The pandemic, coupled with Australia’s ageing population, means an extra 205,900 healthcare and social assistance workers will need to be added to the workforce by 2025, according to a report by the National Skills Commission released this morning.
But with low immigration and COVID-19 risks, where is Australia going to get all those extra workers from?
The state of the workforce
The healthcare sector is dominated by women aged 20-34. There were more than 586,000 registered health practitioners in Australia in 2018, of which just 146,000 were men. Also 46% of the workforce is employed part time.
Health Services Union (HSU) national secretary Lloyd Williams told Crikey more needed to be done to address ongoing issues in the sector before a recruitment drive.
“The HSU is less concerned about where we can source these workers from and more concerned about how to retain workers once they’re in the system,” he said.
Disability, aged care and mental health workers earn some of the lowest wages in the country, and the industry is becoming increasingly casualised.
“For too long workers have only been offered low hours, short shifts and insecure employment; it makes a long-term career in the sector almost impossible,” Williams said.
“This pandemic has exposed just how broken the system is and left many of the current workers burnt out.”
Cash, immigration and education are key
Immigration is key to Australia’s health sector. One third of medical practitioners working in Australia received their initial qualification overseas.
CEO of the Grattan Institute Danielle Wood told Crikey Australia often looked abroad to recruit healthcare workers.
“Historically we have relied on immigration to fill gaps in government services, health and aged care sectors,” Wood said.
But Australia’s border closures in response to COVID-19 has seen immigration slow to a trickle. In September, arrival numbers dropped by 57% compared to August 2019.
Earlier this year, the federal government announced a massive shakeup to how university courses are funded. The cost of a three-year nursing degree is now $11,850 — a decrease of 42%.
The aim is to get more students into vocational studies — but Wood said this approach might not be as successful as the government hopes.
“It doesn’t look entirely economically coherent,” she said. “Students aren’t too influenced by fee changes as they don’t pay fees upfront.”
Wood told Crikey the government would have to up its investment in the sector.
“There will be pressure going forward on government spending to meet the growing need.”
There seems to be a confusion here between “Disability, aged care and mental health workers” and “registered health professions (which)includes Aboriginal and Torres Strait Islander health practitioners, chiropractors, Chinese medicine practitioners, medical radiation practitioners, occupational therapists, optometrists, osteopaths, pharmacists, physiotherapists, podiatrists, psychologists, oral health therapists, dental hygienists, dental therapists, dental prosthetists, dentists, nurses, midwives and medical practitioners.”
They’re different people, with different qualifications, employment conditions, and pay
One of the manifold joys of intersectionality – it means never having to say “sorry, my fault”.
From observation most of the practitioners are still badly paid and that also includes contract doctors.
What has horrified me, is that recently I was talking to a GP, trained in the UK with no requirement for vocational training in Australia, given a Medicare provider number because she was in an area of “need” 1 hours drive from the center of the capital.
The practice of Obstetrics in Australia has many very common and unique variations to the the UK model which has a mortality rate 30 times higher than Australia.
Whilst chatting I discovered that she thought the recommendations for folate supplements to be encouraged prior to conception to be an overkill.
When I pointed out that our soil is deficient in folate and that folate deficency caused midline defects such as Spina Bifida she was surprised.
Why are we training so many doctors through our universities and yet are importing the UK doctors looking for a better life, releasing them uninformed regarding local conditions?
“UK mortality 30 times higher“?
Truly? THIRTY?
Did you mean 3 times or 30% higher?
Hard to believe.
There’s not only low wages but also unpaid overtime is forced upon workers through unrealistic work routines. Complain and the shifts dry up.
The problem is retaining staff when conditions of employment – pay, hours, other conditions, treatment at work are not good. Nurses for example do a university degree but are looked down on by most medical practitioners, their salaries and conditions are often undermined by the hospitals where they work and they are bullied by HR staff, managers and nursing supervisors. Why would you stay?
Our nurses are also highly prized overseas, for their skills and hard work, and just increasing our nursing graduates might just see us teaching our young so they can go overseas and pay taxes elsewhere (or not, if they go to Saudi Arabia).
Which would be quite karmic, given that we drain other countries health professionals.
Our nurses with experience are prized overseas because Australians do work.
Our paramedics are highly valued overseas.
Nursing staff who graduate from their degree then begin to learn how to be a nurse, a junior part of a care team, their position improves as their performance.
I have observed that the term “Ignorant” is misused, however, there is a moment when the saying of “you don’t know what you don’t know” sums up the problem found with placing new graduates on wards.
“Meanwhile, a third of our medical practitioners received their initial qualification overseas.”
Agree, but this can be problematic. Expecting a qualified nurse or carer from a thirdish world country to give unequivocal care and service ( wiping b-cksides ) to an aging white person who is a symbol and representative of their previous oppression and deprivation will need an exorbitant amount of love.
Isn’t this also because Australian-trained doctors on the whole want to stay in the cities and overseas-trained doctors have to be recruited to fill country practices?
Yes, but go to most, obviously not all, country towns and you will see a conga line of complaints regarding the commitment of foreign doctors. It’s becoming quite serious where hospital auxillary staff are having to lay official complaints and when even the CWA are having their 2 cents worth you know it’s serious.
Hadn’t heard about that.
There is plenty on the net. Go to Life Hacker and place “Overseas-Trained Doctors Cause More Complaints In Australia”
Thanks.
The CWA is the place to go in the country if something needs fixing.
There are lots of complaints about the “Just serving my time” doctors in the country, and then you go to NSW where they refuse to contract the local GP because they can get a teleconference from Switzerland cheaper.
Not particularly helpful if you need a doctor to stabilize and transfer out a few people injured in a car accident.
But that would be NSW Health at the moment.
Do you have any published evidence of this? If true, is it the actual cause or simply the symtpom of lax or incompetent state/federal health regulation?
Of course it can occur, but in one’s own experience and reading regional media it’s the opposite, trying to stop overseas trained doctors and related leaving regions for the city after qualifying period….
Although Australians will reflexively claim we have high population growth and/or immigration (of sub-optimal candidates etc. vs. old days), without any compelling evidence, this does not acknowledge the global competition for health care personnel.
Maybe we could ask former Greens leader Dr. Bob Brown, Sustainable Australia related experts including mate and patron Dick Smith, Bob Carr, Dr. Bob Birrell, Andrew Bolt et al. and then MacroBusiness or The Oz?
They all complain about and deem ‘population growth’ as a cause of environmental degradation, but never present any clear evidence for this deeply nativist trope?
Only 150% correct – have a look at Central NSW.
In the 80s, I was a teenager with a sister going through the revolving doors of mental health and (nascent) drug and alcohol services. We contributed to the Burdekin inquiry into mental health systems post-deinstitutionalisation, an incredible report that sadly did not get acted on.
In the 90s, I was a health promotion worker in HIV / AIDS in inner Sydney, working across an incredible range of fields that most of us had to learn on the ground, running.
Now I’m a nurse working in the AOD sector under the Victorian nursing Mental Health Award. Mental health workers, AOD clinicians, and frontline service workers have never received the opportunities or wages commensurate with either their roles or their expertise, and still nobody really cares (at least, nobody with the power to change anything).
As a small piece of perspective on the issue, thousands of students will take on nursing studies at an Australian university in this coming year. 50% of them will be offered a graduate year in an acute health care setting to enable them to practice upon graduation. The federal government offers incentives to universities to train nurses, and has lowered the fees so more people will apply, but this will mean little in the future as hospitals and other setting are naturally reluctant to employed university trained nurses without a year of semi-supervised practice in a hospital. Graduate year numbers are decided and funded by government – and they are not increasing the numbers to match the graduates, or capping the university entrances to match the number of graduate years. If this happened to medical students, the stink raised would be enormous – but it won’t happen, because medicine remains a capped degree, as it should as there is no point training extra medical students who can’t get places as interns because they don’t exist.
Also, Australia demands EVERYONE does a general nursing degree before specialising, unlike other countries where nurses do a general first year and then spend the remainder of their degree in the area of their choice: mental health, oncology, theatre and surgery, etc. We lose many potentially excellent nurses because of this system.
So many factors, so much to consider – and sadly, so little being done.