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Future Health Workforce: Exploring Options for Sustainable Solutions

This article discusses the challenges and potential solutions for the future health workforce. It explores the issues of workforce shortages, declining local school leavers, and difficulties in retaining nurses. The article also examines the current healthcare models and suggests the need for new models of care, workforce approaches, funding, and remuneration models. It emphasizes the importance of addressing these issues before it is too late.

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Future Health Workforce: Exploring Options for Sustainable Solutions

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  1. THE FUTURE HEALTH WORKFORCE: OPTIONS WE DO & DO NOT HAVE Robert Wells

  2. BIG PICTURE • Environmental change • Globalisation • Trade agreements • Free markets: competition policy; small government • Balanced budgets • Health costs ‘out of control’ • ‘Intergenerational’- increased ‘dependency’ • Urbanisation • Centralisation of policy within governments

  3. WORKFORCE IMPERATIVES • Workforce shortages in all health professions • Measures such as rural bonded scholars will alleviate for a while only • Over reliance on temporary foreign workers is risky • Declining local school leavers over next decade • Reduced workforce participation by both males & females • Cannot fill all our GP training places • Difficulties retaining nurses

  4. CURRENT HEALTH CARE MODELS • Doctor intensive • Strong professional demarcations: little flexibility • Increasing specialisation • Medicare $ demand-driven rather than strategically applied to need • Basically a ‘one size fits all’ model • Rural operates as a ‘pale reflection’ of urban models

  5. ANALYSIS • Current models of service delivery & funding for rural communities are unsustainable • Therefore need to explore alternative approaches • Cannot focus just on workforce • Need to begin that process now before it is too late

  6. CHANGE THE SYSTEM • New models of care- evidence based • New approaches to workforce • New funding & remuneration models • One level of government

  7. NEW MODELS OF CARE • A decade of research, trials & pilots • Many innovative models to be evaluated • Synthesising & evaluating this material in a systematic & policy focussed way a first step in setting a rural health research agenda

  8. NEW APPROACHES TO WORKFORCE • Multidisciplinary teams • Nurse practitioners & physician assistants • Need for reforms to education & training • Expand the education, training and research infrastructure provided through rural clinical schools & university departments of rural health

  9. NEW FUNDING & REMUNERATION MODELS • Time to review fee for service from care and workforce perspectives • Would per capita funding better suit needs of rural areas? • More flexibility in budgets & accountability for rural health authorities • Public investment in infrastructure

  10. ONE LEVEL OF GOVERNMENT • Problems in funding divide especially problematic in rural areas where there are fewer resources to go around • Could one level of government take total responsibility for rural health care?

  11. CONCLUSION • Rural health crisis likely to get worse on current trends • Need innovative solutions at several levels: care models; workforce & infrastructure; funding & remuneration; government ‘ownership’

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