University of Waikato vice-chancellor Professor Neil Quigley at the university campus. Photo: RNZ / Natalie Akoorie
The business case for a third medical school at the University of Waikato is not expected until next year.
University of Waikato vice-chancellor Professor Neil Quigley expects the Ministry of Health's cost-benefit analysis of the proposal in the first quarter of next year.
It comes as the university withdraws a call for tenders on the government procurement website GETS to build the school.
Earlier this month, the university began demolishing the old and vacant B Block to make way for the new medical school.
If green-lit, the medical school was expected to open with 120 enrolments in 2027 to help address the country's drastic shortage of doctors.
A business case was agreed in February after the university and Ministry of Health signed a memorandum of understanding.
Quigley said the $380 million estimated to fund the medical school was a figure scaled up to incorporate inflation and the doubling of students from 60 to 120 since the last bid for a third medical school in 2016.
That cost was proposed to be split across the government ($280m) and the university ($100m).
The government's contribution would include $140m to pay for a new building at the university and renovations of existing labs, and $140m to invest in rural hospitals and other locations to create clinical placement capacity.
"New Zealand has allowed our rural hospital network to run down over the past 30-40 years and this sort of medical school we're talking about would be a new lease of life for those locations."
In the Waikato region, this included hospitals in Thames, Tokoroa, Te Kūiti and Taumarunui, as well as general practice and iwi/Māori-led clinics.
The school aimed to train students from more diverse backgrounds, who were committed to long-term primary care outside the main centres.
The graduate-entry programme would only take four years and the entire third year would be spent on placement.
When asked about the pressure supervision might place on GPs where there was a major workforce shortage, Quigley said it was possible supervisors would include overseas-trained GPs.
The University of Waikato had also partnered with an Australian university for the project, but Quigley would not say which one yet.
"The evidence from overseas says that to get different workforce outcomes you have to do everything differently. You can't just say we'll have a longitudinal placement in our existing programme and that's going to make a difference."
It currently costs about $400,000 to train one doctor, with $97,000 paid by the student and the rest by taxpayers, over six years.
Because of the high cost - and the loss of up to 25 percent of New Zealand-trained doctors overseas each year - the Tertiary Education Commission caps the intake of students at existing medical schools in Otago to 302, and Auckland to 289.
The number was expected to increase by 50 in this week's Budget.
Those in charge of medicine at Otago and Auckland said an interprofessional rural medical model that also trained nurses, pharmacists, and physiotherapists should be prioritised, instead of a third school focused only on training doctors.
University of Auckland Faculty of Medical and Health Sciences Dean, Professor Warwick Bagg. Photo: Supplied
University of Auckland Faculty of Medical and Health Sciences Dean Professor Warwick Bagg said it was not about individual universities, but the best and most cost-effective way for the country to train doctors.
A rural medicine model would have a collaborative approach, with the biggest limitation on training in clinical placement capacity and supervision, Bagg said.
Next year the university would offer a year-long full immersion rural programme, a course that had been offered at the University of Otago for a decade.
Otago medical school dean, Professor Tim Wilkinson. Photo: Supplied
Otago medical school dean Professor Tim Wilkinson said between its schools in Dunedin, Christchurch and Wellington, it was a $550m per year operation underpinned by hundreds of millions of dollars of investment in facilities and equipment, plus 550 full-time academic staff.
Wilkinson said it was the scaling up of clinical placements that was difficult.
"We'd envisaged that we would want to make more use of regional settings but that may well require some infrastructure development to cater for more students. These things are all achievable but that would require a national, joined-up approach."
Health Minister Dr Shane Reti said a third medical school was an absolute priority for the government to address workforce pressure.
"The University of Waikato has presented an innovative proposal to support the domestic growth of this workforce: a new medical school that focuses on primary care and the needs of people in rural, provincial and high-needs communities, where there are significant doctor shortages."
He said the Waikato proposal would provide another pathway for medical training, that differed from Otago and Auckland.
Reti said a cost-benefit analysis would take a range of options into account and include input from the other medical schools.
He said the doctor shortage was critical.
"We need to look at new ways of doing things to grow the health workforce of the future. I am fully committed to considering whether a new medical school focused on rural and primary and community care is credible and financially viable option."
Ministry of Health public health system group manager Allison Bennett did not say when the feasibility would be complete.
"Establishing a medical school is a major undertaking, requiring significant investment and careful engagement through the tertiary education and health sectors.
"The ministry is committed to take the time to getting this right and ensuring that ministers have the best information from which to make decisions."
Bennett said the work would include an independent cost-benefit analysis to assess the value and impact of a third medical school on the health system and provide assurance of the feasibility of the programme.
She expected Cabinet to consider next steps for the development and timeframes of the analysis this month.