New Zealand’s health workforce constraint
Written by Tom Varghese
Workforce planning and development is a key constraint in New Zealand’s current health and disability system, according to the Health and Disability System Review. Research suggests that concerns over NZ’s health workforce sufficiency, distribution and sustainability continue despite numerous policy interventions over past decades.
In December 2019 there were 246,500 people employed in the health care and social assistance sector. This includes 76,213 people employed by the 20 DHBs. Another 33,400 were employed in social assistance services. The sector is the second largest industry employer in the country and represents 11% of all those employed. Between 2000-2019, the number employed in the health care and social assistance sector increased by 58%. However, a critical omission from workforce data has been the absence of reliable information about the unregulated health workforce which could be of the scale of 110,000 plus people.
The workforce is predominantly female at 83% compared to 48% across all industries and it is apparent that women drive wealth creation through their employment in the health economy and the consequent familial and social benefits help build inclusion and cohesion.
A broad focus on economic growth and wellbeing has been reinforced by the development of the Treasury’s Living Standards Framework and its four capitals – financial/physical, human, natural and social. Health is one of the 12 wellbeing domains set out in the Framework.
Employment in the health sector, cuts across several of the wellbeing domains and these affect five key pathways to economic growth and wellbeing (see figure). A neglected topic in health workforce planning is the value of the health workforce, both socially and economically. Health institutions are often viewed as ‘anchor institutions’, a term used to describe the fact that in tough economic times they are economically and socially connected to the communities in which they are based, and so act as economic stabilisers. Employment in the health and disability sector tends to be less sensitive to cyclical fluctuations, such as recessions, than employment in other sectors of the economy.
Systemic and direct attention to health workforce issues will be critical to the success of the implementation of the Health and Disability System Review. Challenges relating to wellbeing will arise for the health sector workforce as the management of COVID-19 becomes part of an abnormal ‘normal’ and New Zealand learns to live with the global pandemic. The psycho-social impacts of COVID-19 are beginning to emerge for clinical and nonclinical staff alike across containment, management and eradication of the virus.
The overarching question is how will NZ transition towards a desired health workforce while maintaining current functionality?
