Medical School vital to hospital rebuild

The place of the Dunedin Medical School in the planning of the rebuilding of Dunedin Hospital is vital, writes Prof David Jones.

It is essential the planning for the rebuilding of the Dunedin Hospital takes into account the importance the University of Otago and the Dunedin Medical School. The future of these key institutions are inextricably linked and are vital to the future prosperity of our city.

The currently held attitude of those involved in the planning process appears to be that the teaching of medicine and the Medical School in Dunedin are little more than an impediment that constitutes a drain on the health budget. This has to be of grave concern and cannot be allowed to prevail.

The University of Otago constitutes by far the biggest and most important business activity in our city. The future of Dunedin depends heavily on its continued international standing, success and viability.

It has annual revenue of more than $656million and brings in more than $130million in external research funding. Its total assets amount to more than $1.74billion and the estimated national annual economic impact of Otago University has been calculated to be $1.6billion.

Otago University is ranked 169th in the world and is in the top 50 in five subject areas and in the top 100 in 12. The Faculty of Medicine is ranked as 66th in the world. It has 383 formal research and teaching collaborations and more than 100 student exchange agreements.

There are more than 20,000 students, most of whom come from outside Dunedin. These include about 2600 international students from 100 countries. The university employs more than 3800 staff. Of these 95% are regularly involved in community service activities with a value estimated at $30million and 27% of academic staff serve on government advisory boards and committees.

The university is also New Zealand's leading postgraduate research university with more than 4500 postgraduate students including 1380 PhD students.

Central to the standing, success and viability of the university is its Division of Health Sciences. This is by far the largest, with a budget slightly larger than Commerce, Humanities and Science combined. The Health Science first-year course in Dunedin serves as the entry point for dentistry, medical laboratory science, medicine, pharmacy and physiotherapy and also counts as the first year of study for 13 different majors leading to BSc and BBiomedSc degrees.

The role of the Division is to provide New Zealand society and other communities with a highly qualified workforce in the health professions through its research-based undergraduate, postgraduate, and professional programmes.

At the heart of the Division is the Otago Medical School, four entities across three campuses. These include the Dunedin School of Medicine, the School of Biomedical Sciences, the University of Otago, Christchurch, and the University of Otago, Wellington. All medical students undertake their first three years of study in Dunedin, before choosing Wellington, Christchurch or Dunedin for their clinical training.

At any one time, the Dunedin School hosts about 900 medical and postgraduate students and about 500 staff.

The continued standing, success and viability of the Dunedin School of Medicine is vital to the long-term future of the Division of Health Sciences, Otago University and the city of Dunedin. Fundamental to this is a close working relationship and strong linkages between the Medical School and the Dunedin Hospital to ensure the retention of specialist medical service and staff in Dunedin.

The importance of the ability to continue to provide world-class, research-based, undergraduate and, postgraduate programmes in medicine and the other health sciences in Dunedin cannot be overstated. A major strength of the university lies in its professional health science academic programmes and its strengths in basic, applied and clinical research.

Otago University would rapidly lose national and international status and pre-eminence if these key areas are not adequately fostered, resourced and funded.

It is essential that, in its planning, the Southern Partnership Group puts the needs of the patient first. However, any perceived dichotomy between the aim of providing high quality health care delivery and the need to maintain a world-ranked Medical School is unjustified.

Surely, future regional medical care provided by the SDHB will be much better if it has access to a high-class teaching hospital, staffed by clinical specialists of the first rank. Downgrading Dunedin Hospital and disrupting its relationship with the Medical School would certainly have the opposite effect.

We are told that the planning and rebuild could take up to 10 years. In the meantime the inadequate and dated facilities and the lack of modern medical technology will exacerbate the likely loss of accreditation for the specialist clinical programmes and make the difficulty of attracting and retaining experienced high-quality clinical and research-focused staff more and more problematic.

The citizens of Dunedin need to be aware of the importance of these issues and cannot afford to remain apathetic or uninterested. It is vital the scope of planning process encompasses the concept of providing a modern teaching hospital, situated as close as possible to the existing hospital buildings and the Medical School, and close to Otago University.

It is, therefore, essential Otago University be represented on the planning committee and is fully involved in the planning process. This is an election year. It is important that our city becomes more actively involved in the planning of our hospital.

-Emeritus Prof David Jones is a former Dean of the Otago School of Medical Sciences.

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