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Forecast health demand outstrips growth

5 June 2019

Forecast health demand outstrips growth in specialist workforce

A ballooning “service gap” has been revealed in an analysis of specialist numbers and population trends.

A Research Brief published today by the Association of Salaried Medical Specialists (ASMS) examines forecast health needs, including population growth and the effects of the aging population alongside projected growth in specialist numbers.

The paper, the second in a two-part series looking at workforce strains, is available online:

Written by ASMS Director of Policy and Research, Lyndon Keene, the paper shows that by 2028 health demands will have outstripped the expected growth in specialist numbers. This will mean longer waiting times, higher thresholds to access services, and continuing high levels of burnout among specialists.

About 100 more new specialists are needed per year, over and above the current growth rate, to meet projected population growth. New Zealand’s public health service has an existing shortage of about 1000 specialists. Unless this shortage is addressed and the workforce growth rates improve, the service gap is set to worsen over the coming years.

Some specialties will be affected more than others. In a case study using Ministry of Health workforce and service use data, ophthalmologists’ individual workloads will need to increase 20% by 2028 to match current service levels.

Mr Keene says the entrenched long-term shortage of specialists is in part a legacy of poor decision-making nearly 40 years ago. In 1982, the then government cut medical school places by 50 when they should have been increased. The cap of 285 medical school places per year remained static for 22 years, before places doubled between 2004 and 2015 due to a series of increases. Despite this, in 2016, New Zealand had a low rate of medical graduates compared with comparable countries.

The paper highlights the potential for progress by designing and implementing retention measures that consider the needs of different specialties.

District Health Boards can help by fostering a positive workplace environment.

“DHBs should consider adopting as a key focus a goal of becoming employers of choice to attract and retain staff. Workplace quality and management styles are central factors in staff satisfaction,” Mr Keene says.

“More broadly a long-term system-wide approach is needed looking 20 years ahead to allow for the training time of specialists. For too long governments considered this too hard and failed to come up with solutions or adequately plan for the future,” Mr Keene says.


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