New Zealand appears set to get a third medical school, after the coalition government¡¯s cabinet approved the business case for a graduate-entry programme at the University of Waikato.

The government¡¯s promised contribution of NZ$83 million (?37 million) is far less than the NZ$280 pledged before the 2023 election, and the school¡¯s start date has been pushed back 12 months to 2028, amid questions over the project¡¯s rationale.

Health minister Simeon Brown said the ¡°innovative¡± programme would increase doctor training places by 120 a year on top of 100 additional places in the existing schools at the universities of Auckland and Otago. He said Waikato could now start planning for clinical placements and begin constructing new teaching facilities.

Universities minister Shane Reti hailed a ¡°major milestone¡± for the university and a ¡°real boost¡± for tertiary education in the Waikato region, south of Auckland. ¡°This is exactly the kind of forward-thinking initiative this government wants to see from our universities ¨C investing in regional growth, building local capability and delivering on the needs of rural communities.¡±

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Waikato said an it had commissioned had found that New Zealand was ¡°very unusual¡± in having only two medical schools for a country of its size, and that a four-year graduate entry programme ¨C as opposed to the five-year undergraduate model at Auckland and Otago, where applicants must also complete at least a year of health science studies prior to entry ¨C could cut costs enough to bankroll an extra 40 places a year.

Vice-chancellor Neil Quigley the country had retained only five-year medical programmes when postgraduate options could significantly reduce costs. ¡°The explanation may relate to the power that accrues¡­when there are only two providers and they cooperate to manage the market and the political processes associated with it,¡± he said.

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¡°We will be offering a programme that selects and trains doctors in a fundamentally different way. It will be designed to produce more graduates who choose to become GPs and who want to work in regional and rural communities.¡±

The three universities have been at loggerheads for years over the proposal. Sceptics consider it a vanity project that is difficult to justify, given that Waikato¡¯s main campus is only about 130 kilometres from Auckland in a country over 2,000 kilometres long. They say the university has compromised its independence by cosying up to the governing National Party and helping to write its pre-election policy platform.

The concluded that the Waikato school was the best value of three options, which also included increasing the medical school intakes at Auckland and Otago or funding the two institutions to jointly run a specialised rural medical training programme. Waikato boasted the lowest ¡°monetised lifetime costs¡± and a ¡°benefit-cost ratio¡± of NZ$1.99 for every dollar invested, compared?with NZ$1.50 and NZ$1.80 from the other two proposals.

Auckland health dean Warwick Bagg welcomed the announcement of the third school as a ¡°positive signal¡± for medical education in the country, even though his university had been ¡°open¡± to training more doctors.

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But Bagg told that the analysis had not factored in the cost of educating undergraduates to make them eligible for the graduate-entry programme. ¡°They¡¯ve used the most optimistic possible outcome that could be found to make the case for the new programme.¡±

The Waikato-commissioned analysis found that around 30 per cent of medical students at Auckland and Otago already had degrees, and that some 300 extra places sought by the two incumbents would make their medical schools bigger than any in Australia, the UK or US.

Advocacy thinktank The Integrity Unit the approval of Waikato¡¯s proposal as ¡°a textbook case study of policy capture¡±. Director Bryce Edwards, a former political science academic, said ¡°the interests of a well-connected institution, amplified by high-powered lobbyists¡±, had overridden ¡°expert advice, fiscal prudence and superior alternatives¡±.

Francisco Hernandez, Green Party spokesman for tertiary education, the alternative proposals ¡°would have seen twice as many doctors trained each year¡­without the nearly quarter of a billion dollars in establishment costs¡±.

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Hernandez asked whether Waikato could afford the project, given that the Tertiary Education Commission had last year questioned the university¡¯s capacity to contribute NZ$100 million ¨C a price tag that now exceeds NZ$150 million.

Brown said the project had ¡°passed the cost-benefit analysis¡± and would introduce an Australian-style postgraduate model into Kiwi medical training. ¡°People who¡¯ve had other careers can study medicine and enter the workforce,¡± he told parliament. ¡°It¡¯s an exciting proposal and I encourage members on the other side of the house to¡­share the excitement.¡±

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john.ross@timeshighereducation.com