“But there is always more that can be done to ensure Australia has an adequate supply of safe health professionals.”
Why are there major shortages?
Peter Breadon,the Grattan Institute’s health and aged care program director,said Australia’s health workforce issues did not stem from the raw numbers.
“All these problems[with major shortages] are real. But it’s about the structure of the system and the way you manage it ... rather than how many workers there are,” he said.
The first major issue is that there are too few clinicians in areas that need them the most.
“There are big shortages in a lot of rural and remote areas,but also parts of most cities,” Breadon said.
The second is red tape holding back health practitioners from operating to their capacity. For example,nurses say they could do more to screen patients,conduct health checks,help people manage their care regime and treat issues such as wounds.
“We’re not making the best use of[their skills] compared to other countries. Nurses and pharmacists do less than overseas,and there’s not as much administrative support for GPs as in other countries,” Breadon said.
There is also a mismatch regarding workers required,such as nurse-midwives and psychiatrists,while added complexity comes from the changing burden of disease in Australia.
“On average,people are expected to live almost one extra year in ill health today,compared to 20 years ago,” Breadon said.
Chronic disease and ageing mean the health workforce must keep growing faster than the population.
Other factors affecting the healthcare workforce include burnout and a long-term trend towards part-time work. The lingering effect of the pandemic – from backlogs to delayed care,mental health problems and long-COVID – is another.
Where are the biggest shortfalls?
City centres are generally well served. The latest census data shows there are 5.9 GPs per 1000 people in inner Perth,4.5 in inner Brisbane,and almost 3.6 in inner Sydney and Melbourne.
But in north-west Melbourne,that drops to just 1.2 GPs per 1000 people,while in regional NSW,the Hunter Valley and Murray regions have only 1.3 GPs per 1000 people.
There are also four regions across Australia without a single psychiatrist. Northern Sydney has 173 psychiatrists for a population of 424,000. But Blacktown,in Sydney’s west,is home to just 16 psychiatrists for more than 400,000 people.
That disparity continues for clinical psychologists, creating a major access gap as Australians experience elevated levels of distress.
Inner Melbourne has 2.9 clinical psychologists per 1000 people – or 1761 professionals for a population of 617,000. Victoria’s Shepparton,however,has just 0.3 clinical psychologists per 1000 people.
How will the problem be solved?
Getting more doctors,nurses and psychologists out to places that need them,making sure they’re being fully utilised and ensuring the workforce pipeline remains strong will be some of the government’s major challenges.
Fletcher said some things were already happening to boost numbers,such as cutting the time it took to assess applications for registration in Australia,boosting exam places for internationally qualified nurses and making English language requirements more flexible.
“We are working closely with governments and employers to identify areas of specific need,which allows us to escalate applications for registration where critical health workforce vacancies need to be addressed,” he said.
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Health Minister Mark Butler said the government was also working to boost domestic workforce numbers. There has been a one-off increase of 2600 Commonwealth-supported places to train nurses,and 92,000 fee-free TAFE courses for the care sector.
“We will need to continue to grow the workforce over time as the population grows and demand for care increases. Governments are already throwing quite a lot at that,” Breadon said. “But we need those other reforms[also].”
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