Charismatic

National radio the other day (right click and “save as” or open directly with Windows Media Player): http://www.radionz.co.nz/audio/natio...health_workers

If we don’t offer salaries commensurate with competing countries will we still get enough people moving here of a high enough calibre? In other professions we would say you attract people with wages and then keep them with working conditions (which is why no one wants to remain in a hole like Saudi Arabia forever no matter how much money they offer).

Could we attract the most talented people offering significantly less than other countries but better working conditions? Can we even offer better working conditions without investing more money?

drrobert

Yes, you can bring top healthcare staff to NZ without matching Australian pay. I am a UK-trained hospital specialist doing research in NZ. I hope to take a consultant post here next year, despite attractive offers from large centres in Australia and the UK, all for more pay.

Why am I keen to work here in NZ despite the lower salary?
- quality of life
- friends and family (my partner is a kiwi)
- excellent state schooling (where I live)
- great food and coffee!
- can-do attitude w.r.t. research and service development (so far)

For me, the deciding point is the quality of life that you can buy with your salary. It is not the absolute level of salary itself.

To pull off successful recruitment, NZ needs to:

1. Focus on attracting younger doctors here, before they take out a huge mortgage and send their kids to British schools. After that, it is much more difficult to convince people to emigrate.

2. Keep the terms and conditions attractive. This is a cheaper way to buy goodwill than to pay higher salaries. T&Cs are already quite good (superannuation, continuing professional development budget, reimbursement of Medical Council expenses). Note that matching the restrictive European Working Time Directive hours is NOT necessary - most doctors are happy to work longer hours than the EU allows if they are recognised/reimbursed and have enough annual leave in return.

3. Show flexibility in recruitment. I know of doctor-doctor partners who would like to settle in smaller NZ cities, but can't do so because only one of them can find a job there (the other doctor's specialty has no current available posts). Medical Personnel in the smaller centres need to have a flexible attitude to help bring a whole family over. That might mean funding an extra 0.5 FTE doctor, but with a bit of inventiveness, this extra time could be used for valuable service development, or the cost shared with other local DHBs.

4. Lower the administrative hurdles. Immigration and qualification requirements must of course be met, but a helpful and enthusiastic attitude from the Medical Council goes a long way to encouraging doctors to turn a job enquiry into an actual immigration plan. Prompt replies to enquiry emails are one helpful example. The Medical Council of NZ is actually already much more helpful and easy to deal with than their UK counterpart, but there's always room for improvement!

5. Build a reputation. Although NZ is small, it has a lively research community. The small population base could make it a great 'testing ground' for new IT systems (after the UK's monstrous programme failed). The restricted drug budget (via Pharmac) also makes NZ an attractive place to run randomised trials of drugs which are funded in other OECD countries. Raising the profile of NZ healthcare and healthcare research will do a great deal to attract more specialists to the country.

Aliwales

I think so. NZ has a fab reputation for new patient led initiatives within psychiatry, as well as producing excellent research in alternative treatments in nursing care, and if your a nurse that cares about what u do the pay packet is defo not the motivation anyway!!lol

add that to living and bringing up your family in a country as stunning and as "safe" in comparison to the uk and us then I say deal done

JohnThePom

I think the answer is yes. Some of move here for other reasons than improving our pay. I'd go so far as to say most of us probably do, as NZ in not renowned for paying high rates.

I'm actually quite happy about that, I'm uncomfortable around people who are totally focussed on their income - I don't care how professional they are, I think people provide a better service and do better work if they love their job than if they are pursuing their careers just to leverage more income.

I think it requires some imagination though and fair dealing. Most of us have to earn a living one way or another.

(My partner is a nurse btw)

tkirya

well, judging by the fact i will take quite a drop in pay, and i am still coming, i think yes, you will attract people.

Charismatic

And here is a shiny $2 coin in place of this year’s wages:

Who says that cutting back on healthcare spending won’t be easy?

Charismatic

Very good, could we increase our own output capacity of medical professionals and still retain them? I once read that, pretty exactly, as many doctors are qualified here as move abroad every year. So it’s well known that, doctors particularly, end up with large loans by the time they graduate (which is no doubt one reason other countries are so good at poaching young talent from us) but if we systematically “forgave” medical professionals study loans who worked here 5-10 years would doctors be more inclined to stay in the long term and perhaps take up the profession in the first place?

drrobert

I think there are two separate situations: the first its a doctor that works overseas for a short period (say up to two years) to gain experience, then returns to NZ (bringing back new knowledge and techniques). The second is one who moves there long-term. From a local service provision standpoint, the first is to be encouraged, the second isn't.

You are correct: the greater the student debt racked up by a NZ doctor, the greater the incentive for them to go overseas and work there to pay it off faster. So yes, a system of forgiving debt for length of subsequent service in NZ might help. But preventing doctors from working overseas completely ("bonding") is both unworkable and undesirable.

luvwelly

Totally agree re forgiving loans to retain staff in NZ.
I have realised after 3 years that the other downside of the shortage of medical specialists is that even the NZ private sector has significant delays in obtaining consultation/treatment appointments.