New Zealand is haemorrhaging specialist doctors and struggling to replace them, an issues paper prepared by the Association of Salaried Medical Specialists (ASMS) says.
ASMS executive director Ian Powell said the paper highlighted the severity of a specialist workforce crisis in New Zealand's public hospitals.
Findings in the union's paper included that:
* By 2008 the specialist workforce shortfall was over 600 specialists based on international benchmarks;
• Another 1300 specialists were needed to equal Australia (population adjusted);
• New Zealand had the second highest emigration rate of doctors in the OECD; the highest dependency on overseas trained specialists (40 percent), and the lowest number of specialists per head of population (0.8 per 1000).
• To meet the OECD average by 2021, New Zealand would need an average net increase of 380 specialists per annum.
• 29 percent of New Zealand doctors were working overseas; the second highest expatriation rate in the OECD (behind Luxemburg);
• Half of New Zealand's registrars training to be specialists leave New Zealand in their final year to take up their first specialist positions overseas, mainly Australia and mainly for better salaries and conditions.
"New Zealand is losing too many of the specialists we are training, the specialists we currently have, and many of the overseas trained doctors we struggle to recruit," Mr Powell said.
"This places those specialists remaining in New Zealand under increasingly intense workload pressure. Too much increasing work is falling on too few shoulders. Our hospital specialist workforce is fragile and is making our health system unsustainable."
Mr Powell said at the same time younger trainee specialists wanted better work-life balance and were less prepared to shoulder "excessive workload pressures".
He said until the shortage was fixed, the Government could not achieve goals around improving training, increasing clinical leadership in public hospitals, and increasing health service collaboration between district health boards.
"We don't have enough specialists to achieve these objectives."
Labour MP Ruth Dyson said Health Minister Tony Ryall had no plan to deal with the problems raised in the paper.
Mr Ryall said that was incorrect.
"The health workforce shortage is serious. That's why it's one of our top priorities," he said.
"The Government is taking action on a number of fronts to increase training and retain staff. Medical student intakes will rise by 200, and the voluntary bonding scheme is in place.
"We are also focusing on improved opportunities for teaching, research and clinical leadership. October's tax cuts will put an extra $7000 a year into the average hospital doctors pay-packet."
Mr Ryall said district health boards were involved in salary negotiations with the ASMS at the moment.
