A history of poor pipeline management From the late 1980s health workforce governance and planning underwent constant change involving a series of different organisations. These changes had an adverse impact on the development of the health workforce and health service delivery. It is not clear how the latest handover, from Health Workforce New Zealand (HWNZ) to the Health Workforce Advisory Board, will make a difference.
1980s:
1990s:
2001:
2007:
New Zealand’s health system is relatively stable until the late 1980s and health workforce planning is centralised. The Department of Health reports directly to the Minister of Health on the health workforce with plans informed by stock and flow modelling.
Rapid and dramatic restructuring and fragmentation significantly impacts the health workforce. The Minister of Health establishes a Committee Advising on Professional Education (CAPE). CAPE proposes that a health education agency be established, but this advice is not acted on. Health sector employers continue to determine plans based on market needs, which continues into the 2000s.
The Health Workforce Advisory Committee (HWAC) is established to independently advise the Minister and assess workforce capacity and foreseeable workforce needs. HWAC sets up a Medical Reference Group which argues the case for self-sufficiency for the medical workforce in response to shortages and proposes a national body with a coordinated planning function. This does not happen. HWAC produces a series of reports and some actions are undertaken with DHBs, but little progress is made. HWAC concludes its work in September 2006.
The Medical Training Board (MTB) is established, reporting to the Ministers of Health and Tertiary Education. Its mission is to oversee and co-ordinate an integrated system of medical education and training, to meet the current and future needs of the medical workforce. Significantly, it concludes that the impact of historic poor planning will continue for 15 years.
Structural and health system ‘reforms’ arrive which neglect workforce planning and leave workforce issues to health sector employers. Key Ministry of Health directorates are disestablished, leading to loss of workforce planning, development structures and knowledge.
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BUILDING THE WORKFORCE PIPELINE, STOPPING THE DRAIN NOVEMBER 2020