Health of the Health Workforce

Non-regulated workers (kaiāwhina)

The wide and varied non-regulated workforce is so named because the professions it comprises are not regulated under the HPCA Act. (It should be noted that this does not imply a lack of professional standards.) The term covers professions ranging from corporate and administrative positions to carers and support workers. In this report, non-regulated allied health, science and technical professions are discussed in the Allied health workers section.
Opportunities in the non-regulated workforce are expected to rise as the population grows and ages and as care moves closer to home. Models of care increasingly focus on carers and support workers, to make more efficient use of the clinical workforce. Under such models, for example, health care assistants might undertake tasks and activities that free up doctors and nurses to concentrate on treating patients.
Workforce data is scarce, in part because no registration requirements apply and also because of the range of employers in the private and public health sectors. District health boards employ non- regulated workers, but so too do private companies and non-governmental organisations.
However, new research for Careerforce, the organisation responsible for the education and training of carers and community support workers, has cast light on the make-up of the non-regulated workforce.²⁵ Careerforce and HWNZ term these workers kaiāwhina (a list of the health and disability roles covered by this term can be found in Appendix 5).

Examples of kaiāwhina roles:
Disability support workers	Personal care assistants	Aged carers
Mental health workers	Nutritionists	Audiologists
Youth workers	Rehabilitation assistants	Whānau Ora workers

Careerforce’s analysis of 2013 Census data identified 62,910 kaiāwhina – an increase of 13.5 percent, or 7520 people, since the 2006 Census. This figure represents 3.3 percent of the total New Zealand workforce.

The demographic profile of kaiāwhina is older and female-dominated, with greater ethnic diversity and lower income and qualifications on average than the total New Zealand workforce (shown in brackets):

61 percent of kaiāwhina were aged 45 or older (47%)

84 percent were female (48%), but there was growth in male employment between 2006 and 2013

15 percent were Māori, 8 percent were Pacific peoples and 13 percent were Asian (11%, 5% and 11% respectively)²⁶

31 percent were born overseas (28%), particularly carers and support workers

56 percent earnt $30,000 or less a year (32%)

37 percent worked less than 30 hours a week (22%).
Carers account for two-thirds of kaiāwhina, particularly personal care assistants (47%) and aged or disabled carers (9%). Numbers of both have risen significantly since 2006.
The remainder of kaiāwhina is split between support workers (eg, community workers and family support officers) and occupations such as welfare workers and traditional Māori health practitioners. About 4 percent are in technical occupations and can also be considered part of the allied health workforce.
About one-third of kaiāwhina workers are employed by residential care providers, the largest employer group.
Carers and support workers are thought to make up the majority of the Pacific health and disability workforce.²⁷ More than 4200 Pacific peoples work in these roles, compared with almost 1300 Pacific nurses,²⁸ the next largest occupational group of Pacific health workers by a considerable margin.
A similar trend applies to the Māori workforce. There are almost 7500 Māori care and support workers, compared with about 3400 nurses, 410 doctors and 140 midwives.
HWNZ is developing a kaiāwhina taskforce and work programme with Careerforce, using the same approach that has been applied to other workforce groups. See our companion report, The Role of Health Workforce New Zealand, for more information.

Future prospects for joining the workforce

Health Workforce New Zealand’s main aim is to ensure the long-term sustainability of the health and disability workforce.
The projections in this section assess job prospects for particular areas within the workforce in the next five years, to provide information to those interested in joining the workforce, or those currently working in the health sector and thinking about future opportunities. The intention is to indicate overall trends rather than provide exact forecasts.
These projections are based on data and workforce intelligence from a range of sources. Note that workforce trends are affected by a complex range of events, some of which are very difficult to predict. Sometimes job prospects can change within a short period of time.
For information on training requirements and pay rates for a number of health careers, see the Occupation Outlook 2014 report or app on the Ministry of Business, Innovation and Employment’s website.

Medical workforce

Prospects are particularly good for GPs, especially in rural areas, and for other specialties, including: dermatology general surgery internal medicine paediatric surgery palliative care pathology psychiatry rural hospital medicine.

Prospects may be limited for specialties including: urgent care emergency medicine paediatrics. The specialties with poorer job prospects are those that currently have high ratios of postgraduate trainee doctors to senior staff. If this trend continues within a given specialty, there will be greater competition for future senior vacancies. See Appendix 2 for a graph showing ratios of trainees to senior doctors for all specialties, including GPs.