Medical Council Fears Political Interference Over Doctor Shortage

Thursday, 8 May 2025, 4:48 pm
Article: RNZ

Nine To Noon

• Medical Council fears potential political interference in overhaul of health workforce regulations
• Retention - not red tape - to blame for doctor shortage
• Cultural competency ("listening to patients") vital for effective care for all patients, not just Māori

Politicians should not be allowed to decide who can practise as a doctor in New Zealand in the current shake-up of health workforce regulations, the Medical Council has warned.

Consultation on updating health workforce regulations has just closed.

Health Minister Simeon Brown has said the current system was overly bureaucratic, and he wanted to streamline overseas recruitment while maintaining clinical standards.

However, Medical Council chair Dr Rachelle Love told Nine to Noon red tape was not stopping overseas trained doctors getting registered in New Zealand.

About 44 percent of doctors in New Zealand were overseas-trained, and each year, about 70 percent of new registrations were for international medical graduates, and fewer than 1 percent of international applicants were declined registration.

"Where the concern is, is the retention of those doctors. So the international medical graduates who come to New Zealand, by year one, 40 percent have left. By year two, 60 percent of internationally medical trained doctors have left New Zealand."

Love, a Christchurch head and neck surgeon, said the focus needed to be on why these doctors were "not thriving" in the New Zealand health system, and what support they needed to integrate and stay.

"It's not about getting doctors in the front door."

Room for 'streamlining' - but not at the cost of patient safety

The Medical Council, which oversees clinical standards and cultural competency for doctors, was supportive of the idea of modernising the regulatory system, Love said.

There was room for more collaboration and even consolidation.

"We agree with many of the tenets in this document. We think it's important to prioritise patient voices, it's important to drive efficiencies and streamlining regulation is important.

"The document is an opportunity to ensure the regulatory system is working, and it's aligned to the needs to patients, communities, practitioners and the wider health system."

However, any overhauled workforce regulations had to ensure they matched the "risk profile" of the professions. For instance, ensuring doctors were fit to practise was "high stake".

"Too far is when the public is affected. The public need to be safe in any decisions that are made. The groups also need to have independence, they can't have political independence, they need to stand aside from the politics of the day. And clinical input is really important."

Tribunal must be 'politically independent'

The Health Ministry's proposal includes the set up of a tribunal to allow individuals to challenge decisions made by the regulatory bodies without having to go to court.

Love said the council was open to having a tribunal as it was confident in the integrity of its processes - but its fear was that this would "not be an independent body, that in fact politicians would be determining who would become a doctor in New Zealand".

Doctors and other health professionals had also been taken by surprise by the signalled intention to remove proving "cultural competency" from requirements to practise in New Zealand, Love said.

"In health care in general, we're a little surprised that cultural safety has become a political issue.

"Cultural safety is fundamentally about listening to patients and centring them in their healthcare. And it's not a new concept. Hippocrates - 2500 years ago - talked about the importance of listening to patients, hearing their account of their symptoms, how they made sense of their own health, and then looking at factors like their family history and environmental conditions in their health."

Cultural safety was integral to effective clinical care and the evidence showed it led to improved health outcomes for all patients, not just for Māori, she said.

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