Many people with chronic, complex or difficult-to-treat migraine could benefit from being seen by a neurologist. Although GPs can manage many people with migraine, when they’ve gone through the recommended list of treatments and things are still not right, it’s reassuring to have a specialist who can confirm that migraine is the cause, consider alternative diagnoses and offer advice about the other management options.
But getting to see a neurologist in Aotearoa New Zealand, whether in private or public, can be a challenge. From our survey of people with migraine in 2022, around half said they’d been unable to see a health professional for migraine and for more than half of those, the health professional they’d wanted to see was a neurologist. The top reasons for this were expense (for private appointments), unable to get or declined an appointment (referrals to public neurology departments are often declined; GPs may even refuse to make a referral) and long waiting times (for public and private).
One reason for this has been revealed in a new analysis of the neurology workforce. This looked at the numbers of neurologists working in both public and private in 2024, finding only 83. Not all were working full time so this translated into 67.3 full-time equivalents, including 8.3 paediatric neurologists. So only 59 working in adult neurology.
Patch that onto our population and we have one neurologist per 71,500 adults (including those neurologists working in private and public) or one per 74,600 adults if only including neurologists in public hospitals. Compare that to Australia, who has one neurologist per 41,000. Compare that to what is recommended to achieve best practice, which is one neurologist per 28,000. And consider that this calculation is based on number of neurologists, not number of full-time equivalents. If we look at the number of full-time equivalent adult neurologists serving the adult NZ population, we get one neurologist per 88,500 adults (or 1 per 99,200 for public hospital neurologists only).
It’s predicted that the situation in Aotearoa will get worse, due to an ageing population, more advanced treatments now available for neurological conditions and insufficient numbers of neurology trainees, training and specialist positions.
From the survey of neurologists this analysis is based on, 47 provided information about their primary subspecialty interest. Only one of these mentioned headache. So despite migraine being the most common and one of the most disabling neurological conditions, it’s not a popular area of interest for neurologists.
This is a health workforce issue that needs to be addressed, not only for people with migraine but for the one in three New Zealanders who will be affected by a neurological condition at some point in their lives. In an election year, this is a question we can all ask of the politicians seeking our vote – what are you doing to increase the neurological workforce so that the thousands of people with neurological conditions can access the specialist support that they need?
Read the source:
Ranta A, Mottershead J, Buchanan SM, Chan C, Child N, Jolliffe E, et al. Aotearoa New Zealand’s neurologist workforce: a 2024 analysis of demand, supply and projections. BMJ Neurology Open. 2026;8:e001397. https://doi.org/10.1136/bmjno-2025-001397
