In 2007–08, the Department supported health professional training and addressed workforce shortage issues through initiatives that provided additional medical school places for doctors willing to work in rural, remote and other areas of medical workforce shortages on completion of successful fellowship training in a specialty. There is evidence that rural students are more likely to seek and maintain employment in a rural area after completing their studies.
Over 600 first year students were provided with a medical school place through the Bonded Medical Places Scheme, with 25 per cent of all Australian Government-supported medical school places now being allocated under the scheme. Students that accepted a place did so on the condition that they would work in a district of workforce shortage of their choice, for a period of time equal to the length of their medical degree.
The Medical Rural Bonded Scholarship Scheme has helped approximately 700 people to date. In addition, 100 new scholarships were offered in 2007–08. Students awarded scholarships will practice in rural or remote areas of Australia for six continuous years upon completion of basic medical and vocational training as a specialist (including general practice). Participants in both schemes are already graduating as doctors and some Medical Rural Bonded Scholarship Scheme doctors will be commencing their return of service obligation in rural areas in 2009–10.
The Department supported the More Doctors for Outer Metropolitan Areas initiative which saw more than 100 general practitioners and specialists agreeing to relocate to outer metropolitan areas under the Relocation Incentive Grant Program. As a result, access to general practice and specialist services for people living in the outer metropolitan areas of Australia’s capital cities improved.
The Department worked with the states and territories, medical colleges, health professionals, private and community sector providers, and consumers, to deliver Council of Australian Governments initiatives that aim to support specialist medical training in a wider range of settings.
The Department collaborated with state and territory health departments and specialist colleges, to establish and accredit new medical specialist training positions in locations such as private hospitals, community settings and rural or regional public hospitals. A major achievement was the provision of funding for 98 new medical specialist training positions, located in all states and territories, across a range of areas including medicine, surgery, anaesthetics and pathology. This was in addition to 48 specialist training positions in expanded settings for psychiatry funded under Outcome 11 – Mental Health.
The Department also commenced a funding round for expanded specialist training positions to begin in the 2009 academic year. The Department received approximately 460 applications for funding and commenced consultations with state and territory health departments and specialist colleges to determine future funding priorities.
The Department will continue to focus on improving the quality of training in the Australian medical workforce in 2008–09; working with the states and territories and the private sector, to improve medical professionals’ training nationally. It will also review existing methods of training beyond traditional public hospitals and community settings in metropolitan, rural, regional and remote areas.
On 13 April 2007, the Council of Australian Governments agreed to the development of a national registration and accreditation scheme for nine health professions: nursing and midwifery, medicine, physiotherapy, chiropractic care, osteopathy, psychology, optometry, pharmacy and dental care (including dentists, dental hygienists, dental therapists and dental prosthetists).
The scheme will ensure that only health professionals who are suitably trained and qualified to practise in a competent and ethical manner are registered on a national basis. It will also reduce the red tape associated with separate state and territory systems for the registration of health professionals and accreditation of their education and training, making it easier for health professionals to work across borders. The scheme’s data on registered health professionals will also assist with national workforce planning.
In 2007–08, the Department played a key role in the development of the national registration and accreditation scheme, by maintaining collaborative arrangements with State and Territory Governments, providing comprehensive policy advice and options for consideration by government, and managing effective relationships with key stakeholders representing the nine professions.
This work facilitated agreement by the Council of Australian Governments on 26 March 2008 to implement the national scheme by 1 July 2010. The Council of Australian Governments also formally handed responsibility for the scheme to Health Ministers in April 2008. To assist Health Ministers with implementation of the scheme, an Implementation Project Team was established, supported by all jurisdictional governments. The project team reports to Health Ministers through the Health Workforce Principal Committee of Australian Health Ministers’ Advisory Council. The Department assisted the implementation project team in its work to establish the national scheme.
During 2007–08, the Department awarded 95 new scholarships for students of rural origin to study allied health disciplines under the Rural Allied Health Undergraduate Scholarship Scheme and over 160 new scholarships under the Australian Rural and Remote Health Professional Scholarships Scheme, to help practising allied health professionals in rural and remote Australia to continue their professional development.
The professional scholarship scheme removes the financial barriers faced by rural and remote allied health professionals who want to undertake continuing professional development. It also supports rural and remote allied health professionals to update and maintain their skills, and encourages them to continue to provide their services in their current location. This contributes to increasing the capacity of the allied health workforce in rural and regional Australia, and assists in enhancing people’s access to services in these areas.
In addition, the Department implemented the Support for Allied Health in Rural Areas initiative, via the Australian Allied Health Rural and Remote Clinical Placement Scholarship Scheme. This scheme will provide scholarships from the 2009 academic year to support allied health students from metropolitan, regional, rural or remote areas to undertake clinical placements in a rural or remote community during their degree. The Department consulted with key stakeholders, including the Services for Australian Rural and Remote Allied Health, to develop the guidelines, eligibility criteria and marketing strategies of this scheme.
Through the Nurse Scholarship Program, which is administered by the Royal College of Nursing Australia, the Department helped nurses and midwives undertake undergraduate or postgraduate study, attend conferences, update their skills and qualifications, or re-enter the nursing workforce. The program offers incentives to individuals wishing to pursue or build a career in rural or remote area nursing, and to nurses wishing to re-enter the nursing workforce, anywhere in Australia.
During the year, the Department awarded 166 undergraduate scholarships, 552 postgraduate scholarships, and 227 nurse re-entry scholarships, exceeding targets set for this period. In addition, the Department continued to support scholarships for formal training programs for practice nurses, awarding 600 postgraduate and professional development scholarships in 2007–08. These scholarships will help increase the number of qualifying nurses and support professional development, thereby improving the quality and provision of health care to the community. The nursing scholarships are demand driven and the Department manages this initiative through information dissemination, consultation with stakeholders and peak nursing organisations, and ongoing review and monitoring of the program. The success of this strategy is evident in the number of scholarships awarded this year.
A priority in 2007–08 was to encourage nurses to return to the nursing workforce in public or private hospitals or residential aged care homes. To help achieve this, the Department implemented the Bringing Nurses Back to the Workforce Program, which provides cash bonuses to nurses and midwives who have been out of the Australian nursing workforce for 12 months. The Department entered into contractual arrangements with state and territory health departments, private sector hospitals and hospital groups, and private administrators to administer this initiative. In addition, the Department undertook promotional activities to disseminate information at major nursing and health expos, and in professional newsletters.
The Department also entered into a contractual arrangement with the Congress for Aboriginal and Torres Strait Islander Nurses to encourage Aboriginal and Torres Strait Islander nurses to return to the workplace, through targeted communications and promotional strategies.
During the year, the Department conducted a process to recruit a Commonwealth Chief Nurse and Midwifery Officer, with the appointment made in June 2008.
The Chief Nurse and Midwifery Officer will play a key role in developing a strategic and collaborative approach to national nursing policy across all jurisdictions, and work towards building and strengthening the nursing profession as a career of choice. This new national leadership role is part of the Health and Hospitals Reform Commission’s plan to improve health and hospital services, and deliver better health outcomes to the community.
While actively addressing the shortage of Australian trained doctors, the Department continued to attend to the immediate medical needs of communities in areas of workforce shortage through other initiatives such as the recruitment of qualified overseas trained doctors.
The Department supported the placement of appropriately qualified overseas trained doctors, by meeting the associated recruitment costs for employers and doctors through the International Medical Practitioner Recruitment Strategy, provided the recruitment agencies assisting in filling the vacancies were contracted by the Department for this purpose. This major achievement saw 182 overseas trained doctors recruited into rural, remote and other areas of workplace shortage across Australia. Of the 157 general practitioners and 25 specialists, 115 (63 per cent) were placed in Rural and Remote and Metropolitan Area classification 3–7 locations.1
1Rural, Remote and Metropolitan Areas classifications: 3 – Large rural centres; 4 – Small rural centres; 5 – Other rural areas; 6 – Remote centres; and 7 – Other remote centres.
In addition, in 2007–08, scholarships funded by the Department through the Identification, Assessment and Counselling Permanent Resident Overseas Trained Doctors project assisted 134 permanent resident overseas trained doctors to pass the Australian Medical Council clinical examinations and 107 to pass their Multiple Choice Question examination. This project has to date resulted in over 150 overseas trained doctors qualifying for entry into the Australian medical workforce.
Following the announcement at the Council of Australian Governments July 2006 meeting, a national assessment process for overseas trained doctors is being implemented by all states and territories. The national process ensures that overseas trained doctors, regardless of where they work, meet a set standard of knowledge and skills before they are allowed to begin seeing patients. The Department has played a key role in facilitating its implementation, through funding for stakeholder consultation, provision of chair and secretariat services, and funding the Australian Medical Council to accredit pathways and increase access to testing. The new assessment pathways have been endorsed by Health Ministers and are now being phased in across all jurisdictions. The Competent Authority pathway of assessment is now operational in all states and territories, and the mandatory screening exam for non-specialist doctors was in place from 1 July 2008.
Figure 2.3.12.1: Number of Overseas Trained Doctors Recruited and Working on the International Recruitment Program
Source: Department of Health and Ageing (with data obtained from Recruiters of Overseas Trained Doctors).
A priority for the Department in 2007–08 was to address the developmental needs of other health workforce groups contributing to Aboriginal and Torres Strait Islander health, with particular focus on improving the training, recruitment and retention of Indigenous Australian health professionals working in Aboriginal and Torres Strait Islander primary care. Boosting the number of Indigenous people working in health is critical to bridging the 17 year life expectancy gap between Indigenous and non-Indigenous Australians.
A major achievement was the funding of peak Indigenous professional bodies, including the Australian Indigenous Doctors Association and the Congress of Aboriginal and Torres Strait Islander Nurses, to support and mentor Aboriginal and Torres Strait Islander health professionals and students. This strengthened the capacity of a range of Indigenous and non-Indigenous health professional and education bodies to support Aboriginal and Torres Strait Islander health professionals and students.
Under the auspices of the National Aboriginal and Torres Strait Islander Health Council, the Department supported the Australian Indigenous Doctors Association to prepare Pathways into the Health Workforce for Aboriginal and Torres Strait Islander People: A Blueprint for Action. This report makes recommendations that aim to promote and improve pathways between schools, vocational education and training, and higher education. It also seeks to retain and build the capacity of the existing Indigenous health workforce. The Department is working with a range of portfolios, states and territories and the Aboriginal community controlled health sector to take forward the recommendations of the Blueprint for Action report.
The Department also funded the Medical Deans of Australia and New Zealand to oversee the Leaders in Indigenous Medical Education Network and to coordinate the integration of high quality curriculum and teaching processes focusing on Indigenous health. This also involved developing and implementing strategies to support the recruitment and retention of Aboriginal and Torres Strait Islander medical students across Australia.
The Puggy Hunter Memorial Scholarship Scheme was established in recognition of Dr Arnold (‘Puggy’) Hunter’s significant contribution to Aboriginal and Torres Strait Islander heath. The Department administers the scheme through the Royal College of Nursing, Australia, to help Indigenous Australians to study at undergraduate or TAFE levels, in a broad range of health professions, including medicine, dentistry, mental health, midwifery and nursing.
In 2007–08, the Department provided funding to 221 scholarship awardees, including 107 full-time equivalent places for new recipients, exceeding targets set for this period. Disciplines of study include nursing, medicine, dental and oral health, allied health, medicine, Aboriginal Health worker and health management.
During this period, the Department worked with stakeholders to increase the participation of potentially suitable candidates in the Puggy Hunter Memorial Scholarship Scheme through information dissemination, consultation with peak Indigenous professional bodies, and ongoing review and monitoring of the scholarship scheme.
The Department collaborated with State and Territory Governments and the Aboriginal community controlled health sector, to develop and implement new national qualifications for Aboriginal Health Workers, including training for nationally accredited assessors. This recognises and enhances the vital role these workers play in providing health care for Indigenous Australians.
In addition to the medical specialist training-related activities discussed earlier in this chapter, the Department worked to deliver more rural training opportunities for students in Rural Clinical Schools, and University Departments of Rural Health.
The Department supported a national network of rural training infrastructure through the Rural Clinical Schools, the University Departments of Rural Health and the Rural Undergraduate Support and Coordination programs. The Department also established a new rural training initiative, the Dental Training – Expanding Rural Placements Program, to enable students from Australia’s six established dental faculties to undertake rural placements from 2008–09.
The Rural Clinical Schools Program’s annual placements increased from approximately 380 in the 2006 calendar year to 467 in 2007. This reflects the expansion of existing schools, and the three new schools that joined the program in 2006–07; the Australian National University, James Cook University and the University of Newcastle.
The University Departments of Rural Health Program multidisciplinary placements also increased from 3,355 in 2006 to 3,444 in 2007. Part of this growth can be attributed to the Department’s provision of funding to the new Monash University Department of Rural and Indigenous Health in Victoria.
Two additional medical schools, Deakin University and the University of Notre Dame Sydney, joined the Rural Undergraduate Support and Coordination Program in 2007–08 and began to receive funding support for their rural training activities.
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