Third medical school folly

It may take a lot to stop the wasteful and unwise plan for a University of Waikato medical school. There it is in the coalition government’s first 100-day plan list: "Sign a memorandum of understanding with Waikato University to progress a third medical school."

We already knew university vice-chancellor Neil Quigley was in cahoots with National health spokesman Shane Reti in the formation of National’s policy.

Prof Quigley in March even sent an email to Dr Reti explaining that "the first student intake would be 2027 — a present to your second term in government!"

We also, thanks to RNZ investigative reporter Guyon Espiner, know Prof Quigley received lobbying advice from former National government Cabinet minister the influential Steven Joyce. Mr Joyce’s company, Joyce Advisory, was paid nearly $1 million over three years for consultancy services to the university.

A former press secretary and political advisor to Mr Joyce was then used to lead the university’s communications strategy about the school.

The matter is a class on how to make poor policy.

Waikato desperately wants a medical school for the prestige, research and funding it brings.

Its proposals emerged in 2016 and National was looking into them. Labour, under Prime Minister Jacinda Ardern, herself a Waikato graduate, halted progress.

Interestingly, RNZ also revealed that Waikato paid a $6900 a month retainer to Capital Government Relations to lobby on behalf of the university from January 2020. The lobbying for the new medical school was led by CGR part-owner Neale Jones, a former chief of staff to former Labour leaders Ms Ardern and Andrew Little.

As part of the coalition agreement with Act, National agreed "a full cost-benefit analysis must be presented before any binding agreement is made with respect to the Waikato medical school".

Dr Reti claims such an analysis would always have been required. No such caveats were mentioned in National’s policy or comments.

The question now arises about the power of the promised memorandum. Will it just be a PR point to help make the 100-day pledge look good and show Waikato interests that National is following through? Or will it pressure or tilt the "analysis"?

How that analysis is done and who does it will matter. Even so-called independent studies are inevitably clouded in presumptions, pressures and interests.

On the other hand, Act’s insistence might give National scope to back out.

After all, this Government is making a play on more efficient spending and the costs of another medical school will be higher than adding capacity to Otago and Auckland.

Its tax cuts and other spending commitments mean it must be loath to add another several hundred million dollars in start-up costs alone. The 2016 figure was $300 million — the amount National said it would invest pre-election.

That was always totally unrealistic, even with a large contribution from Waikato. The costs will have soared with building inflation and other price rises as well as a planned student intake increase by 20% to 120.

Staffing the new school could also be a nightmare.

As health commentator Ian Powell said, the government was sending "very mixed messages".

Mr Powell was correct to note it was wrong to rush into these projects. It should be a whole of country and business approach rather than a push from a single university, he said.

Waikato and Prof Quigley have their narrow interests at heart. Otago and Auckland, for that matter, are hardly disinterested in the outcome.

Any cost-benefit analysis must also look at the wider picture of medical training, particularly the clinical oversight of trainees.

There is no point pumping out part-baked doctors if they have not been well-supervised and received positive practical training. This is already a challenging bottleneck. A third medical school competing in this area will not help. As it is, the disturbing dearth of rural health practitioners — a rationale for the new medical school — has been recognised and several initiatives are already underway.