Expanding settings for medical specialist training
Appendix D: Extract from COAG Communique July 2006 (Health Workforce)
Australia's health system relies on the dedication and skill of its workforce to deliver high-quality care for all Australians. COAG has agreed to a package of reforms to help ensure that the health workforce is able to respond to the evolving care needs of the Australian community, while maintaining the quality and safety of health services. The Commonwealth's total contribution to the package is in the order of $300 million over four years. In February 2006, COAG received a report from the Productivity Commission on Australia's Health Workforce.
Strengthening the health workforceCOAG noted that the Commonwealth and the States and Territories are undertaking significant investments to address health workforce shortages. The Commonwealth announced on 8 April 2006 that it would provide 400 new medical school places and 1,000 new higher education nursing places. Today, the Commonwealth has agreed to provide an additional 205 medical school places, including five places for Tasmania. COAG has agreed that the Chief Ministers from Northern Territory and the Australian Capital Territory will write to the Prime Minister about medical school places in their jurisdictions. To support these places, the Commonwealth and Victoria will jointly provide a total of $46 million in capital funding for medical schools at Deakin and Monash Universities. The Commonwealth has offered to provide further capital funding of about $26 million for New England, Queensland and James Cook Universities, subject to matching funding from the States. The Commonwealth will also provide about $120 million over four years to fund the 605 new medical places and $93 million over four years to fund the additional nursing places. In addition, the Commonwealth will provide about $31 million over four years to increase its contribution toward the cost of nurses' clinical training from about $690 to $1,000 a year per full-time student.
As the major employer in the sector, the States and Territories have always partnered the Commonwealth in its education of medical and nursing students by providing clinical placements. The States and Territories have agreed to guarantee to provide high-quality clinical placements and intern training for Commonwealth-funded medical and nursing students. States and Territories have also agreed to continue to invest significantly in on-the-job and post-graduate training for these health professionals.Top of page
States and Territories are playing their part in systematically addressing health workforce needs, and have always supported the Commonwealth in its responsibility for university education of health students by providing clinical placements and for many, pre-registration employment. States and Territories remain willing to play their part in attracting, retaining and developing the health workforce, including through:
- New South Wales is funding recruitment and retention initiatives for the nursing health workforce as well as for targeted recruitment, education and training strategies for the health workforce. In support of the oral health workforce, New South Wales will recruit more dentists, allied dental health providers and specialists.
- Queensland, amongst other things, is funding 235 medical students; is increasing the number of specialist trainee positions by 75 places; and is increasing the number of TAFE places for health workers by 1500 over the next three years.
- Victoria has recently announced extra funding for internships, extra specialist places, and TAFE places for 1500 extra nurses and 420 extra allied health staff.
- Western Australia's commitment to training, recruitment and retention of the health workforce during 2006-07 includes expenditure on specialist trainees, nursing programmes, mental health recruitment and retention programmes, and a podiatry clinical training facility at University of Western Australia. Other funded training programmes planned for 2006-07 include Population Health, Enrolled Nurse training for Aboriginal people, and scholarships for Nurse Practitioners and Radiation/Nuclear Medicine students.
- South Australia has completed a Generational Health Review and State Strategic Plan that have set numerous health targets focussing on prevention.
- Tasmania has committed funding towards the building of a new medical clinical school at the University of Tasmania at Hobart; is improving nurse training with the appointment of 43 clinical nurse educators; and allocated funds in 2006- 07 for on-going employment of new dentists and trainers, scholarships for dental training and the development of a new clinical training facility in Hobart.
- The Northern Territory has funded six medical students and has provided additional funding for clinical training. The Northern Territory has also provided additional funding for health worker training including support for post-graduate nursing training.
- The Australian Capital Territory has committed significant resources to health workforce initiatives. These measures include better coordination of medical appointments and junior doctor training; recruitment and retention measures for nurses, midwives and allied health including scholarships for new staff and those re-entering the workforce. Top of page
Improved structures to support health workforce reformCOAG noted the importance of ensuring that health education and training is better aligned with workforce needs. To assist with this, the Commonwealth and the States and Territories signed a Memorandum of Understanding for better consultation on health-related university places. COAG agreed that the responsibilities of the Ministerial Council on Education, Employment, Training and Youth Affairs (MCEETYA) would be expanded to include annual agreement on national workforce priorities and advice on education and training that addresses current and emerging national skills shortages. COAG also agreed to establish a taskforce on the national health workforce, reporting to the Australian Health Ministers' Conference through the Australian Health Ministers' Advisory Council, to undertake project-based work and advise on workforce innovation and reform.
More effective use of the health workforceThe Commonwealth will introduce a new Medicare item for practice nurses and registered Aboriginal health workers to provide ongoing support for patients with chronic disease for, and on behalf of, general practitioners. This item, with other Commonwealth initiatives supporting practice nurses, will be available for services provided by registered nurse practitioners, working for, and on behalf of, general practitioners, where Medicare and other programme requirements are met.
Facilitating workforce responsiveness and mobilityIn order to facilitate workforce mobility, improve safety and quality, and reduce red tape, COAG has agreed to establish by July 2008 a single national registration scheme for health professionals, beginning with the nine professions currently registered in all jurisdictions. COAG has agreed to undertake consultation with stakeholders on its preferred model of a national cross-professional registration body which would also involve health professions participating in the scheme’s governance through profession-specific panels and committees. COAG noted that this is the first tranche of national registration and that other professional groups (including Aboriginal Health Workers) may be added over time. Top of page
COAG further agreed to establish by July 2008 a single national accreditation scheme for health education and training, in order to simplify and improve the consistency of current arrangements. COAG has agreed to undertake consultation with stakeholders on its preferred model for the scheme which would ensure that accreditation activities retain and draw on essential health profession-specific expertise. Both the national registration scheme and national accreditation scheme would be self-funding, with establishment costs jointly funded by the Commonwealth and the States and Territories.
COAG also agreed that health ministers will implement initiatives to establish by December 2006 a national process for the assessment of overseas-trained doctors.
Strengthening the health workforce in rural and remote areas and in Indigenous communitiesCOAG noted that, in order to attract more general practitioners with procedural skills to rural areas, and subject to the Australian College of Rural and Remote Medicine’s training programme being accredited by the Australian Medical Council, the Commonwealth will provide rural medicine with formal recognition under Medicare as a generalist discipline by April 2007. COAG agreed that health ministers should provide, by the end of 2006, options to improve service delivery in rural and remote areas. In addition, the Commonwealth's increase in medical school places will lead to an expansion in the number of medical school places bonded to areas of workforce shortage, and in Commonwealth programmes supporting rural students, including Indigenous students, and training.
COAG also agreed to enhancements to the health workforce servicing Indigenous communities. As part of the provision of the 605 medical school places, universities will continue to be supported to encourage selection of Indigenous applicants for entry into medicine. New chronic disease treatment arrangements under the Medicare Benefits Scheme for practice nurses, nurse practitioners and registered Aboriginal health workers will also provide Indigenous communities with greater access to the sorts of health services they most need. Other initiatives aimed at increasing the numbers of doctors in rural and remote areas, and at better managing rural and remote health services between the Commonwealth and States and Territories, will also benefit Indigenous Australians.Top of page