Ignorance about learning centre may be expensive

The space where a new Dunedin hospital, but possibly not a new Interprofessional Education Centre...
The space where a new Dunedin hospital, but possibly not a new Interprofessional Education Centre, will be built. PHOTO: ODT FILES
Delaying building a promised Interprofessional Education Centre means the future for health education in Dunedin looks bleak, David Tordoff writes.

Having read Pete Hodgson’s defence for the "shelving" of the Interprofessional Education Centre I really fear for the future of health professional education in Dunedin.

He suggests that IPE is "progressively becoming adopted globally". Well, yes, but it is taking its time to reach New Zealand: it has been around since the early 2000s.

In the late ’90s I taught interprofessional postgraduate management programmes at the University of York. In 2001 the UK Department of Health made funding available to develop IPE within pre-registration health programmes by 2003. Four sites were initially selected. The early 2000s saw developments in Scotland and the late 2000s in Wales.

In 2006, while working as an education adviser at Dunedin School of Medicine I was fortunate to visit Oxford Brookes and Leeds Universities to view their IPE set-ups. These were mainly done on a shoe-string budget but the facilities were impressive.

These consisted mainly of old nursing school facilities that had been repurposed. The facilities were enabling the development of IPE programmes.

In the early 2000s attempts were made to bring senior Otago medical and pharmacy students together to enhance their prescribing, dispensing and communication skills.

Sadly, the project fell over because it proved impossible at the time to bring the students together due to their differing timetables.

There are many factors to overcome when developing IPE. The history of the different professions, their differing philosophical approaches, funding, timetables, and academic abilities to name but a few. Typically, the students are, if not on a different campus, then in different departments and do not necessarily share facilities, yet an important part of IPE is the development of a social cohesion within the groups. One thing was very clear from the UK experience, dedicated space was essential, this in addition to the usual academic and clinical learning environments.

The new hospital build is indeed a once in a lifetime opportunity to enable the university, hospital, and polytechnic to develop IPE here for the benefit of all the health professions and, ultimately, patients. IPE does not necessarily need a special building but to do it well it needs dedicated space and equipment. It cannot be done in a broom cupboard (believe me, I have held tutorials in a ward broom cupboard). The facilities need to be accessible for the staff and students whose duties will cross academic and clinical environments. So, not necessarily a separate building but certainly dedicated space. The initial (shelved) plan appears to have been on the mark.

Much of the really valuable learning is on-the-spot, informal teaching from clinicians (usually unpaid) in clinical areas. There needs to be space to do this within the hospital in an efficient and convenient manner in addition to IPE facilities. I understand that this too has been cut back.

We can all see why the plan has been shelved. The university and polytechnic are substantially underfunded so they can no longer afford the scheme. Putting the blame on them is disingenuous; the vast majority of their funding comes from Government; they have no control over what they are given. Let us be clear, the Ministers of Finance and Health (and Cabinet) have not been generous or supportive. They have decimated the agreed plans for the hospital and IPE in Dunedin while squandering billions on pet projects, over-paid consultants and wasted time on the hospital planning and replanning. The implication that the university and polytechnic could miss out on joining in if they do not toe the HNZ party line is nothing more than blackmail.

All are agreed that Dunedin, Otago, and Southland need a hospital that is fit for purpose now and for the foreseeable future, up to 2080 according to Mr Hodgson. That being the case we cannot afford a cut-price version that will be barely adequate from day one. The same goes for the IPE facilities. The Government is slowly realising we have a major staff shortage in both medicine and nursing but is unwilling to fund the necessary places and, just as important, the necessary supervision and facilities for clinical practice. How do they expect to attract and retain staff to second-rate facilities? Do they think that construction costs will go down in future? Another way at looking at this is, it will never be cheaper to build, so let’s get on with it.

A former President of Harvard commented, "If you think training is expensive, try ignorance." It appears our current ministers are unfamiliar with the quote.

— David Tordoff is a retired Dunedin School of Medicine education adviser.