1 / 22

AUSTRALIAN MEDICAL WORKFORCE Reforms and challenges Robert Wells,October 2004

AUSTRALIAN MEDICAL WORKFORCE Reforms and challenges Robert Wells,October 2004. WORKFORCE REFORM THEMES. Needs of the health system & patients Workforce planning: supply; distribution; composition Training from undergraduate to fully qualified specialist

lundy
Download Presentation

AUSTRALIAN MEDICAL WORKFORCE Reforms and challenges Robert Wells,October 2004

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. AUSTRALIAN MEDICAL WORKFORCE Reforms and challenges Robert Wells,October 2004

  2. WORKFORCE REFORM THEMES • Needs of the health system & patients • Workforce planning: supply; distribution; composition • Training from undergraduate to fully qualified specialist • Skills maintenance: ‘licence’ to practise • Assessment of International Medical Graduates

  3. A DECADE OF REFORM (1) • Early 1990s: GP reforms, eg ‘VR’; GPET • 1995: AMWAC created • 1996: new arrangements for access to provider numbers

  4. A DECADE OF REFORM (2) • 1996: Medical Training Review Panel • 1997: pre vocational medical councils nationally • 1997: specialist training selection reforms

  5. A DECADE OF REFORM (3) • 1997: reforms to assessment of IMG doctors • 1999: rural education- UDRHs & RCSs • 2000: AMC accreditation of specialist training programs

  6. A DECADE OF REFORM (4) • 2000: Rural Bonded Medical School Places • 2001: Outer Metropolitan medical workforce scheme • 2000-02: specialist training outside hospitals pilots

  7. A DECADE OF REFORM (5) • 2000: new medical schools JCU, ANU etc etc… • 2003: ‘Fairer/Plus/Enhanced Medicare’-more medical school places; more IMG doctors; PGY 2/3 doctors rotation scheme • 2004: national medical registration

  8. A DECADE OF REFORM (6) • Workforce planning for nurses & other health professions: AHWAC • Link workforce planning & policy: AHWOC • Nursing reviews • Nurse practitioners

  9. A DECADE OF REFORM (7) • momentum from ‘AHCAs/ health reform’ processes • Practice nurses in primary care • MBS nurse item • Access to other health professions under Medicare • Safety and quality issues,eg credentialing

  10. SYSTEM ISSUES: LACK OF DIRECTION • No national health plan • 8 separate health delivery systems • No agreed national objectives & performance indicators • Separate funding streams within jurisdictional programs at both state & commonwealth levels

  11. SYSTEM ISSUES: WORKFORCE • Shortages and maldistribution • Declining hours of work & workforce participation by doctors • Some specialties (eg GP, geriatrics) less attractive for doctors • Poor data on other health workforces, but strong anecdotal evidence of similar problems

  12. GLOBAL ISSUES/DEMOGRAPHICS • Australia’s competitiveness at risk in a global health workforce market • Long term outlook mixed: declining birth rates- ‘2020 problem’

  13. THE CHALLENGE • The system, problems & solutions are complex • Every part of the system needs to be involved in working on solutions: • state & commonwealth; • professions; • universities, PGMCs • the public

  14. FUTURE HEALTH SYSTEMS • Patient-centred: accessible; whole needs • Flexible use of resources including workforce • Safe and effective care: the best care available for the needs of the patient • Technology: more care can be delivered away from hospitals • More attention to management of risk factors and prevention of disease

  15. AND SO TO WORKFORCE REFORM • How does workforce reform help deliver the desired health system? • Needs to be comprehensive: no ‘magic bullet’ • workforce planning • education & training • International Medical Graduates • practice changes • continuing licence to practise

  16. EDUCATION and TRAINING • Funding is complex and no one has overall responsibility • Takes too long to train a doctor: 10 years + • Results in workforce rigidity-too many professional & specialty demarcations • Training settings are built around a past health system- hospital dependent • Outdated learning methods, eg • apprenticeships vs. skill centres • ‘one size fits all’

  17. 3 POINT PLAN for TRAINING • Needs major attention • Getting it ‘right’ is basis of continuing excellence of our health system

  18. 1. MAKE SOMEONE ACCOUNTABLE • Federal health minister should be responsible for all health worker training • Supported by a national training authority • Responsible for undergraduate, prevocational, vocational & continuing professional training • Work with and through existing authorities: build on what’s there

  19. 2. SEPARATE TRAINING BUDGET • Training $ separately costed and budgeted-includes salaries for trainees; training costs • Hard to do but worth the effort • Mix of existing & new $

  20. 3. FOCUS ON THE TRAINING • The prime task is to train tomorrow’s workforce • Training needs to provide the capacity for continuing learning & the skills to work in a changing environment • Cannot overlook the service contribution trainees currently make- but this can be sorted out

  21. CAN IT BE DONE? • Prime Minister’s announcement on 22 October • Task Force on health • Look at health policy, in particular Commonwealth/state issues • Possibly change some areas of the interface • Aim is to better align national, state & local

  22. CONCLUSION • There is both need and opportunity for continuing training reform • Setting directions will be key • Think outside the box- innovation • National direction: local solutions (one size does not fit all)

More Related