A New Approach to Australia's health workforce

In this new paper Jill Iliffe argues that any serious attempt to improve Australia's health policy must address the capacity, efficiency and flexibility of our health workforce.

Download the paper, 'A New Approach to Australia's Heatlh Workforce' (pdf)

The health workforce comprises around 5% of the total workforce in Australia, and absorbs around two thirds of Australia's total health spending. Health spending itself is about 9.7% of GDP.

Australia employs similar ratios of health professionals to the OECD average; however the rate of employment growth in the health system, concentrated among allied health and complementary health professionals, is now twice our rate of population growth.

Health workers are highly diverse, ranging from entry level workers educated at a Certificate II or III level, to highly qualified professionals with Bachelor, Masters or PhD qualifications. It is this specialisation that makes evidence based workforce policy and management essential.

Why do we need to reform health workforce policy?

• The ageing demographics of both health care consumers and the health workforce;
• The need to shift the focus of health service delivery towards prevention, early intervention and self-management;
• The need to evolve existing workforce roles to match these new modes of health servicing;
• Inherently conflicting service, educational and funding interests between the commonwealth, state and territory governments;
• An uncoordinated health education regime, whereby system demand and supply are poorly measured and matched;
• Fragmented clinical training - no central funding, measurement or profiling of the clinical training resources and outcomes within the system;
• The need to practicably integrate relevant innovation and technology into clinical and administrative practice;
• The need for work/family balance among health workers in a long-lived, double-income society;
• Poor distribution and utilisation of the health workforce relative to requirements;
• Workforce shortages and erosion, as a consequence of the unsustainable structures within this changing health environment; and
• Australia's resulting reliance on permanent or temporary migration of health workers;

'A New Approach to Australia's Heatlh Workforce' recommends:

That the National Health Workforce Strategic Framework be properly executed by all Australian governments, to:

• collaboratively involve all health stakeholders in policy development;
• produce evidence-based health workforce policy and planning, linked to the broader health system;
• ensure and sustain supply;
• distribute workforce to optimise health care access and meet the needs of all Australians;
• use skills and knowledge to the optimum, and foster workforce adaptability;
• ensure that the health workforce is always skilled and competent; and
• produce health environments where people want to work.

A change in policy is essential for Australia's health care system to be sustainable, and the following should proceed immediately:

• introduce an independent health reform commission to examine the best model of health funding, and the best ways to utilise the Australian health workforce;
• establish and strengthen community health centres across the nation, staffed by primary health care teams that include existing general medical practitioners; and
• conduct comprehensive national workforce planning, linking education places to workplace needs.