Plans to make it easier for New Zealand doctors to work wherever they like in Australia are predicted to worsen this country's medical workforce crisis.
New Zealand already has shortages of doctors in many areas and an easing of restrictions in Australia from April is likely only to increase the attraction of higher salaries across the Tasman.
"It's a threat to the whole medical profession in New Zealand," Association of Salaried Medical Specialists president Jeff Brown, a Palmerston North paediatrician, said yesterday.
"We would have major anxieties at the very time when we are trying to address our own workforce crisis, to suddenly have our near neighbours suck us dry potentially."
The crisis Dr Brown was referring to is hitting New Zealand's rural areas and provincial centres particularly hard with shortages of GPs and specialists, and hospitals in the main cities are light on resident doctors and specialists.
In Auckland last year, more than a quarter of the 900 resident doctor positions in hospitals were vacant.
Current Australian laws on overseas-trained doctors, including New Zealanders, allow the federal Government to control where GPs practise.
They can generally be prevented from providing non-hospital health care funded by the Medicare insurance scheme for 10 years after becoming medically registered in Australia - but an exemption can be granted if they work in the outback or other rural areas where there are shortages of GPs.
Australian Health Minister Nicola Roxon said the exemption was "a key mechanism" by which her Government influenced the distribution of the medical workforce in rural and remote areas of Australia, to give those suffering shortages appropriate access to medical services.
However, a Bill to be enacted in April will lift the restrictions on New Zealand citizens and permanent resident doctors who gain their first medical degree from a New Zealand or Australian university.
"It's one less barrier - or one more hurdle for us in retaining our own medical practitioners," Dr Tim Malloy, of the New Zealand Rural General Practice Network.
"There is already a flow to Australia of junior doctors. For some of our senior medical practitioners and now for general practitioners it will be just that little bit easier to practise anywhere in Australia."
The network says measures to keep doctors in rural New Zealand, such as placing medical students in rural areas and the new voluntary bonding scheme, although beneficial, "won't counter the promise of better pay and conditions in urban Australian centres".
Dr Brown, of the Association of Salaried Medical Specialists, agreed that lifting the Australian restrictions would undermine the voluntary bonding scheme, in which he understood more than 100 doctors had enrolled, in return for having their student loans written off.
"This is going to run as a direct counter-magnet," he said.
"Certainly, from a senior hospital doctors' perspective, we'd see that as very frightening because Australia could soak up almost the entire New Zealand medical workforce to fill their vacancies."
He said the greatest threat would be of losing doctors undergoing their years of specialist training.
"Even just to lose one of those is one too many, and the earlier you lose them, the less likely they are to come back."
Resident Doctors Association secretary Deborah Powell said the Australian changes, while offering her members greater choices, would deepen the workforce crisis in this country.
"We are already behind the eight ball and we still have district health boards saying there's no crisis," she said.
She understood the Australian Government agreed to lift the restrictions after coming under legal challenge from a New Zealand doctor who argued it was unfair to force him to practise where directed for 10 years.
Dr Powell said many young doctors rushed to Australia to get their feet in the door by registering to practise there, then spent the next 10 years moving to and fro across the Tasman filling lucrative short-term locum posts.
Although the changes meant the doctors could take their time before going to Australia, there was a serious risk they would not come back.
