Fighting for our med school: Time is right for Waikato medical school

Saturday, 17 August 2024

A proposed Waikato medical school is back in the spotlight after Auckland and Otago universities have once again combined to try to head it off at the pass.

Eight years after it was first proposed, the school’s fate is in the balance, after National’s junior partner Act insisted on a fresh business case.

The cabinet is due to make decisions on the business case by the end of September.

The decision can’t come soon enough, as doctor numbers continue to languish. The GP shortfall was estimated at 485 in a Te Whatu Ora briefing to Health Minister Shane Reti in January. It said that figure could grow to around 1000 in the next 10 years.

Primary care, including GPs, will be the focus of the new school, which will enrol graduate students, including from non-traditional areas.

Nothing has improved since Auckland and Otago piled in on the proposal in 2016, with Auckland University medical and health sciences dean Prof John Fraser describing the programme as “an ill-considered and expensive folly”.

Auckland and Otago responded with rival plans to create a national school of rural health, and Auckland University medical programme head Professor Warwick Bagg said the university planned to increase student placements into rural GP practices.

The two existing schools have rolled out similar arguments now the National Government is eyeing the Waikato proposal favourably.

They commissioned a report by PwC, which found Otago and Auckland could increase the number of doctors trained in New Zealand by 300 if additional funding was available.

Its release at the start of this month gave the big two a further opportunity to push their case.

Bagg said both Auckland and Otago universities were ready to step up and could, by 2027, increase the number of students being trained from 589 to 889.

That is likely to be the year a new medical school in Hamilton would have its first intake of 120 students.

Acting University of Otago Medical School dean Professor Tim Wilkinson said the country’s biggest problem was not about facilities.

“It is about funding more students to study medicine and ensuring sufficient clinical placements around the country for them to learn on the job.”

He said any decision to increase student capacity and training had to be “cost-effective and timely to meet this demand”.

But it could be argued Auckland and Otago have had plenty of opportunity to address the chronic shortage of GPs, including outside the main centres. There are questions around their ability to produce enough graduates prepared to leave the bright lights for more provincial surroundings.

Yet again, the two established medical schools are combining to try to scotch the newcomer.

The story so far

Back in 2016, the university and Waikato Hospital jointly pitched the med school idea to the Government. Its intake would be graduate students, who would take on a four-year degree, rather than the usual six-year programme. And it would have a focus on graduating GPs with an interest in rural health, an area of high need.

A further point of difference would be a concerted effort to attract students from Māori, Pasifika and rural backgrounds.

In 2017, Waikato University vice-chancellor Neil Quigley paid tribute to Canada’s Northern Ontario school, which provided a model for Waikato. “They do a fantastic job, working with different communities, and ensuring they recruit students who are committed to going back into those communities.'

Flinders University in Australia offered another successful model, reported on by the Waikato Times which lent its weight to the campaign for the med school.

Waikato University professor of population health Ross Lawrenson said there was compelling evidence that community-engaged medical schools were successful at placing more GPs in disadvantaged and rural communities.

In April 2017, Auckland University dragged its feet over an OIA application from the Waikato Times, refusing to release 202 emails discussing the proposed Waikato medical school - unless it was paid $570.

After leading academic Andrew Geddes slammed Auckland for its refusal, the university finally coughed up some - but not all - of the emails the following month.

But the Labour-led Government elected in September 2017 was lukewarm about the med school proposal, and cancelled it in 2018.

Fresh legs for Waikato school

National won office last year after committing to the third medical school during the election campaign. Its coalition deal with Act included a requirement for a full cost-benefit analysis of the proposal.

Since then, things have begun to move.

On February 13, the Ministry of Health and Waikato University signed a memorandum of understanding to progress a business case.

By the end of April, demolition was set to begin on the university’s ageing B block, with the site tagged for the future medical school. Capital costs were estimated at $380m, with the Government to fork out up to $280m and the university to raise the rest.

The Government’s current three-month action plan, ending in September includes the following: “Take Cabinet decisions on the programme business case, including cost-benefit analysis, for a proposed third medical school at Waikato University.”

Waikato University already runs a graduate-entry nursing programme and expects to add pharmacy and midwifery next year.

When it comes to the proposed medical school, graduate students - say, with a bachelor of science - would be taken on for a four-year degree, instead of the usual six-year programme.

The battle lines are drawn.