figures cited in this section are from the New Zealand Nursing Council Register as of 31 March 2015, unless otherwise stated.
The number of practising nurses per 1000 population has increased from 10.6 in 2009 to 11.5 in 2015.17,18 See Appendix 2 for numbers of nurses per 100,000 population by DHB and in New Zealand as a whole.
Nurses currently work an average of 29.9 hours a week (just under 0.75 FTE, based on a 40hour week), down slightly on 2009’s average of 30.6 hours. The practice area with the highest percentage of nurses is surgical (9.6%), which is a slight decrease on the 10% in 2014. The lowest percentages are in youth health (0.23%) and family planning and sexual health (0.3%).19
The Voluntary Bonding Scheme includes aged care (aged residential care and older persons’ health services), primary care and mental health, including addiction services, as 2015’s hard-to-staff specialties for nurses (see Figure 5). The percentages of nurses currently working in these specialties are: