Consultants are among an exodus of medical staff from New Zealand to countries whose immigration policies are more attractive.
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One of the sticking points is the parent category - the government has reiterated that no decision has been made on when the programme will re-start, but said it was not part of the border re-opening plan.
One specialist has an offer from an Australian hospital almost tripling his salary and with a sign-on bonus of $300,000. He will leave to take the job in April, but says he will stay if the government agrees to re-start the process of accepting migrants' parents as residents.
The specialist, who is a New Zealand citizen and UK-trained, said his father, who is in his 80s, is staying with him and applied for residence under the parent category before the policy was frozen in 2016.
Thousands of families waited for years to find out when the new programme would open, but when it did - and before any applications could be made - it was closed again when the pandemic broke out. His father has been on a series of visitor visas, some as short as three months.
"I personally know heaps of colleagues - doctors and nurses who are in a similar situation to me and are actively looking at leaving NZ for good," said the doctor, who asked not to be named.
"There are hundreds, if not thousands, of highly qualified and experienced doctors, nurses, teachers, and other essential workers who will be leaving too if the visas for our parents are not extended and the parent category remains closed.
"I am a senior medical specialist at my local DHB. I am a New Zealand citizen, and I made this country my home due to the promise of its family friendly environment. While I would like to stay and contribute to the health response in NZ, I cannot do it if I am unable to care for my own parent during these tumultuous times."
Some parents were already in New Zealand, so posed no additional Covid-19 risk to the community, he said. The loss to the healthcare system was staff with decades of experience.
"The working conditions in NZ hospitals are poor, and so are the salaries. The trade-off has always been family togetherness, but that is no longer possible due to the lack of concern shown by the government for no good reason.
"The difficulties that my employing DHB will face if I leave will be enormous. Already, senior doctors and nurses are unable to take leave as there is no one to cover the clinics and wards in their absence. The clinicians at the front line are unable to manage their own burgeoning caseloads."
'A very blinkered view'
Psychiatrist Arnob Chakraborti has already decided to leave - his mother will be able to join him from India after he moves to Tasmania. She is among 8500 parents who are waiting for their expression of interest to be drawn to be able to apply for residence.
"I am leaving New Zealand due to the unfavourable visa policies," he said. "I have worked as an SMO [senior medical officer] across various DHBs over nine years. I acknowledge work conditions have been tough but I would have gladly stayed if NZ immigration allowed my mother to join us here.
"I don't have any siblings and the support systems, informal or services, are not very suitable in India - definitely none that I can rely on. I would be happy to sponsor her entirely - housing, healthcare, social whatever - if that's what the worry is from an immigration point of view, but, unfortunately the system maintains a very blinkered view."
Australia had maintained some options for sponsored long-term parent visas and for sponsored permanent visas despite Covid-19, he said. The cost and effort of recruiting overseas staff through international agencies was lost if retention policies were inadequate.
"Obdurate and unaccommodating" immigration policies were exacerbating other issues, such as long hours and low pay, and prompting migrants to look at new countries, he said.
"Plenty of personal stories where healthcare staff had to leave because they struggled or their partners struggled to gain residency status or a work permit.
"Plenty of stories where vacancies perpetuate and understaffed teams continue to provide services as best as possible for long periods while someone recruited overseas also continues to wait to be granted entry and join the workforce.
"For a workforce reliant on overseas skills it would be easy to estimate why uninformed immigration policies and an imperceptive stance where right-hand doesn't know the left, or in this case, immigration doesn't know about healthcare, are failing the overall system and the people of the country."
Immigration New Zealand said in a statement expression of interest (EOI) selections for the Parent Category and Skilled Migrant Category were not restarting as part of the five-step border reopening.
"Decisions around reopening the Parent Category and resuming EOI selections are made by the government," said immigration policy manager Ruth Isaac. "No decisions have yet been made."