Health bonding

Occasionally, old solutions may prove to be the best solutions, and there was more than a touch of "back to the future" about the Government's voluntary bonding scheme for health professionals launched this week.

"Bonding", with financial advantage during training or education traded off against a period of "service" or employment with the sponsoring organisation, has been popular at various times in our young history.

Following an extended period of shortages in critical professions in rural or otherwise hard-to-staff areas, the scheme seems both obvious and elegant in its simplicity.

There will of course be room for argument around the detail, but something had to be done to address workforce deficits and the qualified welcome of the proposal by the health sector at large shows the Government is on the right track.

For many years now, New Zealand graduates in valued professions have sought work and higher salaries overseas, at least in part to pay off their student loans more quickly.

This has led to the untenable situation in which taxpayers have subsidised the high-quality training of these professionals only to find that they must turn around and recruit from overseas to fill essential positions in mostly rural areas.

The Government's new bonding scheme, which offers cash incentives for health professionals, vets and teachers to work in hard-to-staff locations, should help to reverse the trend.

Under it, students can opt to be bonded for five years and in return get loan repayments, or cash if they did not have a loan.

The first payout would not be given until they had been in the scheme three years and the final two years would be paid annually.

It is expected that 100 doctors, 250 midwives and nurses, 1800 teachers and 40 vets will take up the proposal in its first year.

Doctors will get an extra $15,873 a year before tax, midwives $5224 and nurses $4229.

The medical scheme would cost $7 million in the 2011-12 year, which is when the first payouts are expected, and $10 million per annum thereafter.

Teachers will get before tax payments of $3500 a year, and vetinarians $11,000.

The measures have been carefully targeted at specific shortages so as to address immediate problems.

The argument has already been made that the initiative will not solve all critical shortages, and that it ought to be extended into other fields - such as physiotherapy or pharmacy.

While there may be some force in this, we live in increasingly straitened times and it is incumbent on the Government to take a conservative approach.

It has to draw the line somewhere and, for the moment, it has probably got the mix about right.

If the proposal is a roaring success, and proves its economic worth, there might be scope for adjusting its boundaries.

In addition to the economic and self-evident social imperatives of the scheme, there may be less obvious spin-offs: for example, a drawing together of rural and urban New Zealand that an influx of urban professionals might occasion - that is, a different kind of "bonding".

On occasion, there is a perception, exacerbated by the Auckland-dominated electronic media, that life barely exists south of the Bombay Hills whereas, in fact, much of the wealth of the country is still generated from the regions and their rural communities - in the form of the dairy industry, the wine industry and the tourism industry especially.

A period spent reabsorbing some of the country's "heartland values" will do "townie" teachers or doctors or nurses no harm at all in their future careers.

They might even find they enjoy the virtues and qualities of rural or semi-rural life in New Zealand that tourists spend small fortunes to sample.

It is also probable New Zealand recruits, their urban backgrounds notwithstanding, will require less in the way of cultural adjustment to those coming from offshore to fill identical positions.

So, while the bonding initiative is unlikely to solve all the issues relating to skills shortages in rural areas, it is certainly a welcome - indeed healthy - step in the right direction.

 

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