New Zealand's peak neurological organisations are warning that the country trains specialist neurologists but loses them to private practice or overseas because there are no funded public hospital positions for them to take up.

The Neurological Alliance, which represents 20 organisations focused on stroke, dementia, Parkinson's and epilepsy, is calling on the government to fund two additional public hospital neurology positions every year and develop a national neurological workforce strategy. The Alliance advocates for an estimated 1.5 million New Zealanders living with neurological conditions and is running a public campaign under the hashtag #Train5Keep5.

Neurological Alliance chair Rich Easton said New Zealand trains five neurologists per year through its vocational training pathway, but workforce planning funds only three to enter the public health system. The remaining two go into private practice or leave for overseas. RNZ

Easton said the country currently has about 68 full- and part-time neurologists. He put the number needed to meet current demand at 100, rising to 120 by 2036.

Those figures sit alongside a University of Otago workforce study that counted 83 neurologists working across the public and private sectors in 2024, providing 67.3 full-time equivalents. That study, a peer-reviewed publication available through the US National Library of Medicine's PMC repository, received funding support from the Australian and New Zealand Association of Neurologists. University of Otago

The gap between the two sets of figures — 68 against 83 — reflects different counting methods and cut-off dates, but both point to a workforce well below the level the sector says is needed.

Dr James Cleland, chair of the Neurological Association, which represents neurologists, said the current workforce was aging and needed rapid expansion. RNZ

The structural problem the Alliance identifies is straightforward: the public system pays to train five neurologists a year, then has no funded roles for two of them. The #Train5Keep5 campaign asks the government to close that gap by funding the two additional public roles annually. The Alliance is also seeking a national workforce strategy to address projected demand growth through to 2036 and beyond.

The broader context is that neurological disease is not a niche or static burden. Recent Global Burden of Disease research showed neurologic diseases have surpassed cancer and cardiovascular disease in disability-adjusted life years — a measure that combines years of life lost with years lived in poor health. That finding reframes the workforce shortfall not as a slow-burn issue for future planning cycles but as a gap already pressing against a rising burden of disease. RNZ

Funding for neurological research has also been flagged as scarce. The Neurological Foundation's 2021 Annual Impact Report noted that research funding is difficult to secure in New Zealand and that maintaining a skilled workforce is an ongoing challenge. That same year, the Foundation allocated $223,385 to Alzheimer's research. Neurological Foundation

For those working in health workforce planning, the figures tell a familiar story. The training pipeline produces graduates at a rate the funded system cannot absorb. The gap between five trained and three funded is not large in absolute terms, but compounded over years it produces the shortfall the sector is now measuring. Easton's projection of 120 neurologists needed by 2036 assumes demand growth that, on the Global Burden of Disease data, may be conservative.

The Alliance's ask is modest in fiscal terms — two additional funded positions per year — but it requires a commitment from Health New Zealand and the Minister of Health to fund positions that do not currently exist. The call for a national neurological workforce strategy would align neurology with the sort of structured workforce planning already applied to other specialist shortages in the public system.