Leading brain health and neurological organisations are warning the country is training specialists, only to lose them due to a lack of funded hospital positions.

But health officials say their attempts to grow the workforce are not "exclusive to neurology".

The Neurological Alliance is calling on the government to fund two additional public hospital neurology positions every year and commit to developing a national neurological workforce strategy to plan for the future.

The Alliance represents 20 New Zealand organisations focused on stroke, dementia, Parkinson's and epilepsy, which advocate collectively for the interests of the estimated 1.5 million people living with neurological conditions.

Neurological Alliance chair Rich Easton told Nine to Noon the shortage of neurologists was already causing significant consequences across the health system, including "exceedingly long and very frustrating" wait times and declined referrals.

"Every year at the moment we train five neurologists to enter into the workforce. The resource planning has availability for three of those trainees to enter as neurologists in the public health system, which means the other two either end up going into private health or in many, many cases going overseas as a loss to New Zealand.

"So really we're calling on the government… to train five and keep five in our public health system and also to make a commitment to building a longer-term workforce strategy that meets our future needs as well."

Workforce aging alongside population

At present New Zealand had about 68 full- and part-time neurologists, when it needed at least 100 to meet current demand and 120 by 2036, with an ageing population, Easton said.

The current workforce was also aging according to Dr James Cleland, chair of the Neurological Association, which represents neurologists.

"We have been wanting to make noise in this space for a number of years, but as neurologists, sometimes we find it hard to engage with the political parties…

"We need to rapidly expand our neurology workforce - partly by immediately recruiting the remaining two neurologists that are not funded, but also increasing the number of neurologists in the country probably by at least 10 - if not 15 - to bring us up to even close to parity with our closest neighbor Australia."

He said recent research had shown "neurologic diseases have actually surpassed cancer and cardiovascular disease" in terms of disability-adjusted life years, which Ministry of Health documents describe as "the loss of one year of life lived in good health" - so not just years lost of life, but of good, healthy life.

"We have tended to focus on health outcomes in terms of death rates perhaps at the expense of looking at the chronic diseases."

Cleland said neurology covered a lot of conditions that do not show up in mortality statistics, such as migraines and epilepsy, that "lead to a lot of disability, but that disability is not being met with provision of neurologic care".

Dementia was also a growing problem.

"One of the critical problems… is that we are actually training these people currently, but we are not actually giving them jobs to come back to. So we are spending the resources to do it, but losing the output… We have an aging population that is expanding, neurologic burden, if you like… And if we're not meeting that rate of expansion, then we will continue to fall behind."

Easton said patients often needed multiple appointments, over time, as specialists tried different treatments and the patient's condition changed. Cleland said any delays could dramatically reduce a patient's chances of living without burden.

"In the case of motor neurone disease… if it takes 12 months to get a diagnosis after the onset of symptoms, that's potentially more than a third of the patient's remaining life, and to be uncertain of the diagnosis in that time and to be able to plan is really a huge lost opportunity."

In some parts of the country there were no neurologists, Easton said, relying on specialists from elsewhere.

"[Patients] have to wait and hope they can get access to one of those visiting clinics or travel to one of the main centres, and in particular for some people and their neuro conditions… they're not always able to travel on their own, so they need a support person with them.

"And travelling into a major city, that can be a whole day which can be really tiring and stressful alongside living with the condition that they have as well".

Hands tied

Cleland said while it was the "best job", he often felt he was "practicing with one hand tied behind my back".

While improving wait-times for first specialist appointments was great, he said if follow-ups were delayed, it made it difficult to provide the level of care needed - which in turn piled pressure back on the person's GP.

"We're all aware that the care is not ideal, but we are really hamstrung in how to fix it because the resources are not there to do it."

In a statement, National Chief Medical Officer Dame Helen Stokes-Lampard said Health New Zealand was "committed to giving New Zealanders timely access to the health care they need".

"We know that as part of this we need to grow our healthcare workforce, and this is not exclusive to neurology."

She said healthcare targets - such as shorter wait times for first specialist assessments - also applied to neurology.

"We are committed to strengthening our healthcare workforce and are working hard to achieve this. Our workforce planning enables us to identify priority services and target efforts into training, recruitment and staff retention in these areas."