Republished with Permission
Bryce Edwards
Political Analyst in Residence, Director of the Democracy Project, School of Government, Victoria University of Wellington.
Government officials have raised significant concerns about the University of Waikato’s ambitious proposal to establish New Zealand’s third medical school. The saga therefore continues as a battleground for competing perspectives within healthcare policy, education, and government.
The ongoing Waikato med school developments underscore the political stakes, financial concerns, and conflicting visions for addressing New Zealand’s doctor shortage, especially in underserved rural areas. This saga is as much about political influence, fiscal responsibility, and public accountability as it is about healthcare.
Government pushes ahead, despite criticisms
The proposal’s recent progression to a detailed business case, championed by Health Minister Shane Reti, reflects the National Party’s commitment to its election promise. During the 2023 campaign, National vowed to support a new $380m medical school in Waikato to increase the number of doctors, especially rural general practitioners. This promise came after Reti concluded negotiations with the Waikato’s Vice Chancellor Neil Quigley, who emailed saying: “The first student intake would be 2027 – a present to you to start your second term in government!”
In late September this year, Reti announced that an initial cost-benefit analysis had been carried out and the results gave the government “confidence” to push the project to the next stage, affirming that the school was essential for tackling New Zealand’s healthcare challenges. Reti emphasised that New Zealand’s rural and primary care networks face a critical shortage of practitioners, especially with many GPs approaching retirement over the next decade.
Newly released information
Behind the scenes, however, officials have warned the government about the problems of the Waikato project – especially in terms of financial viability. The Otago Daily Times’ Matthew Littlewood reports:
“The government was advised a full two months before progressing a plan for a third medical school to the next stage that there were serious concerns whether the University of Waikato could afford to do it. The Tertiary Education Commission and the Ministry of Education advised Tertiary Education Minister Penny Simmonds on August 2 this year they had little confidence in a cost-benefit analysis of the project that relied on untested assumptions, had ‘significant gaps’ in financial data and did not fully consider alternative options.”
Also reporting on the Tertiary Education Commission (TEC) memo, Richard Harman says: “A third financial risk has been redacted from the paper supplied” under the Official Information Act. Harman also reports from the memo that “the TEC might have to reduce funding to other university courses or even reduce the number of students at the Auckland and Otago Medical Schools.”
A second TEC briefing to the Tertiary Education Minister also expressed concern that Waikato wouldn’t be able to contribute its $100m share of the medical school’s establishment costs, as the university is struggling to maintain its existing buildings. The university is attempting to raise money from philanthropic funding, but TEC officials raised concerns about whether Waikato could secure these funds in time without resorting to large-scale borrowing, which would not be an option under the university’s current financial standing.
Despite these reservations, the project advanced, raising questions about whether the decision was motivated by political considerations rather than fiscal prudence or an impartial analysis of healthcare needs. The government has committed to moving forward with a detailed business case, led by the Ministry of Health, in collaboration with the University of Waikato.
Otago and Auckland’s strong opposition
The strongest opposition to the Waikato proposal comes from New Zealand’s two established medical schools – Auckland and Otago – which argue that Waikato’s plan is both inefficient and costly. These universities, backed by a recent PwC report they commissioned, contend that they could quickly increase their doctor training capacity without the need for a new school.
According to their PwC report, Auckland and Otago could scale up to produce an additional 300 doctors annually by 2027, using existing facilities and resources. This approach would not only be faster but also significantly cheaper, requiring minimal government funding compared to the projected $380 million for Waikato’s school.
Professor Tim Wilkinson, acting dean of Otago Medical School, has been vocal in criticising the government’s prioritisation of the Waikato project. He argues that the government could achieve the same outcome more efficiently by expanding the intake caps for Auckland and Otago, which already have regional training programs in place. Wilkinson warned that the proposed Waikato school would divert critical resources from existing institutions, create competition for clinical placements, and further strain the healthcare system.
Critics might, of course, suggest that Otago and Auckland are simply motivated by protecting their patch.
The Steven Joyce lobbying controversy
The university’s decision to hire former National Finance Minister Steven Joyce as a consultant has added a layer of political intrigue to the project. Joyce’s lobbying firm, engaged without a competitive procurement process, was paid over one million dollars by the university to help on this and other projects. This arrangement drew the attention of the Auditor-General, who criticised Waikato for a lack of transparency and accountability in its hiring practices.
The Joyce-lobbying fiasco will have damaged the public’s confidence in the project. But hiring Joyce might also have been a major mistake in terms of winning over National’s coalition partner NZ First, who are reportedly unconvinced by the Waikato med school proposal. Therefore, Richard Harman has recently written that hiring Joyce “may not have been such a smart move. There is a long-standing antagonism between NZ First Leader Winston Peters and Joyce.”
Coalition tensions and ACT’s demand for accountability
The political implications extend beyond Waikato and have triggered tensions within the National-led coalition. The ACT party, National’s coalition partner, has expressed strong reservations about the financial prudence of the Waikato school, urging a rigorous cost-benefit analysis before any binding commitments are made. Act leader David Seymour emphasised that his party’s support is contingent on proving the proposal’s economic viability and its potential to deliver healthcare outcomes better than the existing medical school expansions.
ACT’s insistence on a detailed analysis reflects its commitment to fiscal conservatism and responsible public spending. The coalition’s agreement requires this analysis, introducing a potential delay to the project and raising the stakes within the government if National appears overly keen to expedite the proposal.
Regional benefits vs broader healthcare needs
Supporters of the Waikato proposal, including Hamilton Mayor Paula Southgate, see the medical school as a major step toward regional empowerment and an economic boost for the Waikato area. Southgate has championed the project as a chance to attract investment and create jobs, emphasising the economic benefits that a major educational institution can bring to the region.
Neil Quigley has also argued that the graduate-entry program would help diversify the medical workforce, attracting candidates who are more likely to commit to rural healthcare, a key aim of the proposal.
However, critics, including some newspapers and public health experts, question the wisdom of prioritising regional economic growth over immediate healthcare needs. A pointed editorial in the Otago Daily Times calls the Waikato proposal a “folly”, arguing that the project diverts funds from pressing healthcare demands.
The editorial underscored the timing of the government’s announcement, which coincided with large public protests in Dunedin and Westport over healthcare cuts. For these critics, the decision to fund Waikato’s medical school instead of expanding Auckland and Otago’s capacity signals misplaced priorities. The editorial asserts: “When the government wants to put every taxpayer dollar spent under intense scrutiny, so it is not funding dumb stuff, it is hard to understand why the third medical school proposal is not a dead duck.”
Here’s the newspaper’s conclusion: “We would be encouraged if the government shelved this flimsy pork barrel folly as soon as possible, citing the cost. Giving it the green light will merely provide ammunition for the many voters next election who may have a grievance about health spending cuts.”
The path forward and key questions
As the proposal progresses to a full business case, Waikato’s supporters and opponents are locked in a battle of influence and credibility. On one hand, the government’s push for a Waikato-based medical school aligns with its long-term vision to address New Zealand’s healthcare needs, particularly in underserved rural communities. On the other hand, the financial risks, coupled with political controversies surrounding Joyce’s lobbying, cast a shadow over the proposal’s perceived integrity.
Key questions remain unanswered. Can the Waikato medical school, if approved, realistically deliver the promised outcomes of rural and primary care doctors faster and more effectively than expanding current programs? Will the coalition government remain unified in its support of the project as the business case unfolds, or will Act’s demands for accountability slow its progress?
The Waikato medical school proposal has become a focal point for debates about New Zealand’s healthcare infrastructure, government spending, and the influence of political lobbying. In the coming months, the detailed business case will likely determine whether Waikato’s medical school moves forward or if the government, faced with mounting financial and political pressures, reconsiders its path.
But given the latest revelations, it seems appropriate that intense scrutiny and scepticism should be applied to what increasingly looks like a politician’s ‘pet project’ that delivers to vested interests rather than a robust expansion of health education for the public good.
Dr Bryce Edwards (with AI assistance)
Key Sources
Nicole Bremner (1News): Proposed Waikato medical school’s impact on doctor shortage queried
Bryce Edwards (Democracy Project): Political Roundup: Lobbying for Waikato’s Medical School causing problems for the Govt
Bryce Edwards (Democracy Project): Political Roundup: What’s behind the Med Student cuts?
Richard Harman: Putting pressure on the Government (paywalled)
Ruth Hill (RNZ): Hundreds more doctors could be trained if government funded them – report
John Lewis (ODT): Proposal to train extra doctors (paywalled)
Matthew Littlewood (ODT): Govt told of concerns over third med school plan (paywalled)
Matthew Littlewood (ODT): Proposal for third medical school at University of Waikato ‘does not stack up’
Matthew Littlewood (ODT): Third medical school passes first hurdle
Ke-Xin Li (the Post): Waikato medical school passes its first government test (paywalled)
Otago Daily Times: Editorial – Waikato medical school folly (paywalled)
Otago Daily Times: Editorial – More doubt about third medical school (paywalled)
This article was originally published on the author’s Substack.
