The healthcare workforce challenge in Australia & New Zealand

Australia and New Zealand have excellent health systems, and not enough people to run them. This is the primer on why.

None of this is one problem with one fix. Populations are ageing while the clinicians who care for them retire. Training a replacement takes the better part of a decade, graduates don’t always stay, and the ones who do aren’t always where the need is. Meanwhile, every other developed health system is fishing in the same pool. This primer walks through each pressure, with the numbers.

Understanding those pressures is the starting point. Without a clear view of what is driving shortages, it is difficult to build fixes that last. This primer sets out the landscape the rest of the toolkit works within.

Five pressures, acting at once

No single force explains the shortage. Together they define it — and each one is measurable.

The challenge, in numbers

Six figures that show why this is a system-level challenge, not a run of isolated vacancies.

The dependence is deepening, not easing. New Zealand’s own workforce plan estimates the country needs around 13,000 more nurses and 5,000 more doctors within a decade, and in 2022 roughly 6,000 of about 8,000 newly registered nurses came from overseas. A system this reliant on international professionals cannot treat recruitment as an afterthought.

The workforce challenge at a glance

Six pressures, acting together. No single one explains the gap; combined, they define it.

The challenge is not simply finding more people

The response has to be broader than hiring. We need better visibility of the domestic pipeline. We need to understand where graduates go, and why they leave. We need to retain experienced professionals for longer, plan for retirement and succession, and strengthen supervision and training capacity. We need to know where shortages are hurting services and patients most. And where international recruitment is required, we need to become far better at planning, coordinating and supporting it.

The workforce of the future will not be built by one solution. It will be built by understanding the whole ecosystem, and making better decisions about where and how to invest.

Why domestic development alone cannot close the immediate gap

Building a stronger domestic workforce must remain a priority for both countries. Investing in universities, training places, clinical placement capacity and stronger pathways into healthcare is fundamental to long-term sustainability. But there is an unavoidable challenge: the workforce needed tomorrow cannot be created overnight.

Training takes years. Expanding university places today strengthens the workforce of the future; it does little for a service struggling with critical vacancies now. And more places only help if students progress all the way through the pipeline.

A weakness at any point reduces the number of professionals ultimately available to deliver care.

The time-lag problem

Planning operates across very different timescales. A hospital may need a professional today; a domestic initiative may take years to produce one. International recruitment can bridge that gap. It is not a replacement for domestic training. It is a complement that keeps services running while longer-term initiatives take effect.

The OECD has highlighted this across developed systems: countries expanded training capacity in response to shortages, yet international recruitment kept rising. Since 2010, the number of foreign-trained doctors working across the OECD has grown by 62%, and foreign-trained nurses by 71%.

Retention matters as much as recruitment

There is little value in increasing supply if people leave at the other end. A sustainable strategy gives equal weight to every stage of the workforce, not recruitment alone.

The workforce is also moving

Professionals have always moved between countries, but mobility now shapes planning. Australia and New Zealand do not simply receive internationally trained professionals; they also lose domestically trained ones. For New Zealand, proximity to Australia adds a further dynamic: the OECD’s 2026 economic survey notes that New Zealand faces significant competition for medical professionals from Australia and elsewhere, alongside regional disparities in access.

So planning cannot stop at one question.

It must also ask:

International recruitment as a bridge

The decisive idea of this toolkit: these strategies are not sequential. They run at the same time.

International recruitment addresses immediate and medium-term needs. Domestic development builds long-term capacity. Retention protects the investment made in both.

The risk of over-reliance

There is a balance to strike. International recruitment cannot substitute for fixing underlying problems. If turnover is high because of poor culture, heavy workloads or weak career development, recruiting more people from overseas will not solve it. Nor can a country rely indefinitely on professionals trained by others without investing in its own workforce. The OECD notes a growing reliance across developed economies as shortages intensify, and the implications this carries for source countries.

A dual workforce strategy

Australia and New Zealand should aim to become increasingly self-sufficient in developing their workforces. But self-sufficiency is a long-term ambition, not an immediate solution. In the meantime patients still need care, services still need to run, and existing professionals cannot absorb the pressure of persistent vacancies indefinitely.