Australia’s health workforce comprises a range of professionals working across diverse settings. Information on roles and demographic characteristics of the Australian health workforce should assist in better understanding the effectiveness of current workforce policies. Understanding the existing workforce and anticipated trends should aid in the development of policy reform.
It is of course always important to remember that workforce development is not a goal in itself, the ultimate goal is to provide appropriate access and service for the Australian population, and to produce improved health outcomes across the country.
This chapter provides an overview of the Australian health workforce, including current numbers, distribution and education and training requirements.
For the purpose of this review, the term ‘health workforce’ generally refers to medical practitioners (general and specialist), nurses (registered and enrolled) and midwives, dental (dentists and other oral health professionals) and certain allied health practitioners. These allied health workforces include, but are not limited to, those subject to the National Registration and Accreditation Scheme (NRAS) – chiropractors, optometrists, osteopaths, pharmacists, physiotherapists, podiatrists, psychologists, Aboriginal and Torres Strait Islander health practitioners, Chinese Medicine practitioners, medical radiation practitioners and occupational therapists. Other groups, such as audiologists, dietitians, exercise physiologists, genetic counsellors, paramedics, speech pathologists, social workers, prosthetists and orthotists, are also usually included as part of the health workforce.
Concerns about the capacity of Australia’s health workforce to meet community needs was identified in the first Intergenerational Report4 released as part of the 2002-03 Budget, which highlighted the future expected increase in government spending. The report focused on the implications of demographic change for economic growth and an assessment of the financial implications of continuing current policies and trends over the following four decades.
The report found that Commonwealth spending on health was projected to increase to 4.3% of Gross Domestic Product (GDP) by 2011-12 and to 8.1% of GDP by 2041-42. Projections showed spending on Medicare Benefits Scheme (MBS) subsidies as a proportion of GDP was expected to grow by 60%, with hospital and health services expenditure growing by 40%.
In 2005, the Productivity Commission was requested to undertake a research study on health workforce issues, including supply and demand pressures over the next ten years. This study arose from a decision by the Council of Australian Governments (COAG) in June 2004.
The report was also to cover the efficacy of health workforce planning and its linkages to health services planning and the education sector, as well as workforce-related policy measures that would help to ensure efficient and effective delivery of quality health services.
The research report5 was released on 19 January 2006 and included several recommendations to COAG. The Productivity Commission found that:
- Australia was experiencing workforce shortages across a number of health professions despite a significant and growing reliance on overseas trained health workers. The shortages, which in many cases were a question of uneven distribution rather than absolute numbers, were most acute in rural and remote areas and in certain special needs sectors.
- With developing technology, growing community expectations and population ageing, the demand for health workforce services would increase while the labour market was likely to tighten. New models of care were also required.
- There was a need to train more health workers and there would also be benefits in improving the retention and re-entry to the workforce of qualified health workers.
- The report also found that it was critical to increase the efficiency and effectiveness of the available health workforce, and improve its distribution.
In November 2010 (the newly created) Health Workforce Australia (HWA) was requested by the Australian Health Ministers’ Conference to undertake a workforce planning exercise for doctors, nurses and midwives over a planning horizon to 2025. This study resulted in the release of Health Workforce 2025,a three volume report, which aimed to model future health workforce supply and demand across a number of possible policy scenarios. Health Workforce 2025 will be discussed in further detail later in this chapter.
4 Australian Government, Intergenerational Report 2002-03 http://archive.treasury.gov.au/contentitem.asp?ContentID=378&NavID=, viewed 30 August 2012.
5 Productivity Commission, Australia’s Health Workforce,2006, accessed at http://www.pc.gov.au/projects/study/health-workforce/docs/finalreport