- 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.”
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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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