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Wednesday, 13 May 2009
Page: 3615


Ms ROXON (Minister for Health and Ageing) (9:23 AM) —I move:

That this bill be now read a second time.

There can be no doubting that Australians enjoy one of the best health systems in the world.

One of the reasons we have such good health outcomes is because of the quality of our health workforce.

Our doctors, nurses, midwives, allied health professionals, paramedics and researchers are the backbone of our health system.

It is absolutely essential that we do all we can to support our health workforce in their work.

That is why today I rise to introduce the Rudd government’s latest initiative to building a sustainable health workforce—the Health Workforce Australia Bill 2009.

Unfortunately we are currently dealing with the legacy of a historic underinvestment in our health workforce. The end result of this neglect by the previous government is there are now chronic shortages in general practice, various medical specialities, dentistry, nursing and certain allied health professions.

These shortages are particularly acute in rural and remote communities around the country, with some communities having limited access to health services and state and territory health departments spending vast sums of money to send health professionals to work in understaffed facilities.

Workforce shortages and inflexibilities and inefficiencies in training and service delivery can contribute to poor health outcomes, particularly in certain regions, such as our rural and remote areas, and for certain population groups, particularly Indigenous Australians.

We also currently have very poor national data on the health workforce which further inhibits our ability to better plan for the health workforce needs of the community.

In addition to existing shortages, a number of imminent supply and demand issues will exacerbate pressures on Australia’s health system and its workforce in the near future. These factors include:

  • population and workforce ageing;
  • lower average working hours;
  • potential decreases in availability of the overseas supply of health workers;
  • changes to population health and patterns of disease;
  • increasing community expectations for health care; and
  • broader labour market issues.

For instance, the ageing of the population will have significant implications for the health workforce in terms of demand, with the over 55s being the heaviest consumers of medical services, and supply, with increasing numbers of health professionals expected to retire in the near future. Increasing levels of chronic disease are expected to increase the demand for services even further in coming years.

The Productivity Commission’s Australia’s health workforce report concluded that the workforce is a fundamental enabler in ensuring all Australians have access to high quality, effective, efficient and financially viable health services. Long-term planning and policy development are needed now and are needed on a national level.

Without action, access to appropriately trained health workers will be further reduced, ultimately affecting the health outcomes of the Australian population.

Although all jurisdictions are now investing more heavily in training of the health workforce, increased university and TAFE training places have resulted in a significant increase in the requirement for effective clinical training, which is essential to the development of practical skills and the quality of future health professionals. Training of health professionals is further hampered by the current split in clinical training responsibility between education providers and the health sector.

Improvements to clinical training arrangements, including funding and supervision, are urgently needed. There is also a clear need for greater effort and more effective governance arrangements around health workforce training, planning and policy development that can work across and with jurisdictions and the health and education sectors.

For too long the previous government ignored the warning signs and chose to do nothing, simply playing the blame game with the states.

But the Rudd government has chosen to act and to work with the states on solutions.

That’s why in November 2008 the Council of Australia Governments (COAG) signed off on an historic $1.6 billion health workforce package.

The package forms part of the National Partnership Agreement on Hospital and Health Workforce Reform, signed by all states and territories in March 2009. The package, comprising $1.1 billion of Commonwealth funding and $539.2 million from states and territories, is the single largest investment in the health workforce ever made by Australian governments.

This investment will improve health workforce capacity, efficiency and productivity by improving clinical training arrangements, increasing postgraduate training places for medical graduates, improving health workforce planning across Australia and enhancing training infrastructure, particularly in regional and rural areas.

A critical component of the COAG package is the establishment of a national health workforce authority—Health Workforce Australia—to produce more effective, streamlined and integrated clinical training arrangements and to support workforce planning and policy.

The Health Workforce Australia Bill 2009 establishes Health Workforce Australia (HWA) and implements a majority of the COAG health workforce initiatives.

The bill specifies the functions, governance and structure of Health Workforce Australia, enables health ministers to provide directions to Health Workforce Australia and requires Health Workforce Australia to report to health ministers.

Health Workforce Australia will be responsible for:

  • funding, planning and coordinating undergraduate clinical training across all health disciplines;
  • supporting clinical training supervision;
  • supporting health workforce research and planning, including through a national workforce planning statistical resource;
  • funding simulation training; and
  • providing advice to health ministers on relevant national workforce issues.

The authority will also ensure best value for money for these workforce initiatives and a more rapid and substantive progression of the necessary policy and planning activities.

Given the functions and level of funding for which the authority will be responsible, it is essential that there is a legislative basis for its operations and governance arrangements that reflect the shared funding and policy interest of all jurisdictions.

HWA will be established as a statutory authority under the Commonwealth Authorities and Companies Act 1997.

It will be governed by a board comprising a nominee from each state and territory and an independent chair and may also include up to three other members selected by health ministers. A chief executive officer will be responsible for the day-to-day administration of Health Workforce Australia, and expert committees and consultants will be engaged to assist with functions as required.

Health Workforce Australia is to commence management of undergraduate clinical training from 1 January next year. The bill is required to establish Health Workforce Australia by July 2009 to ensure it is operational within the time frames agreed to in the COAG national partnership agreement.

The COAG health workforce package is a major investment to making the necessary improvements to the health workforce through effective planning and policy development.

It will work with and across jurisdictions and with and across the education and health sectors and is pivotal to the success of the COAG package.

For the first time, there will be one single body responsible for the delivery, funding, planning and oversight of all clinical training in this country.

I want to our hardworking and dedicated health professionals to know that the Rudd government is committed to addressing the chronic shortages which are afflicting our health system.

I am pleased to be able to present the Health Workforce Australia Bill 2009 to the House. It will help equip us with the tools we need to help improve the health workforce, and therefore the health system, and therefore benefit all of the Australian community. I commend the bill to the House.

Debate (on motion by Mr Lindsay) adjourned.