Doctor cartel

For years it's seemed that how New Zealand's medical system treats foreign-trained doctors is best explained by the crudest cartel model. 

If you've designed a pathway for foreign-trained doctors to practice here that depends on a critical chokepoint, availability of supervised practice roles, that you know damned well will never work because all the spaces are allocated to fresh NZ grads, how is that legal? 

My column in today's Stuff papers:

Here is how the trick works.

Imagine that you are a 50-year-old doctor with decades of experience, wanting to move to New Zealand and set up practice for the long term. You go to the Medical Council of New Zealand’s website. It provides a helpful flow-chart.

You did not graduate in New Zealand or Australia and you do not have a medical degree from the UK or Ireland, so tick those boxes. You have not previously been registered here – your career has been based elsewhere. You have never had an Australasian Fellowship, so you do not have an approved postgraduate qualification. Tick those boxes too.

You will be required to work under supervision.

If you are lucky, you are a general practitioner from Europe, Canada, the United States, or Singapore allowed to work under the supervision of another GP through the Comparable Health System pathway. You will have to find a General Practice office willing to serve as your supervisor.

If you are unlucky, you are not from one of those countries, or you are a specialist. General practitioners from other countries must pass the registration exam, then find a supervised position. Specialists must work under supervision for six to 18 months.

It all sounds like it makes sense and is designed to ensure that doctors are up to spec. Except for one small detail.

There are effectively no positions available for foreign doctors to do the required supervised work in New Zealand hospitals.

Ripu Bhatia reported last week that at least 150 foreign-trained doctors are in New Zealand right now and would like to help.

Doctors who have passed their New Zealand exams and done everything they are supposed to do to be able to practice here are not able to do so.

The rules require that they work under supervision. But the system seems designed to throttle the number of doctors entering the system.

Limited supervised slots are available and most are allocated to recent New Zealand medical graduates.

In a better world, statutory regimes would not be exempt from cartel investigation and prosecution.