By Lyam Buchanan & Grace Mitchell
Mar 09, 2018

State of the Med School

The proposed Waikato Medical School seems even further away from becoming a reality following the withdrawal of Sir Owen Glenn’s $4.5 million dollar pledge. Glenn’s move is seen as a political one due to the growing sense that the Labour Government does not see the medical school as a priority. Health Minister David Clark recently stated in parliament that Labour was still exploring proposals for a third medical school, however refused to elaborate further on the matter.

When pressed during Question Time over the likelihood of a rural medical school, Clarke stated “It is not in the public interest to explore, in this House, the proposals currently under consideration,”

Sir Owen Glenn has expressed his intention to instead place these funds towards cancer research with MD Andersen Clinic of Houston in conjunction with the Auckland Medical School and Australian liver cancer specialists citing that he was “very disappointed with the news that Labour had discounted the proposal”.

“This is both short-sighted and political,” Sir Owen wrote.

“Until the NZ voter holds those elected to serve the community, and not their own re-election interests, nothing will change.”

Despite this, Vice-Chancellor Neil Quigley recently told Stuff he remains confident this withdrawal is simply an “expression of frustration”, believing the original pledge will be honored if the Government gives the go ahead.

We sat down with Quigley to get his views on the current state of the proposed medical school.

Nexus: How confident are you that this pledge from Sir Owen Glenn “still stands”?

NQ: I think that part of the purpose of his sending the email was to try to put pressure on the politicians to make a decision, and I think that if they don’t relatively soon, then probably we have lost that money. But, I think it’s important that we put that in context, and you go back to last year this time when Sir Owen announced his pledge, the importance of that at the time was as much about the public support that he provided to this and the publicity we got from that as it was the money. It was just a critical time in the development of the case, and when his willingness to put a big amount of money on the table and go public with a statement of support was really important.

Of course, we continue to get the benefits of that, and I think it’s also important the people understand that what he’s done, he’s withdrawn and if there’s no decision really soon, he will certainly withdraw his commitment to giving us the remaining 4.5 million, but he has already given us $500,000 dollars in cash, and agreed that we can use that to cover the expenses that we’ve incurred in developing the business case really, and the ongoing costs of the development of it, so that’s actually a huge contribution in itself, because as you’ll be aware, not everybody around the university is necessarily supportive of the idea of this pursuing the medical school proposal, so it’s really good for me to be able to assure them that actually, apart from my time and some other people’s’ time, we haven’t actually spent any university money doing that, that actually it’s all been covered by Sir Owen’s money. There’s no sense in which I have to take money out of Arts and Social Science to fund the medical school bid, because Sir Owen’s done that for us. I think even with the withdrawal of that money, Sir Owen’s a sort of hero, really, for having given us that support and giving us that much money, so I’m very satisfied with that. I think if we do start to make traction again with the Government and the proposal, then there will be other people who want to provide financial support for us, so all’s not lost.

Nexus: So there’s no update to whether or not the med school will actually happen?

NQ: No. But the thing to bear in mind though, is there will be a third medical school in New Zealand some time— the only question is when. Auckland and Otago have a different view for their own reasons, but a lot of people think we need one sooner rather than later because even if we said ‘let’s get started now’, there’s probably a three year set up time before we take any students, four years in the degree, another three years postgraduate training – it is literally ten years before we’d have fully qualified doctors in the system as a result of the third medical school. The lead times on these things are long, which means if you think you probably need one, that’s the time to do it, not until you desperately need one and then have to wait ten years for the output. It is an idea whose time will come, and I think the key thing is just that we’ve sort of positioned ourselves with the ideas and the alliance with the DHB so whether it happens quickly or whether it happens in a few years’ time, it’s not probably so critical as the fact that we’ve positioned ourselves as the University to be in the right place when it happens.

Nexus: Knowing the reasons why Sir Owen has removed his pledge is the remainder of the financial backing for the project still looking stable?

NQ: Well, I mean a lot of the rest of the financial backing we needed was going to come from government, so that’s why it’s a process that’s run by the Government. If the Government said there was going to be a third medical school, then we would be able to raise a lot of money but still the majority of it is going to have to come from Government.

Nexus: Do you have any suspicions as to why David Clarke is refusing to elaborate on Labour exploring third options?

NQ: No, I don’t know why that is; I think that’s an unusual approach to take. You remember when we were developing our proposal, we went public with it – I actually went to both the Auckland and Otago Deans and told them what we were working on before we went into the public domain with it. They haven’t shown us the same courtesy of letting us know what they’re up to, but yeah so I don’t know actually, but I think the point that Owen is making in his email about this very interesting challenge we have in our political system when politicians need to get elected in local constituencies but they have to balance the challenge of doing what’s best for the country in a big national portfolio like health, and their local electorate is one that might be negatively affected by a decision they need to make, so that’s a challenging thing for politicians to have to deal with. I think Owen is certainly right – it’s an interesting aspect of our political system, that tension that politicians face being local representatives, but then when they’re cabinet ministers, having to deal with the national portfolio.

The Pitch for a National School of Rural Health

Pressure from established medical schools in Otago and Auckland have led some to speculate that the Government could refuse the Waikato pitch in favour of the status quo.

While David Bennett maintains that it would be a tragedy for the Waikato bid to fail under this Government, it is worth noting that (then) Minister of Health Jonathan Coleman could have accepted Waikato’s proposal, but instead created a review process involving Waikato, Otago and Auckland.

Nexus: Along with Sir Owens withdrawal, Stuff brought up the opposing pitch from Auckland and Otago for the National Rural School of Medicine. Do you believe this would be more beneficial than the Waikato proposal?

NQ: The health workforce has a number of problems at the moment, but probably the two big ones are we are not training enough doctors to meet our health workforce needs overall, so we’re training about 200 doctors a year less than we need to add to the workforce every year, that’s why we import so many foreign doctors, and that’s been going on for a long period of time, and it obviously will continue at the moment because population increase, natural increase, plus immigration plus the aging population is all headed in the direction of needing more doctors quite quickly, and we’re just not adding medical student places at a rate that’s consistent with that.

We have an absolute shortage of doctors, and then we have a shortage of people who want to have general practice or general medicine, some other specialties that are in really short supply, psychiatry is also one where the vast majority of our new doctors are imported from overseas rather than local graduates. What Auckland and Otago are proposing is more of their students will specialise in general practice and want to practise in areas outside the main centres, but of course even assuming they’re successful with that, that doesn’t address the overall shortage problem we have. What it means is, if more of their students choose general practice as a specialty, then we just have to import more orthopaedic surgeons and gynaecologists etc.

In my view, as I understand it, the best that Otago and Auckland can achieve is to shift the health workforce outcomes more towards the areas of critical shortage in New Zealand, but it’s actually not addressing the overall problem that we’re just not training nearly enough doctors to meet our needs. I think part of the support for what we’ve talked about comes from the families of students who would’ve liked to get into medicine, and almost made it but didn’t make the cut, because if we know we need an extra 200 doctors a year, then what that means is 200 New Zealand students every year who wanted to do medicine have been told they can’t only so that we can turn around and five years later import foreign-trained doctors to fill the space. Partly I think this is about all those families and New Zealand students who wanted to do medicine and didn’t have the opportunity, even though there’s jobs for them at the end, which is crazy.

Opposing Point of View

We asked (acting) University of Auckland Media and Communications Manager Lisa Finucane, why a national school of rural health would be more beneficial to the future of New Zealand Healthcare than the current Waikato proposal. She has since clarified that “planning for national rural health education pre-dated the Waikato Medical School proposal” and stated, “it was not a response to the Waikato proposal.

“We developed the National School of Rural Health proposal with the University of Otago, AUT, the Royal College of GPs, and the Rural GP network. The Minister of Health is aware of this proposal and we await his advice on how the Government sees the issue of rural health provision and how we may assist.”

This was a view shared by Senior Communications Adviser of the University of Otago Liane Topham-Kindley. She responded “recruiting and supporting health professionals in rural communities is a matter of considerable national importance. The collaborative National School of Rural Health Proposal involves, amongst others, the Royal New Zealand College of General Practitioners, the New Zealand Rural General Practice Network, the universities of Auckland and Otago, and AUT. The proposal focuses on all aspects of the rural health workforce—nursing, physiotherapy, dentistry, medicine etc—and aims to create and nurture rural training hubs in rural communities in partnership with those communities. The Waikato proposal focuses on producing more medical graduates based in a medical school in a major urban centre.

“Ultimately, it is for the Government to decide which proposal will be more beneficial”.

So for now at least we have no clear direction from the Government and at least one funder with cold feet. We will keep you updated as the story develops. Meanwhile, for you budding med-school hopefuls, plan for a graduation in approximately 2032.

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