University of Otago Medical School

National has broken another manifesto health promise, apparently to save only $550,000.

It will now train an additional 25 med students next year rather than the 50 it promised.

This comes on top of the delays caused by National’s coalition partners in pushing ahead with the Waikato Medical School and the Budget failure to fund 13 cancer drugs as the party’s health manifesto had promised.

The Government now faces the prospect that it could end up with far fewer New Zealand-trained doctors than it promised last year when leader, Christopher Luxon, declared it would deliver “medical doctors rather than spin doctors.”

Health Minister Shane Reti claimed yesterday that the decision to cut back the student numbers was made because it took time for medical schools to adjust to the increased places.

“They’ve had a substantial increase this year with 50 new places,” he said, referring to an increase approved by the Labour Government last June.

However, the Auckland and Otago medical schools dismissed that claim; both said they could easily take more students next year.

The low cost-savings achieved and Reti’s unconvincing explanation for why the numbers were cut has left some observers wondering whether the real motive wasn’t to protect National’s other manifesto promise of a new medical school at the University of Waikato.

Last week, Reti said that work on the business case for the Waikato School had yet to begin.

That case has to be approved by the Cabinet before any moves can be made to begin construction.

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When completed in 2026 or 2027, it would produce 120 graduates a year from its four-year course.

However, Cabinet approval may be difficult to get as POLITIK understands that New Zealand First is ardently opposed to the school, and ACT is not convinced.

The argument against the additional school, which is forecast to cost $380 million, is that the two existing medical schools could provide the same number of places at a considerably lower capital cost.

The Waikato proposal was closely linked to National’s election campaign. RNZ reported last September that it had seen documents showing that Waikato Vice-Chancellor Neil Quigley went to considerable lengths to help National develop its policy to support the school.

RNZ said Quigley was in constant contact with the party’s health spokesperson, Dr Shane Reti, in the lead-up to its announcement in July last year.

The documents also showed Quigley received lobbying advice from former National government Cabinet minister Steven Joyce, whose company Joyce Advisory was paid nearly $1 million for consultancy services to the University of Waikato over three years.

“The university then engaged Anna Lillis, a former press secretary and political advisor to Joyce, to lead its communications strategy about the school,” RNZ said.

“Reti sought information and advice on multiple occasions from Quigley, including asking him how quickly a medical school could be up and running.

“The first student intake would be 2027 – a present to you to start your second term in government!” Quigley wrote, in a March 2023 email to Reti.”

That intake, which Quigley suggests would graduate in 2031,  will now not happen because it was predicated on design work for the new school starting next month.

That work cannot begin without Cabinet approval and ACT has had written into its coalition agreement that before Cabinet makes a decision a thorough business case must be prepared.

Reti told TVNZ last week that the terms of reference for the business case still needed to be prepared.

That would suggest that even if Cabinet does agree to the school it would not be ready to take students till 2028 at the earliest.

But by then, both Otago and Auckland could have another 50 students – almost half of what Waikato is proposing to teach each year — in their last year of training.

That extra 50 students were also National election policy.

“National will also increase the number of medical school placements at Auckland and Otago by a total of 50 from 2025,” Luxon said in campaign pamphlets.

“This will be in addition to the 50 extra places already funded at Budget 2023.”

But that 50 is the number that the Budget announcement has halved.

Yet the cost saving is minimal.

By National’s own admission, the cost of an extra 50 med school students would be $1.1 million for the first year — so cutting 25 out of that would save only $550,000.

That is about the same amount that Ministers spent on travel over the first three months of this year.

Both existing medical schools say they could take more students.

Professor Warwick Bagg, the Dean of the University of Auckland’s Faculty of Medical and Health Sciences, said yesterday they were pleased the Government’ Budget 2024 increased the medical student cap for the country by 25 for intake in 2025.

“That said, as the National Party promised pre-election, we had anticipated an increase of 50 students for 2025 to be shared between the University of Auckland and the University of Otago,” he said.

“We are fully prepared to take 25 or more of those 50 students at the University of Auckland in 2025.

“We have repeatedly signalled our willingness to increase the intake of medical students and continue to do so.

“An additional 25-30 students per year over the next four years, that is  an increase in the domestic cap of 120 students from the current 287 to 407,  at the University of Auckland is the shortest duration to train more doctors and the most cost-effective.”

A spokesperson for Otago University made a similar statement.

“We have indicated to Government that we are on ‘standby’ to lift our intakes further for 2025 and beyond if required,” the spokesperson said.

“We can lift from 302 to 348 places without additional infrastructure and would be able to do so in 2025 if required, or over two years (2025/2026).

“Longer term – indicatively for 2027 – we could lift (from 348) to an annual intake of 450 students.

“This level of increase would, though, require investment and some changes to our delivery.”

Thus, the basics are already in place to deliver on National’s campaign promise to “train more doctors so that Kiwis don’t have to wait as long to see their GP, be treated at hospital or have their surgery.”

Yet, ironically, because of the Budget decision and the coalition politics around the Waikato school, it looks likely now that National will end up training fewer doctors than the existing medical schools already had the potential to educate.