国家报告文书（2024年）

Health New Zealand (HNZ) is responsible for health workforce planning and development initiatives as outlined in the Health Workforce Plan 2024. HNZ employs a specialist team to collate workforce data (typically collected by Regulatory Authorities) and provide modelling and forecasting to inform workforce planning. For example, data captured for emergency department (ED) events and primary care practices with closed books can be used to explore the relationship between ED events and shortages across general practice/primary care providers. This informs health workforce planning and commissioning across the health system. Further information can be found here: https://www.tewhatuora.govt.nz/corporate-information/planning-and-performance/health-workforce/health-workforce-plan-2024/our-approach-to-workforce-planning

The Ministry of Health and Health New Zealand work closely with key stakeholders including the Ministry of Education, Tertiary Education Commission, tertiary training providers, and regulatory bodies. This is to ensure sufficient health education and training places are available and the training models offered to students are supportive of the skills and capabilities the workforce need to meet current and future health needs.

Health New Zealand continues to develop their teaching capacity for ongoing development of the health workforce, as new technologies are introduced and different approaches to delivering care are adopted in line with best practice and system productivity.

Provision of registration pathways and graduate placement programmes that provide roles in areas of need, such in primary and community care. Initiatives include, the Domestic Graduate Primary Care Pathway, which supports greater exposure to primary care settings for domestic students, encouraging more doctors into General Practice; and, the NZ Clinical Examinations Primary Care Pathway for international medical graduates (IMGs), which provides placements for IMGs that have completed the NZ Clinical Examinations pathway provided by the Medical Council of New Zealand, allowing them to gain general registration and be eligible for the General Practice Education Programme.

The Ministry of Health monitors and reviews immigration pathways to ensure New Zealand has the necessary health workforce to meet New Zealand’s health needs. International recruitment is managed by Health New Zealand through the 'International Recruitment Centre' (the Centre). The aim of the Centre is to provide a service that attracts and makes it easy for international health professionals to move to New Zealand to live and work. Specific principles and policies have also been developed to ensure the ethical recruitment of international health workers (as per the WHO code). Workforce planning is informed by the collection of workforce data and associated modelling and forecasting to help improve management of the health workforce, including international health workers.

• Monitoring and forecasting of health workforce movements to improve planning and management of the workforce. • Regular workforce surveys that help inform planning and new initiatives. • Most employed in the NZ health system are on collective employment agreements that have been negotiated between employers and unions on behalf of their registered members.

Regional and rural-based (and focused) training providers and programmes. Where tertiary education providers do not have a physical base in rural areas, they collaborate or partner with health providers to create opportunities for students to undertake placements as part of their health programme, within a rural setting.

Some tertiary education providers offer admission schemes or policies for people from rural/underserved communities, which supports entry into specific health education programmes. For example, the University of Auckland offers the Regional Rural Admission Scheme which allocates places for students of regional/rural background in the undergraduate medicine, optometry, medical imaging, and pharmacy programmes. The University of Otago has the Te Kauae Parāoa policy for students from underrepresented priority groups (Māori, Pacific, rural, socioeconomic and refugee background), which provides an entry pathway into a Division of Health Sciences programme, as well as mentorship and pastoral support.

Health New Zealand (HNZ) provides publicly funded scholarships, grants, and financial assistance for under-represented and at-risk cultural groups, such as Māori and Pacific. These aim to improve health outcomes by growing an inclusive workforce and encouraging under-represented groups into heath careers; enabling and supporting better development of skills and capabilities, including leadership and cultural capabilities; and improving retention. HNZ also fund a range of programmes to support growth and development of at-risk and high-need workforce groups, such as the mental health and addiction workforce. There are also various scholarships and grants administered by private entities (sometimes in partnership with the public sector) that focus on growing cultural representation and capabilities in the workforce and shortages in different professions, and localities. This includes scholarships and grants aimed at addressing key workforce shortages in rural settings by encouraging rural youth into medicine, midwifery, nursing and allied health careers. Further information can be found in the following links. https://www.tewhatuora.govt.nz/for-health-professionals/scholarships-and-grants https://www.tewhatuora.govt.nz/for-health-professionals/scholarships-and-grants/non-te-whatu-ora-funded-scholarships-and-grants

Provision of new and expansion of training programmes focused on increasing workforce numbers in areas of need e.g. the Rural Immersion programme

In recent years there has been a greater focus on promoting growth in the primary health care workforce through, for example, establishing and expanding graduate registration pathways direct to primary care settings for both domestic and international medical graduates, which ensures a limited number of funded positions are available in primary care settings for PGY 1 & 2 years; and the provision of primary care training and education in rural settings with a greater focus on providing care that meets the needs of rural communities.

The Ministry of Health worked with regulators to safely enable a broader range of authorisation for prescribing. For example, nursing and pharmacist prescribers. The Ministry of Health continues work to identify further professions that may have the skills and capabilities to safely prescribe medicines. We have also established a mechanism for health workers to become approved vaccinators to support immunisation programmes.

The Ministry of Health works with regulators to identify common areas of competencies and shared skills, to facilitate multidisciplinary models of care.

The remuneration for the publicly funded health workforce will often reflect the level of need and perceived challenges presented by living and working in different communities and settings, such as in rural and provincial areas. Health New Zealand also administer the Voluntary Bonding Scheme (VBS), which provides new or recent graduates in eligible professions with payments as an incentive to work in select hard-to-staff communities or specialties. The payments are provided in the first 3-5 years of their career, to help repay their student loan or as top-up income. The eligible professions for the 2024 intake included midwives, anaesthetic technicians, pharmacists, general practice trainees, and enrolled and registered nurses. There are also various grants and financial assistance available for eligible new graduates and existing practitioners, including to support training-related travel and accommodation costs. For example, Skills Matter Travel and Accommodation Assistance Grants and relocation grants to support international recruitment of General Practitioners into rural settings.

See responses to 2.2.1.1 Education Measures regarding education and training scholarships, grants and support.

See responses to 2.2.1.1 Education Measures regarding education and training scholarships, grants and support.

Various public and private organisations host regular awards that recognise workforce contributions to such things as primary and community health care; health research, including that related to at-risk cultural groups; specific professions and professional groups, such as doctors, nurses and pharmacists; and for contributions that improve health outcomes for different cultural groups and communities, including Māori and Pacific.

See 2.2.3.1 Professional recognition

The Immigration New Zealand Green List is a list of occupations that qualify for a straight to residence or work to residence pathway. There are 48 health roles on Tier 1 of the Green List which allows internationally-qualified workers and their immediate family to apply for New Zealand residency offshore and enter New Zealand as residents.

All employers and workplaces in New Zealand are required to adhere to employment and health and safety laws and standards, including those that provide for safe and healthy working environments, conditions and practices.

All housing in New Zealand is required to meet nationally legislated standards to ensure safe and healthy living conditions.

A range of distance learning opportunities are available from education and training providers, and through the Health New Zealand website.

Guiding recruitment principles have been developed to guide all recruitment of international workers by public health services and are recommended to all other employers, e.g. private practices. These principals build on the WHO Global Code of Practice on the International Recruitment of Health Personnel and incorporate the WHO's Health Workforce Support & Safeguard List.

as per 5.1

as per 5.1

as per 5.1

An employer in New Zealand is required to be accredited by Immigration New Zealand (INZ) to recruit migrant workers under the Accredited Employer Work Visa (AEWV) scheme. Accreditation ensures that the employer meets specific standards of ethical and fair treatment for migrant workers, aimed at reducing exploitation and promoting transparency in employment. For example, workers currently must be paid at least the median wage, unless specified exemptions apply. Workers must have written employment agreements outlining all terms such as their wages, hours and conditions, allowing migrants to make informed decisions on their employment, and employers must ensure safe and healthy workplaces and environments. Employers who fail to meet standards are at risk of losing their accreditation. Migrant workers cannot be charged fees for job placements. The employer or recruitment agency bears these costs. Under the Accredited Employer Work Visa scheme, employers are encouraged to help migrants adjust by providing guidance on living and working in NZ.

Migrant health professionals must meet the same qualifications, skills and competency requirements as their domestically trained counterparts. Key requirements include: • Professional Registration – All healthcare workers, such as doctors, nurses or allied health professionals, must register with the relevant professional council (e.g. The medical Council of New Zealand or Nursing Council of New Zealand). • Qualifications Assessment – Overseas qualifications are assessed to ensure they meet New Zealand standards. • English Language Proficiency – Migrants may need to demonstrate English language proficiency, often through tests like the International English Language Testing System (IELTS) or the Occupational English Test (OET). Salaries in NZ are governed by collective agreements negotiated by unions, such as the NZ Nurses Organisation (NZNO) or the Association of Salaried Medical Specialists (ASMS).

Migrants must meet the standards of professional councils (e.g. Medical Council of New Zealand, Nursing Council of New Zealand), which include continuing professional development (CPD) requirements.

The purpose of the Accredited Employer Work Visa (AEWV) scheme is to ensure that migrants are recruited fairly and without exploitation via ethical recruitment principles and as per the info outlined above regarding the requirement for employers to be accredited. Also professional bodies ensure that migrants meet NZ standards for practice and provide guidance on registration and professional development. Settlement services are provided to deliver information on housing, healthcare, education and community integration. Organisations such as the New Zealand Nurses Organisation and the Association of Salaried Medical Specialists advocate for migrant workers, ensuring equitable treatment and offering support in employment disputes.

Professional Registration bodies recognise qualifications from several countries under reciprocal agreements or pathways. The AEWV provides opportunities for migrant health workers to work in New Zealand temporarily. Migrants on this visa can return to their home country after completing their contracts and potentially return to New Zealand.

The Employment Relations Act guarantees all workers in New Zealand (including migrants), basic employment rights. The Health and Safety at Work Act and Equal Pay Act also provide consistent protections and rights for all workers in New Zealand. Guiding principles have also been developed to ensure the ethical recruitment of international health workers in New Zealand.

Trans-Tasman Mutual Recognition Act with Australia and the reciprocal agreements in place with professional registration bodies in New Zealand and several other countries.

Return to service registration pathways provided by registration authorities, such as the Medical Council of New Zealand, the Nursing Council of New Zealand, and Midwifery Council.