Embedded Files
PAGE 1
Maintaining an adequate health workforce has been receiving increasing attention at national and state level in recent years. The growing financial pressure on the health system, and a significant shortage of health professionals especially in the public health sector, has forced a consideration of alternative models of providing health care. Notably, the issue of a shortage of health workers is of greatest concern in some rural, remote and Indigenous communities. This maldistribution of available health care resources has tended to disadvantage people living in these communities and attempts at addressing this inequity has been the focus of both state and federal jurisdictions for some time. Federal and state government documents have recognised the need for health reforms, and have instigated strategies to examine opportunities for expansion of health care roles, accelerated recruitment programs, and institution of new training places for medical and nursing students to help deal with the shortage of health workers. A number of health policy position papers, and numerous health care reform analysts, have supported the expansion of health workforce capacity by developing generic health workers, and further widening traditional health roles to capitalise on under-utilised segments of the workforce. In Queensland, the Ambulance Service has made a timely and significant response to this call and is currently training, through partnership with James Cook University, the first cohort of 20 Isolated Practice Paramedics who will graduate in late 2007 with expanded scope skill sets in chronic disease management and public health. This paper describes this initiative, its drivers and the development of an evidence base to support curriculum development and evaluation strategies for this program. Drivers for change Workforce issues Although the number of medical professionals trained in Australia has increased substantially in recent years and there has been some relief from the capping of available places, other factors such as a reduction in shift hours for doctors under safe working hours policies and losses to outside workforces, have resulted in a sustained shortage of doctors and other health workers. This effect has been especially felt in the public health sector. Two other factors that have been noted to have an additional effect on current workforce capacity are the current aging health workforce, and a greater participation of those wishing to work on a part time basis. The average age of health care workers is increasing and has therefore elevated the rate of exit from many parts of the health workforce. The rate of health worker exit from the workforce is expected to continue to increase in coming years as a large segment of the workforce approaches retirement age. Additionally, people entering the health professions are increasingly choosing to work part-time and adopt flexible working hours to suit their lifestyle and commitments. All of the discussed factors have resulted in a reduction of health workforce hours and workforce numbers, making the task of maintaining, let alone increasing, health provision extremely difficult. Exacerbating the national workforce shortage, there is considerable variation in the distribution of health workers across Australia. Additionally, there is a heavy reliance on overseas trained temporary resident doctors to fill non-specialist hospital positions in rural areas. The major cause identified as contributing to the relative under representation of the health workforce in rural and remote areas is a reluctance of health workers to take up these positions due to various factors that include: • perceptions among some health professionals that remuneration levels are lower and prospects for advancement and professional development are fewer in rural and remote areas compared with urban areas • perceptions that professional demands are greater on rural and remote practitioners in terms of expected levels of performance and commitment, heavier workloads, and a reduced availability of supporting health care infrastructure • lifestyle concerns relating to poor community infrastructure such as housing, education, transport, and reduced employment opportunities for spouses • training and education opportunities for health workers may be significantly reduced in rural and remote areas.
Google Sites
Report abuse