Government officials have raised significant concerns about the University of Waikato’s ambitious proposal to establish New Zealand’s third medical school.
Having worked with Stephen Joyce in transport planning and delivery, my observation is B/C ratios are not high on his list of motivations. Retaining National Party seats are. I doubt the $1m fee for his "services" to Waikato would have passed a careful B/C scrutiny.
This government, and Labour, are fixated on the "golden triangle" covering Auckland, Hamilton and through to Tauranga. Close analysis will identify enormous resourcing going specially to this area. My view is we should be supporting Auckland and Dunedin schools. The South Island should not be forgotten on every front by this government. The money saved from spending more in Hamilton will be sufficient to complete the Dunedin hospital properly. I am suspicious of the supposed $3b cost.
Make it a requirement for graduating doctors to spend time under proper supervision in rural areas. Give them a sum off their student loans for serving in these areas. Some will stay.
The first time I heard about the project I thought it was simply me-too empire-building by Waikato. Two medical schools in NZ is surely enough. If and when Auckland and Otago start creaking at the seams coping with students (which they are evidently not), then that is the time to think about whether or not to expand them or, less likely, build another one. It just seems crazy having to have three sets of lecturers and facilities.
They have said themselves that they can cope with increase. And Waikato have said that in order to be successful they would have to crib students from Auckland and Otago. But I take your point, and accept that bigger will not necessarily be better when it comes particularly to practical classes, and in hospital training - one would not want twenty students crowding around a patient’s bedside to learn. There may be an ideal size for an efficient teaching hospital.
A salient point though is that a new school will not solve current shortages. Whatever changes are made in training must be accompanied by a freeing up in the acceptance of qualified immigrant doctors, removing the absurd barriers put up by the self-serving gate-keepers in the profession.
Yes. Ultimately we simply need more doctors. The issue with immigrant doctors when it comes to solving this specific problem however, is that they don't stick around in the NZ health system anywhere near as long as home-grown ones. And GP care is much more beneficial when you have continuity of care.
The other issue is the current system is heavily focused on hospital and specialist training, so as a result you get more hospital specialists, not GPs. This is a problem as GPs are where the big shortage is, and primary care is cheaper and more effective than hospital care.
Einstein: 'Insanity is doing the same thing over and over again and expecting different results.'.
Like year by year throwing more money at so-called "healthcare" in response to the continued increase in the burden of chronic diseases.
We do not have a shortage of doctors: look at the number of doctors on the MCNZ register per capita over the past twenty years. We have more per capita than ever before. What we do have is an ever increasing demand, a demand which outstrips population and economic growth.
Something like 80% of visits to general practitioners and use of pharmaceuticals are for management of chronic diseases which were rare fifty years ago.
What are the causes of this explosion in chronic diseases? (thinking particularly of metabolic diseases such as diabetes; cardiovascular diseases; autoimmune diseases; allergy and asthma; anxiety and depression; neurodegenerative diseases; some cancers). All are driven by poor lifestyle choices - eating too much processed food, being physically inactive, inadequate contact with nature - the soil, plants, animals, microbes, dirt - inadequate social contact, too much exposure to harmful substances, including prescription drugs, too much time in front of screens, too little sleep.
And the ground causes:
- Biggest of all: loss of individual agency, looking to the State to fix what the individual needs to fix themselves.
- The relentless marketing of addictive rubbish whether sugary drinks, fast foods, computer games, tv.
- The corruption of Medicine by Big Pharma and Big Diagnostica, which control the research programme through research funding and substantial control of the medical publishing industry. Most venal is the control of licensing bodies like the MCNZ which demand robotic compliance by doctors with so-called "best evidence", that is, the marketing by Big Pharma.
- Where Lifestyle Medicine has the potential to prevent and indeed to cure chronic diseases for which mainstream pharmaceutical medicine has at best the ability to "manage", there is minimal support for the development, specialist registration, funding, of lifestyle medicine practitioners.
This project also hugely misunderstands where the bottle necks in medical training exist. Whilst both existing medical schools could easily ramp up students, there are many problems post-grad. Firstly, the public system is underfunded and as such there are insufficient PGY-1 positions for the existing yearly students (by about 4ish atm). Secondly, we bleed many of our graduates overseas at the registrar level. Thirdly, specialization is increasingly difficult to access for a variety of reasons. And some specialties like GP have an additional problem of attracting doctors due to poor conditions.
My growing impression is that National is in a number of instances behaving in as bull headed nonsensical manner as Labour, pushing ahead with ideologically and/or politically motivated schemes regardless of the detail of whether they will actually work, make fiscal sense, and whether the upside impacts are likely to be significantly greater than the downsides. There is a need to distinguish between the kind of pushback we're seeing from a nation and more particularly a public service and local councils riddled with woke leftists and genuine problems with what is being proposed. ACT is absolutely correct.
First bit fits. Second part of the sentence is peculiar. Who’s reality, facts and history are you referring to ?
I think I probably am a woke leftist but my involvement in history, reality and facts is far from shallow. I can believe however that what are important facts for me are totally different from what matters to you.
Let me expand a little. The phenomenon that we're discussing is often referred to as post modernism, where reality is perceived primarily as a social construct. I suspect that digital connectivity (social media) has a great deal to do with its rapid spread across Western nations with many of the characteristics of a mass psychosis.
I have nothing to do with social media. I prefer solid book reading - usually of academics- and have done ever since my teens. We are not talking about the same thing. I’ve always been a humanitarian and that is what we need more people to be.
PS I’m almost 80 and my way of thinking was a long time before me so while the term ‘woke’ maybe post modern, what it seems to refer to is an old, proud tradition that has clearly been turned into something with no meaning.
Re woke leftists: I suspect i may be one but can't quite figure what they are. Could you please give me a clear description, then I'll know whether I am one or not.
In a nutshell, a phrase describing individuals or groups on the political left who advocate for progressive social change, social and indeed environmental justice, that reflects a superficial grasp of and indeed often little interest in reality, facts or history.
Having worked with Stephen Joyce in transport planning and delivery, my observation is B/C ratios are not high on his list of motivations. Retaining National Party seats are. I doubt the $1m fee for his "services" to Waikato would have passed a careful B/C scrutiny.
This government, and Labour, are fixated on the "golden triangle" covering Auckland, Hamilton and through to Tauranga. Close analysis will identify enormous resourcing going specially to this area. My view is we should be supporting Auckland and Dunedin schools. The South Island should not be forgotten on every front by this government. The money saved from spending more in Hamilton will be sufficient to complete the Dunedin hospital properly. I am suspicious of the supposed $3b cost.
Make it a requirement for graduating doctors to spend time under proper supervision in rural areas. Give them a sum off their student loans for serving in these areas. Some will stay.
The first time I heard about the project I thought it was simply me-too empire-building by Waikato. Two medical schools in NZ is surely enough. If and when Auckland and Otago start creaking at the seams coping with students (which they are evidently not), then that is the time to think about whether or not to expand them or, less likely, build another one. It just seems crazy having to have three sets of lecturers and facilities.
Not sure about that. Expanding Auckland and Otago further would make them some of the largest medical schools in the world!
They have said themselves that they can cope with increase. And Waikato have said that in order to be successful they would have to crib students from Auckland and Otago. But I take your point, and accept that bigger will not necessarily be better when it comes particularly to practical classes, and in hospital training - one would not want twenty students crowding around a patient’s bedside to learn. There may be an ideal size for an efficient teaching hospital.
A salient point though is that a new school will not solve current shortages. Whatever changes are made in training must be accompanied by a freeing up in the acceptance of qualified immigrant doctors, removing the absurd barriers put up by the self-serving gate-keepers in the profession.
Yes. Ultimately we simply need more doctors. The issue with immigrant doctors when it comes to solving this specific problem however, is that they don't stick around in the NZ health system anywhere near as long as home-grown ones. And GP care is much more beneficial when you have continuity of care.
The other issue is the current system is heavily focused on hospital and specialist training, so as a result you get more hospital specialists, not GPs. This is a problem as GPs are where the big shortage is, and primary care is cheaper and more effective than hospital care.
Looks like they want to run a primary care focused medical school. https://www.waikato.ac.nz/about/major-projects/medical-school/
I'm agreeing with NZ First, and ACT, the very strangest of days
Einstein: 'Insanity is doing the same thing over and over again and expecting different results.'.
Like year by year throwing more money at so-called "healthcare" in response to the continued increase in the burden of chronic diseases.
We do not have a shortage of doctors: look at the number of doctors on the MCNZ register per capita over the past twenty years. We have more per capita than ever before. What we do have is an ever increasing demand, a demand which outstrips population and economic growth.
Something like 80% of visits to general practitioners and use of pharmaceuticals are for management of chronic diseases which were rare fifty years ago.
What are the causes of this explosion in chronic diseases? (thinking particularly of metabolic diseases such as diabetes; cardiovascular diseases; autoimmune diseases; allergy and asthma; anxiety and depression; neurodegenerative diseases; some cancers). All are driven by poor lifestyle choices - eating too much processed food, being physically inactive, inadequate contact with nature - the soil, plants, animals, microbes, dirt - inadequate social contact, too much exposure to harmful substances, including prescription drugs, too much time in front of screens, too little sleep.
And the ground causes:
- Biggest of all: loss of individual agency, looking to the State to fix what the individual needs to fix themselves.
- The relentless marketing of addictive rubbish whether sugary drinks, fast foods, computer games, tv.
- The corruption of Medicine by Big Pharma and Big Diagnostica, which control the research programme through research funding and substantial control of the medical publishing industry. Most venal is the control of licensing bodies like the MCNZ which demand robotic compliance by doctors with so-called "best evidence", that is, the marketing by Big Pharma.
- Where Lifestyle Medicine has the potential to prevent and indeed to cure chronic diseases for which mainstream pharmaceutical medicine has at best the ability to "manage", there is minimal support for the development, specialist registration, funding, of lifestyle medicine practitioners.
This project also hugely misunderstands where the bottle necks in medical training exist. Whilst both existing medical schools could easily ramp up students, there are many problems post-grad. Firstly, the public system is underfunded and as such there are insufficient PGY-1 positions for the existing yearly students (by about 4ish atm). Secondly, we bleed many of our graduates overseas at the registrar level. Thirdly, specialization is increasingly difficult to access for a variety of reasons. And some specialties like GP have an additional problem of attracting doctors due to poor conditions.
What evidence is there that Waikato medical graduates will work in rural areas?
Unless this becomes a requirement of acceptance to the school with financial penalties for non performance, it won't happen.
My growing impression is that National is in a number of instances behaving in as bull headed nonsensical manner as Labour, pushing ahead with ideologically and/or politically motivated schemes regardless of the detail of whether they will actually work, make fiscal sense, and whether the upside impacts are likely to be significantly greater than the downsides. There is a need to distinguish between the kind of pushback we're seeing from a nation and more particularly a public service and local councils riddled with woke leftists and genuine problems with what is being proposed. ACT is absolutely correct.
First bit fits. Second part of the sentence is peculiar. Who’s reality, facts and history are you referring to ?
I think I probably am a woke leftist but my involvement in history, reality and facts is far from shallow. I can believe however that what are important facts for me are totally different from what matters to you.
Let me expand a little. The phenomenon that we're discussing is often referred to as post modernism, where reality is perceived primarily as a social construct. I suspect that digital connectivity (social media) has a great deal to do with its rapid spread across Western nations with many of the characteristics of a mass psychosis.
Thanks tho for helping me understand what woke is.
I have nothing to do with social media. I prefer solid book reading - usually of academics- and have done ever since my teens. We are not talking about the same thing. I’ve always been a humanitarian and that is what we need more people to be.
PS I’m almost 80 and my way of thinking was a long time before me so while the term ‘woke’ maybe post modern, what it seems to refer to is an old, proud tradition that has clearly been turned into something with no meaning.
Humanitarian does not equal woke. Woke in that respect, as an example, would I suggest typically value the perception of humanity over the reality.
Re woke leftists: I suspect i may be one but can't quite figure what they are. Could you please give me a clear description, then I'll know whether I am one or not.
In a nutshell, a phrase describing individuals or groups on the political left who advocate for progressive social change, social and indeed environmental justice, that reflects a superficial grasp of and indeed often little interest in reality, facts or history.