Online version of the 2012-13 Department of Health and Ageing Annual Report

Outcome 12: Health Workforce Capacity

Improved capacity, quality and mix of the health workforce to meet the requirements of health services, including through training, registration, accreditation and distribution strategies

Page last updated: 29 October 2013

Major Achievements

  • An extra 60 doctors are working in Australia’s hospitals after extra intern places were created to ensure all Australian trained medical graduates were offered an internship starting in 2013.
  • More of our future doctors, dentists and nurses have experienced rural practice, following the successful delivery of rural training. This training supported 815 graduating medical students to complete long term rural placements; 4,851 medical, nursing and allied health students completed shorter term clinical placements organised by University Departments of Rural Health; and 242 dentistry students completed rural clinical placements.
  • Patients will be better able to see doctors. More doctors are training to be GPs – 1,108 in 2013 compared to 1,000 in 2012 – and specialist training places have increased – from 600 in 2012 to 750 in 2013.
  • To help more overseas trained doctors to live and work in rural and remote areas, new guidelines were introduced that provide greater clarity on the factors considered in granting exemptions to allow them to access Medicare and reduce red tape and paperwork.
  • The nation’s dental workforce is being boosted – 50 dental graduates started the Voluntary Dental Graduate Year Program in January 2013.
  • Nearly 4,000 accredited general practices across Australia are funded to assist the employment of nurses and other allied health workers to provide immunisations, wound care and other services, working as a team to provide coordinated health care.

Challenges

  • Managing the ongoing demand for places in the Government’s medical vocational training programs, and for most health professional scholarships, which exceeds funded places available.
  • Supporting the GP Rural Incentives Program, which continues to exceed forecast expenditure due to high demand.
  • Increasing Australia’s dental workforce, particularly in rural and remote Australia and areas of need.

Performance

This is a doughnut chart and a table that summarises the results for all deliverables and key performance indicators in outcome 12 during 2012-13. The results show that 80% were met compared with 77.1% in 2011-12, 10% were substantially met compared with 8.6% in 2011-12 and 10% were not met compared with 14.3% in 2011-12.

80.0% MET

10.0% SUBSTANTIALLY MET

10.0% NOT MET

Period Met Substantially met Not met
2012-13 80.0% 10.0% 10.0%
2011-12 77.1% 8.6% 14.3%

Programs contributing to Outcome 12

Trends

Number of Specialist Training Program places for each academic (calendar) year from 2010 to 2013.

Figure 12.1 Specialist Training Program places per year

The figure is a horizontal bar chart and shows the number of Specialist Training Program places (denoted on x-axis) available for each academic year have increased steadily from 2011 to 2015 (denoted on y-axis).
Text Alternative: Figure 12.1 Specialist Training Program places per year

Number of emergency medicine training places for each academic (calendar) year from 2011 to 2015.

Figure 12.2 Emergency medicine training places per year

The figure is a horizontal bar chart and shows the number of emergency medicine training places (denoted on x-axis) available for each academic year have increased steadily from 2011 to 2015 (denoted on y−axis).D

Outcome Strategy

Outcome 12 aims to ensure that Australia has the workforce necessary to address its current and future health needs. In 2012-13, the Department worked to achieve this Outcome by managing initiatives under the programs outlined below.

Program 12.1: Workforce and rural distribution

Program 12.1 aims to increase the number of health professionals in regional, rural and remote Australia; increase investment in health workforce training; and increase access to health services through overseas recruitment.

Increase the supply of, and support for, health professionals in regional, rural and remote Australia

The Department recognises the challenges faced by regional, rural and remote communities in accessing health care. It continues to tackle this through delivering programs aimed at increasing the number of health professionals working and living in these areas.

Australian General Practice Training Program

The Australian General Practice Training Program (AGPT) offers post-graduate vocational training placements for medical graduates wanting to pursue a career in general practice in Australia. At least 50% of all AGPT training is undertaken in regional, rural and remote locations to encourage health professionals to work in these areas. In 2013, the number of training places increased to 1,108. All these places were filled by General Practice Education and Training Limited, which manages the program through a network of Regional Training Providers.

Prevocational General Practice Placements Program

The Prevocational General Practice Placements Program (PGPPP) is a prevocational training program that enhances junior doctors’ understanding of primary health care and encourages them to take up general practice as a career. The program gives junior doctors experience outside of hospitals with 12 week training placements in GP practices. At least 50% of all PGPPP training is undertaken in regional, rural and remote locations. In 2012, the target was 975 with 918 places filled. It is expected that the 2013 target of 961 will be met with General Practice Education and Training Limited working with Regional Training Providers around Australia to increase interest in this program.

Specialist Training Program

In 2012-13, the Department continued to support specialist training by funding medical specialist training posts situated beyond the traditional public teaching hospitals, including private, community and regional and rural settings. The Department funds these posts through specialist medical colleges. The Department has seen continued growth in training places in the public and private health sectors. This has strategically positioned the medical workforce to respond to the dual demands of a growing and ageing population.

Meeting demand for places in the program is an ongoing challenge. The Department will continue to work with program stakeholders to ensure that allocation of new places meets the needs of communities, including in rural and regional areas.

As part of the Tasmanian Health Assistance Package, the Department began planning for additional specialist training places and clinical supervisors in Tasmania’s public hospitals.

Remote Vocational and Procedural Training

In 2013, the Department increased access to maternity services for women living in rural and remote communities by awarding 50 training grants under the General Practice Procedural Training Support Program. This included 35 obstetric training grants and 15 anaesthetic training grants, enabling GPs in rural areas to attain procedural skills.

In addition, the Remote Vocational Training Scheme, which allows GP registrars to remain working in rural and remote areas while training through distance education, filled all the 22 new places available in the 2013 training year.

Practice Nurse Incentive Program

The Practice Nurse Incentive Program (PNIP) provided incentive payments to accredited general practices and Aboriginal Community Controlled Health Services that employed practice nurses and Aboriginal and Torres Strait Islander Health Workers and other allied health workers to provide services such as immunisations, wound care and cervical screening. This support has enabled more effective use of practice nurses within their health care team and provides Australians with access to more coordinated and comprehensive primary care and better chronic disease management.

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General Practice Rural Incentives

The Department continued delivery of the General Practice Rural Incentives Program to provide financial incentives for doctors to move to and/or remain in regional, rural and remote areas. Payments are scaled to provide the greatest incentive to those living and working in the most isolated regions. The more remote, the larger the incentive. Doctors receive a retention payment based on their length of service in a rural community, clinical workload and location of the practice.

Increased investment in medical training and education

The Department delivered a range of innovative training and education programs to improve workforce capacity.

Rural Clinical Training Support

In 2012-13, the Department continued to support 17 Rural Clinical Schools, 11 University Departments of Rural Health and six dental schools under the Rural Health Multidisciplinary Training (RHMT) initiative. People who train and work in rural and remote areas are more likely to relocate there. Recognising this, programs under the RHMT ensure that medical, dental, nursing and allied health students can complete a proportion of their clinical training in a rural or remote area.

Building Emergency Department Workforce Capacity

Under the More Doctors and Nurses for Emergency Departments Program, the Department funds the Australasian College of Emergency Medicine (ACEM) to deliver an additional 22 emergency medicine specialist trainees each year over four years from 2011, reaching a total of 110 in 2015.

In 2012-13, the Department worked with ACEM to deliver 66 emergency medicine specialist trainees. These specialist trainees provided an immediate boost to the delivery of emergency medicine services and will be a critical component of the future specialist workforce. The Department has also engaged with private sector emergency departments to support new senior clinical training supervisors. These private sector positions are critical in building the capacity to train more doctors in new settings, complementing investments in public sector clinical training.

Training for telehealth

In 2012-13, the Department continued to fund activities to support the introduction and uptake of Medicare-eligible telehealth. Through the Telehealth Support Program, which began in 2011, 28 organisations were funded to develop education, continuing professional development activities, and other support services.

Projects across all states and territories supported rural health professionals and specialists to establish telehealth-ready practices. These activities were funded as part of the broader commitment to increase access to services in rural and remote areas, specifically access to specialist services. Many of the projects funded have delivered educational material that will be used for many years.

The program has met its objectives and ceased on 30 June 2013.

Additional Medical Internship 2013 Initiative

In 2013, the Additional Medical Internships 2013 (AMI 2013) initiative resulted in an additional 60 junior doctors starting work as medical interns in Australia. This ensured that all Australian-trained medical graduates who applied for a medical internship were offered a position. The Department worked closely with state and territory governments, private hospital operators, accreditation bodies, the Medical Deans of Australia and New Zealand, and the Australian Medical Students’ Association to establish and implement the AMI 2013.

Of the 60 additional intern places created, 22 were directly funded by the Commonwealth and are located mainly in private hospitals in Western Australia, Queensland, the Australian Capital Territory, Northern Territory and New South Wales. The AMI 2013 has also delivered additional clinical training capacity through encouraging and supporting private hospitals to take a greater role in training junior doctors, and created opportunities for greater collaboration between private and public hospitals to improve medical education and training opportunities for all Australian doctors.

Increase access to medical services through overseas recruitment

The Department continued to support the recruitment of overseas-trained doctors (OTDs) to work in outer-metropolitan, regional and remote areas through the International Recruitment Strategy (IRS). Funding to Rural Health Workforce Australia (RHWA) and its seven-member Rural Workforce Agency network provides a case managed recruitment service for appropriately trained OTDs as well as orientation for the doctor and family members into the local community.

In 2012-13, the number of OTDs recruited through the support of the IRS increased by 51% compared to the previous year. During this period, RHWA undertook an international market expansion project and for the first time subcontracted an overseas recruitment agency to help identify suitably qualified OTDs from the United Kingdom. As a result, 124 OTDs were recruited, which has exceeded the target by 8.8%.

19AB Exemptions for overseas trained doctors and foreign graduates of an accredited medical school

In 2012-13, the Department introduced new legislative guidelines to provide greater clarity for OTDs and foreign graduates of an accredited medical school (FGAMS) on the factors considered in granting exemptions under Section 19AB of the Health Insurance Act 1973.

OTDs and FGAMS are required to seek an exemption so they can obtain a Medicare provider number.

Medicare provider number restrictions are one of the mechanisms used to achieve a more equitable distribution of the Australian medical workforce. OTDs and FGAMS are restricted from accessing Medicare arrangements unless they practice within a district of workforce shortage for their medical specialty. A district of workforce shortage is defined as an area that has less access to medical services when compared to the national average. At 31 March 2013, more than 9,708 OTDs and FGAMS (both GPs and specialists) were accessing the Medicare arrangements across Australia.

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Program 12.2: Workforce development and innovation

Program 12.2 aims to develop innovative workforce models in specific health disciplines, such as mental health and dentistry.

Mental health nurses

In 2012-13, the Mental Health Nurse Incentive Program continued to enable eligible general practices, private psychiatrist services, Medicare Locals and Aboriginal and Torres Strait Islander Medical Services to engage credentialed mental health nurses to provide coordinated clinical care for people with severe and persistent mental illness. Incentive payments for up to 160,000 credentialed mental health nurse sessions were available to eligible organisations. Support provided under this initiative targets patients with severe and persistent mental illness living in the community during periods of significant disability.

Increased investment in the dental workforce

In 2012-13, the Dental Training – Expanding Rural Placements (DTERP) Program continued to address the shortage and maldistribution of dentists, especially in rural and remote areas. It encourages dental students to take up a career in rural practice by providing positive, high quality clinical education and training experiences for dental students in rural areas.

In the 2012 academic year, 242 placements were funded through the DTERP Program.

Voluntary Dental Graduate Year Program

In 2013, the Voluntary Dental Graduate Year Program (VDGYP) provided 50 dental graduates with a structured program for enhanced practice experience and professional development opportunities, increasing dental workforce and service delivery capacity. Where possible, graduate placements have been directed towards the public sector and areas of need.

Outcome 12 – Financial Resource Summary

Program (A) Budget Estimate 2012-13
$’000
(B) Actual 2012-13
$’000
Variation (Column B minus Column A)
$’000
Program 12.1: Workforce and Rural Distribution
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1) 1,020,248 1,026,159 5,911
Departmental Expenses
Departmental Appropriation 1 13,766 13,482 ( 284)
Expenses not requiring appropriation in the current year 2 433 685 252
Total for Program 12.1 1,034,447 1,040,326 5,879
Program 12.2: Workforce Development and Innovation
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1) 300,920 295,963 ( 4,957)
Departmental Expenses
Departmental Appropriation 1 10,111 9,921 ( 190)
Expenses not requiring appropriation in the current year 2 342 523 181
Total for Program 12.2 311,373 306,407 ( 4,966)
Outcome 12 Totals by appropriation type
Administered Expenses
Ordinary Annual Services (Annual Appropriation Bill 1) 1,321,168 1,322,122 954
Departmental Expenses
Departmental Appropriation 1 23,877 23,403 ( 474)
Expenses not requiring appropriation in the current year 2 775 1,208 433
Total expenses for Outcome 12 1,345,820 1,346,733 913
Average Staffing Level (Number) 164 163 ( 1)
  1. Departmental appropriation combines 'Ordinary annual services (Appropriation Bill 1)' and 'Revenue from independent sources (s31)'.
  2. 'Expenses not requiring appropriation in the budget year' is made up of depreciation expense, amortisation, make good expense and audit fees. This estimate also includes approved operating losses - please refer to the departmental financial statements for further information.

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