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Thursday, 18 June 2009
Page: 3712

Senator SIEWERT (1:49 PM) —The Australian Greens believe that an effective healthcare system is dependent upon a skilled and well-resourced workforce. We believe in health funding that supports preventive care and health promotion, multidisciplinary teams and networks, and co-located services. We have championed the need for increases in student places, be they in the medical, dental or nursing schools. We have also called for allied health courses, to address the shortage of health professionals, and commensurate funding for staffing. We believe it is important that we see improvements in facilities to ensure high-quality teaching and mentorship programs. We are also keen to see matters addressed around the planning for Australia’s health workforce and we are concerned that this has been hampered by little or no coordination or leadership, which has created a desperate shortage of appropriately skilled and qualified health practitioners.

Given these circumstances, the Greens pay tribute to the hard work and dedication of all those who have participated and continue to participate in the delivery of health care in this country. Our healthcare workforce provide us with an excellent health service, under extremely difficult circumstances in many cases, and we believe they should be commended. In November 2008 the Council of Australian Governments signed off on what the government calls the ‘historic’ $1.6 billion health workforce package. With $1.1 billion of Commonwealth funding and $539.2 million from states and territories, it does in fact represent a substantial investment in the health workforce. This investment should improve health workforce capacity, efficiency and productivity. We hope it will do this 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 significant part of the COAG package is the establishment of 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 and implements the majority of the COAG health workforce initiatives. This bill specifies the functions, governance and structure of Health Workforce Australia. It is proposed that it will enable the health ministers to provide directions to Health Workforce Australia and should require Health Workforce Australia to report to the health ministers. We understand that Health Workforce Australia will be responsible for funding, planning and coordinating undergraduate clinical training across all health disciplines, and we expect it should also support clinical training supervision and health workforce research and planning—planning being a very important role. It should also provide funding for simulation training and provide advice to health ministers on relevant national workforce issues.

Under the governance of Health Workforce Australia we hope to see a greater capacity to ensure better value for money for these workforce initiatives and a more rapid and substantive progression of the necessary policy and planning initiatives. These are critical pathways to an improved health workforce and we welcome them. We think it is important in the process of establishing Health Workforce Australia that the role of existing health professions and educational institutions should be acknowledged. We have received assurances from the Minister for Health and Ageing that the invaluable knowledge of existing stakeholders will not be lost amid the expected broad changes to workforce planning structures and authority. We agree with the Australian Nursing Federation that ‘cutting out those who both professionally and industrially have the best interests of their professions and their consumers at the forefront of our minds’ would be a mistake. We note concerns raised by key stakeholders during the committee inquiry that this agency should not usurp the functions of accredited agencies or universities in relation to clinical training accreditation. Again we have received assurances from the minister that further clarification about the extent of the remit of Health Workforce Australia in accreditation will become evident when we get to see the draft of the regulations.

We want to see greater consistency around matters of data collection within the health system. We are all aware of the difficulties experienced in data collection. Historically, it has been a spasmodic and unreliable area of health management. We hope that Health Workforce Australia will create a new culture of timely and uniform information gathering. Every issue that is related to health that we talk about in this place has had problems with access to and collection of data, so this is particularly important. Health Workforce Australia provides a national focus to the provision of health care, and with this come significant changes to authority, hierarchies and power. We have received assurances from the minister that these definitions and the impact they have on engagement with existing stakeholders will again be clarified in the regulations. With the promise of $1.6 billion in funding, it is not hard to envisage that, as the AMA has stated, Health Workforce Australia ‘will be able to significantly impact on the standards of medical education in Australia’. A comprehensive strategy to address workforce shortages has been much needed, and we hope that this will be just a part of a significant commitment to the delivery of health care in this country.

The issue in this legislation, as in many bits of legislation we see pass through this place, is that a lot of it is delivered through the regulations. It is imperative that those regulations be right. Of course, regulations are a disallowable instrument. I understand the regulations will be going to COAG. We will seek assurances from government, hopefully in the minister’s summing-up speech, that in fact stakeholders will get to be engaged and will be consulted in the generation and development of the regulations before it goes to COAG. I am sick of regulations coming into this place and us being told that we cannot alter them because they have already been to COAG. It is necessary for the government to ensure that stakeholders are consulted before the regulations go to COAG, because I do not want to see disallowable instruments come in here and be rejected. If the proper consultation does not happen, that is what will happen in this place. We seek assurance from government during this debate that there will be consultation with all stakeholders around those key regulations. Once those assurances have been given, the Greens will be supporting this legislation.