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How a revision of nursing registration processes is affecting healthcare migrants

19:11 pm on 24 April 2024

Nearly 50 percent of registered nurses who have relocated to New Zealand since the country's borders opened in 2022 have arrived from India. Photo: Adobe Stock

Recruiters are divided on the Nursing Council's recent revisions to the registration process for healthcare workers educated outside New Zealand.

While some welcomed the removal of intermediaries from the process as well as a reduction of overall costs, others expressed concern the revision did not accurately reflect an applicant's training and experience.

In December, the Nursing Council said migrants from countries other than the US, UK, Ireland, Singapore and the Canadian provinces of British Columbia and Ontario would need to pass an Objective Structured Clinical Examination (OSCE) before working in the country's healthcare sector.

Consisting of both theoretical and clinical components, the new exam replaced the Competence Assessment Programme (CAP) that was previously mandatory for overseas nurses.

Health New Zealand is currently in the process of phasing out funding for the programme.

Introduced in 2022 to address chronic nursing shortages, the CAP funding helped cover accreditation costs that overseas healthcare workers incurred during the conversion process.

From 4 December, funding for applicants holding a valid CAP certificate ceased.

International influx

New Zealand appears to be plugging the staffing gaps that have appeared in the healthcare sector in recent years.

According to Te Whatu Ora, New Zealand had a shortfall of approximately 4,800 nurses in July 2023.

But Health New Zealand said an influx of new graduates on top of a "strong flow" of internationally qualified nurses into the country last year meant that such gaps were starting to be plugged.

"Frontline feedback indicates that we have filled many generalist nursing vacancies, both in our hospitals and increasingly across the primary and community sector," Health New Zealand said.

However, the agency said it needed to receive updated March nursing figures in July before any conclusions could be drawn on the impact of new graduates.

According to latest statistics from the Nursing Council, 14,232 new nurses commenced work in New Zealand in 2023.

From 1 October to 31 December 31, 4770 nurses were added to the New Zealand Register of Nurses, a 49 percent increase from the same period the previous year.

Of these new nurses, 37 percent were New Zealand qualified, with the remaining 63 percent qualifying abroad.

Of the internationally qualified nurses, 48 percent registered after completing a CAP course, 50 percent registered without needing to complete a CAP course - although some had conditions placed on their practice - and the remaining 2 percent registered under the 1997 Trans-Tasman Mutual Recognition Act between Australia and New Zealand.

From 1 October to 31 December 31, the UK was the most registered country, with 1049 nurses having been registered there previously.

A further 743 nurses had been registered in a Middle Eastern country, while 458 nurses had been registered in India.

Nurses from India continue to migrate to New Zealand in significant numbers, with the number of newly registered Indian nurses rising from 159 in December 2022 to 458 in the last quarter of 2023.

Nearly 50 percent of registered nurses who have relocated to New Zealand since the country's borders opened in 2022 have arrived from India.

Prudence Thompson owns Accent Health Recruitment. Photo: Supplied

Mixed response

Some recruiters embraced the Nursing Council's revisions to the registration process for nurses educated outside New Zealand.

The updated system should substantially reduce overall costs, said Prudence Thompson, a recruiter at Accent Health.

"I see it as a positive move," Thompson said.

Thompson said competency assessment programs previously cost overseas nurses up to $10,000 to complete, whereas expenses incurred in sitting the new exam were around $3000.

Overall, the process would be streamlined, she said.

"OSCE will only take three hours to complete instead of six to eight weeks, so that's really good for applicants," she says.

However, Thompson remained uncertain about whether the new assessment method provided a better understanding of an applicant's training and competencies.

Sumesh Maharaj, director of Wellington-based FITMED recruitment International, also welcomed the new system.

"[The] OSCE cuts the middleman down and gets the nurses directly to New Zealand," Maharaj said.

He highlighted issues with overseas agencies, particularly in India, manipulating the system and resulting in cases like the 20 nurses who arrived in March with accredited employer work visas only to find themselves without jobs.

Maharaj believed the new system will minimize the role of overseas agencies, allowing nurses to manage registrations and competency assessments independently.

However, he acknowledged that nurses might miss out on valuable on-the-job training alongside domestic nurses under the new system.