What was the Submission?
This submission builds on consultation undertaken with health system leaders in developing a blueprint for health reform towards outcomes-focused, value-based health care, and AHHA’s operating model of continuously listening to and engaging with the experiences and evidence from our members and stakeholders, as we contribute to the evolution of our health system.
This review examined how effective our current health workforce ‘distribution levers’ are. These levers consist of policies and geographic classifications that are intended to distribute health workforce across areas that need them most. The final report was published in September 2024.
The following paragraphs are excerpts from the full submission. To read our complete recommendation, please download the full submission.
Q1. In your view/experience, what are the main issues regarding access to primary care, GPs and/or medical specialists, and their distribution across Australia?
Workforce shortages exist across many health professions particularly in rural and remote regions where there are thin or no markets, presenting a significant challenge for health services increasingly exposed to a diverse range of multifaceted and complex physical, social and ecological threats.
Access to education, employment, transport, housing and social infrastructure in these areas can all impact workforce distribution. In turn, health services access can impact the wellbeing of communities, as they can influence employment, investment and purchasing decisions within the local community. The decisions that are made about the way health care is provided thereby impacts the safety, vibrancy, and stability of those communities.
The complex nature of the system, including the various funding mechanisms and scope of practice restrictions, create issues for the workforce in terms of:
- Understanding and navigating the system.
- Delivering care with limited or inflexible resources.
Collectively, these issues create flow on effects for consumers in the affordability of and access to care.
Given this complexity, appropriately and effectively addressing the health workforce challenge requires coordinated effort across all levels of government, public and private sectors.
Achieving health system reform amidst ongoing workforce shortages, particularly in rural and remote areas, requires innovative ideas and models of care, underpinned by a strong evidence base, shared accountability and responsiveness.
Q4. How do the specific workforce distribution levers being reviewed impact the availability of training opportunities for primary care, GPs and/or medical specialists?
Health practitioners in rural and remote areas lack continuing education and clinical research opportunities. Capacity development in the rural and regional workforce requires a focus on supporting place-based models of care, supportive employment and supervisory structures, and flexible (and funded) education, training and research opportunities.
The levers may ensure a workforce is available, but they do not support workforce retention, partly due to 19AB moratorium loopholes and the absence of wrap around assistance to support health professionals and their families build a life in rural and remote areas. This includes support for the existing workforce who are relied upon to train or supervise new practitioners.
The distribution to high need and challenging clinical environments means that practitioners, often IMGs, require support to transition to these settings. This includes support to address feelings of isolation, including cultural isolation, concerns about safety and wellbeing, as well as the lack of continuing education and clinical research opportunities.
Support for supervisors is required as there can be a significant cost to the provision of training in rural and remote areas, due to the complexity of health funding mechanisms, high administrative burdens, high levels of unpaid care and workforce shortages.
Unfortunately, there are also very limited research opportunities in rural and remote areas, especially part-time or fully funded opportunities, which may disincentivise health professionals from practicing in rural and remote locations, as well as be a barrier to improvements to health services
What did the Review find?
The final report contained a total of 26 recommendations, and proposes retaining the current levers with:
- significant reform to maximise their effect and efficiency and improve access to health care for all Australians, regardless of where they live
- improved classification systems to better identify areas of workforce shortage
- careful and coordinated implementation of future reform
- the development of robust governance and review arrangements, particularly relating to the processing of exemptions to current requirements
- longer-term strategies to improve training pathways and reliance on international workforce.
