A consultant radiologist says recruiting and retaining staff in areas of critical shortages is hard while there is inertia on migration policy.
New figures show the numbers of doctors and nurses waiting to apply for residence has balloooned to almost 3000.
Figures released under the Official Information Act show the numbers of doctors who have submitted an expression of interest (EOI) for skilled migrant residence (SMC) has tripled to 675 since May and nurses have more than doubled to 2231.
The Association of Salaried Medical Specialists this week described the process as shambolic,
A consultant radiologist in Hawke's Bay, Phillip Clarke, is worried for the new doctors arriving, including four overseas consultants in his hospital department.
"We've got a new radiologist from Britain, and a radiologist from the States. We've got a radiologist from Germany, who's been with us about a year and we've got a nuclear medicine physician from South Africa. All of these people are on the essential list, and none of them have got residency. None of them have got any idea of when they're going to get residency.
"You're talking about people who are in the mid 30s at the youngest. They've got partners, they've got families, they've got a life. You really are trying to build the rest of your life on no surety whatsoever, and it's very very unsettling.
"Although you can put an expression of interest in moving to New Zealand, even if you are somebody who is from a long term shortage specialty, which consultant radiologists have been to the last 20 years, your application goes on a pile and nobody's actually doing anything about these, nobody has taken anything off that pile since Covid started 18 months ago. So everything is on hold."
In the meantime, he said costly work-arounds - sending radiology scans overseas to cover for the workforce shortages here - would only get worse if they lose staff.
"They outsource the radiology reporting overseas online, which is costing hundreds of thousands of dollars every month," he said. "It would be cheaper to employ radiologists who come and work here, and we've got them, but if we don't do something they're going to go back home again. It's absolute madness.
"After a while you start pulling your hair out, thinking why do they not just look at these urgent cases which we need to keep our population well and we need these guys, these guys are good guys, let's give them residency."
Clarke arrived in 2007 from Britain so got his residence and citizenship before the current problems - but said he is speaking out because of the consequences of govenment inaction. He wrote to the Immigration Minister Kris Faafoi in April.
"I did hear back and he was very nice but didn't actually say anything. He didn't say, we are going to start looking at these in July, we are working on a solution to get round how we're going to do this sometime perhaps.
"We need to say, 'right we're going to start looking at these next month and we're going to make a decision on them before Christmas'. And then that's fine - we appreciate that they've got a lot of work on but just to say, 'well, we're still thinking about it, we've not made our mind up after 18 months how are we're going to deal with it'. If you came to me and I said we could do with doing a scan, I'll just let you know in 18 months what its going to be and then we'll start thinking about whether we'll do it or not - you'd think I need firing."
There was a big problem looming for recruiting and retention, he added, as uncompetitive pay combined with immigration difficulties.
"We've got a big neighbour next to us called Australia, and apparently - and I believe this to be true - the top salary bands that a radiologist in New Zealand is paid by the public health service is slightly less than the starting salary for radiologists in Australia. It will be a factor with getting people to come to work in New Zealand, and the same I think applies for all medical specialists, and nurses with qualifications and experience."
Medical staff are not the only occupations affected by the freezing of the SMC residence channel - there are now 11,660 skilled migrant EOIs, covering 25884 applicants and their families waiting to be selected. Up to 6000 of those are in registered occupations, such as vets, engineeers and dentists, and that also includes 1500 teachers.
Faafoi said medical staff should be eligible for temporary visas while they wait for residence.
The government acknowledged the disruption that suspension of expressions of interest selections for the skilled migrant category had on applicants.
"We are working through advice on when and how to re-open EOI selections, and will have decisions to announce soon," he said.
Speculation continued this week about whether the restarted process would have the same criteria, after INZ accidentally posted a new points system on its website.