Rural medical practices have vacancies for about 150 doctors, with two-thirds of those positions being unfilled for 12 months or more.
The data, released by Hauora Taiwhenua Rural Health Network, is not definitive and based on demand for locums.
It reveals that in addition to those 100 posts that have been vacant for a year or more, there are 20 posts that have been vacant for three to 12 months and 27 for up to three months.
Gill Naylor, the president of Rural Women New Zealand, described the workload facing rural general practitioners and midwives in particular as dire and said the two biggest issues facing rural health are workforce capacity and equity of access to services.
“There is plenty that needs to be done.”
Attracting medical professionals to rural areas and retaining them requires a package suited to the whole family, including schools, services and lifestyle.
“If the rest of the family is not happy, they’re not going to stay,” Naylor said.
Improved access and funding for telehealth services would help reduce the travel burden on families and improve treatment, while also making GP positions more attractive.
Having to travel long distances for healthcare “puts a huge burden on people. They’re away from work, face the cost of travel and need to ensure plans are in place for family, people at home.”
In the interim, communities have found their own solutions such as the Woman’s Health Bus in Otago and Southland, a mobile healthcare facility to assist women.
“There are local solutions being developed because they could see these issues weren’t being met by the public system.”
The NZ Nurses Organisation Kaiwhakahaere, Kerri Nuku, said the health sector needs a long-term workforce plan and those with knowledge and expertise of rural health issues need to be at the forefront of any such initiative.
“Often those planning developments are removed from the reality of those who live in those areas.”
Part of the problem facing the sector is the lack of government data to identify the scale of staffing shortages.
The extreme weather that hit parts of the North Island this summer highlighted the peculiarities and challenges of meeting the health needs of rural communities.
She said nurses had to clamber over fallen trees, traverse flood waters and in some case fly by helicopter to access patients.
Recruiting medical professionals to work in rural areas has always been difficult, but one option is to upskill nurses to nursing practitioners where they can prescribe some medicines and perform some GP roles.
Another is to incentivise nurses to move to rural areas to work.
Pay parity also needs to be resolved.
Nurses employed by private GPs have been excluded from the government pay parity settlement, which means they are paid at least 10% less than those in the public sector.
Nuke said the government believes private businesses should address that discrepancy and have not provided additional funding to achieve it.
She said rural communities need to start lobbying and making noise about the rural health issues.
Nuku said the government’s health reforms were designed to remove post code inequities, but that does not seem to be happening in rural areas.
“It takes communities to make change.”
The complexity of the problems facing rural health is illustrated by midwifery services.
The exact number of rural midwives the sector is short is unknown, but NZ College of Midwives chief executive Alison Eddy said in some areas they are struggling to maintain services.
This is especially relevant for pregnant migrant women living in rural areas, for whom midwives provide support and are a crucial link to access to services.
There are multiple challenges facing rural midwifery services.
Providing a 24/7 service requires collegial support so midwives have cover, which is not always available in rural areas.
Remuneration has failed to keep pace with inflation, especially for the costs faced by self-employed midwives.
Eddy said trainee midwives tend to be older women rather than school leavers, so retraining means giving up wages for four years of study.
She said they are finding some success using satellite schools in rural centres to target rural women for training as midwives.