Photo: 123RF
New Zealand is facing a shortage in neurologists, despite advances in the life-saving treatments available.
A new study from the University of Otago in Wellington shows neurologists will struggle to keep up with the increase in demand for the diagnosis and treatment of conditions such as multiple sclerosis, Alzheimer's disease and stroke.
Professor Anna Ranta from the Faculty of Medicine's Department of Medicine led the study, examining capacity, trends over time and future projections to assist with health sector planning. The findings have been published in the British specialist medical journal, BMJ Neurology Open.
Professor Anna Ranta Photo: Supplied / Luke Pilkinton-Ching
Ranta said while the workforce had increased over the past 10 years, the number of neurologists per head of population in New Zealand ranked well below other high-income countries.
The study, supported by funding from the Australian and New Zealand Association of Neurologists, found there were 83 neurologists working in New Zealand across the public and private sectors in 2024.
But not all of them worked full time - there were actually 67.3 full-time equivalents, including 8.3 full-time equivalent specialist paediatric neurologists.
That was one per 74,000 people. For comparison, the study noted, Australia had one neurologist per 41,000 people.
Ranta said a recent Australian workforce model estimated that to achieve best practice management requirements, one neurologist per 28,000 people would be required.
"If current training, recruitment, retention and practice patterns persist, projections indicate there will be a gradual worsening in the New Zealand neurology workforce over time."
She said the lack of resourcing meant only about one in five patients with chronic neurologic disease were regularly reviewed by a neurologist.
"We should expect about six times as many follow-up appointments as first specialist assessments," she said. "However, Health NZ reports an overall ratio of 1:1 first assessments to follow ups."
And not everyone who would benefit from seeing a neurologist was getting the opportunity to do so.
In May last year, RNZ reported a Palmerston North woman who rushed to the city's hospital after suffering a seizure was surprised to find there was no neurologist on duty - instead, a general doctor took instructions from a specialist in Wellington.
The study noted New Zealand currently only had the capacity to train only four to five new neurologists a year, with neurology specialist training taking three years.
At the same time, the need for neurology services was increasing, as new and sometimes more complex treatments became available.
"Multiple sclerosis treatment options have become more complex, requiring more specialist input, and new Alzheimer's treatments are on the horizon," Ranta said.
"Rarer diseases, such as spinal muscular atrophy, now have treatment options, and there are many more treatments for neurogenetic diseases imminent."
That also included reperfusion therapies for treating a stroke, which could enable doctors to clear blocked arteries and restore the blood flow to the brain quickly.
"There has also been an increase in tertiary hospitals routinely providing telemedicine or telephone expert decision making support to smaller hospitals and in the number of patients transferred for reperfusion therapy."
Despite these advances, there had been minimal additional investment in the neurology workforce.
"New Zealand requires strong funding, recruitment and training initiatives if we want to be ready for the projected increase in neurological burden of disease now and over the next decade."
Te Whatu Ora Health NZ regional chief medical officer Te Waipounamu, neurologist Dr David Gow, said the national health agency was committed to giving New Zealanders timely access to healthcare and strengthening the workforce.
"We know that, as part of this, we need to grow our healthcare workforce, and this is not exclusive to neurology."
Dr Gow said health targets, like shorter wait times, applied to neurology, as for all specialties.
"We value research papers like this one as they can be considered alongside our own workforce planning," he said.
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