Gaping hole in New Zealand's health workforce could blow out if nothing changes

For the first time, we have a clear picture of the hole in our health workforce - and it is huge.

We're short nearly 4800 nurses, 1050 midwives, 1700 doctors, 220 dentists and 200 anaesthetists.

All up, that's around 8000 health workers - a figure the Health Minister herself admits is confronting.

But it could get even worse. As the population ages and demands on the health system increase, that gap could blow out to 24,000 by 2030 if nothing changes.

So the Government has come up with a plan to train and recruit the health workforce we so desperately need.

The Health Minister was once a doctor. It shows.

"Just like in medicine, you can't start the treatment until you've got the diagnosis right," said Dr Ayesha Verrall.

The health system is her patient now. It's just had a check-up and the prognosis isn't good.

"Need more growth," she said.

She made that diagnosis after Te Whatu Ora examined its workforce for the first time. It turns out the size of the health workforce has actually been growing steadily.

One graph shows the increasing nurse workforce - since 2017 it's jumped by almost a quarter.

But there's a catch.

"It's not enough to keep up with the population, the aging population, and the new demands we need so we have to do more," Dr Verrall said.

There are essentially three ways to do that. You train them, import them and keep them.

"This is the first time, that we can see, that we've told New Zealanders what the gap is," said Te Whatu Ora - Health New Zealand chief people officer Andrew Slater.

Te Whatu Ora is also able to tell universities what that gap is so they can target student recruitment. And the students themselves will earn while they learn, getting paid for their placements.

"I think the proof will be in the pudding. That once this plan is put in place that the benchmarks that they wanted to achieve are achieved," General Practice NZ chair Dr Bryan Betty said.

It's also going to take the sugar hit of immigration to recruit specialists.

A hub is being set up in London to directly recruit from the UK - though the National Party have their doubts.

"Health New Zealand being an offshore recruitment arm because their ability to recruit to date has been absolutely appalling," said National's health spokesperson Dr Shane Reti.

And then the plan is to keep workers by treating them right like ensuring access to food on night shifts and more support.

"I had an experience when I was a junior doctor. I had a patient who died on arrest and there was no one whose job it was to speak to me about that experience. For some people that makes the difference between staying in the health sector or driving burnout and leaving," Dr Verrall said.

A lot of midwives have already left their jobs - but the sector says this workforce plan doesn't address that.

The acute shortage can't be filled quickly because it takes four years to train and it's hard to import midwives. So it needs to bring back the ones who've left.

"I think we've had a lot of discussion about the workforce issues but we haven't had the opportunity to have any tangible input like this," New Zealand College of Midwives CEO Alison Eddy said.

"The plan's being launched today and certainly, we'll be consulting with the groups to make sure we incorporate and deliver on the initiatives we've outlined in there," Slater said.

A comprehensive treatment plan for a healthcare system with critical needs.

Amelia Wade analysis

The modelling goes out for the next decade, but is giving itself one year to get all these initiatives running.

It's the first birthday of the health reforms - and there's pressure on the Government to prove the fruits of that pain before the election.

One medical professional told me today the reforms felt like wading through treacle because no one knows who is in charge ownership of the decisions.

This plan is only possible because instead of 20 DHBs with 20 sets of data all competing with each other for workers, there's now one agency able to take a long-term look at the gaps.

The sector broadly seems happy there's a firm diagnosis of what the workforce issues are - though GPs are frustrated that it's too high level and there are no targets.

There is still a lot of work to do to improve the health of our health system and those working in it.