Report on the Audit of Health Workforce in Rural and Regional Australia

1.7 Audit findings

Page last updated: April 2008

Overall, the audit identifies that:

  • Supply of the medical workforce, when considered as the number of doctors in comparison to the population of the area in which those doctors practise, is low to very poor in many rural and regional areas of Australia.
  • The nursing workforce, considered as a ratio of nurses to area population, is relatively evenly available throughout rural and regional Australia.
  • The supply of other health professions in the scope of this audit, particularly dental practitioners, as a ratio of professional to population, is low to poor.
  • The supply and the distribution of health professionals, in particular throughout rural and regional areas, largely correspond with the distribution of state and territory funded controlled health services across Australia.
  • Access to services is dependent not only upon the number and distribution of health professionals, but can also be compounded by the logistical challenges of servicing highly dispersed populations over wide and diverse geographical areas.
  • Difficulties in access persist in spite of the numbers in the medical and nursing workforces relative to the population being similar to those of other countries within the Organisation for Economic Cooperation and Development (OECD) with which Australia is commonly compared.
  • Services to any given area are a combination of Australian Government and state and territory government funded public services and private services. A complete picture of all health service providers is not currently available nationally.

Medical workforce

  • Rural and remote Australia has experienced medical workforce shortages for a considerable period, particularly in terms of general practice services and some specialist services, such as obstetrics and gynaecology.
  • Numbers of GPs in proportion to the population decrease significantly with greater remoteness, with the lowest supply to 'very remote' areas, particularly in New South Wales and Western Australia.
  • There is also considerable variation across jurisdictions. Northern Territory and Western Australia, as well as the Australian Capital Territory, have lower number of GPs proportional to the population.
  • In recent years, the medical workforce in rural and remote Australia has increased modestly, mostly due to restrictions on Medicare provider numbers for overseas trained doctors to encourage them to work in rural and remote areas of workforce shortage.
  • One-third of doctors currently working in Australia were trained overseas.
  • The proportion of overseas trained doctors is significantly higher in rural and remote areas where 41% of all doctors have trained overseas.
  • Although the number of GPs continues to grow, this growth does not indicate increased availability of GPs over time, as the growth in the medical workforce has not kept pace with the rate of population growth.

Nursing workforce

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  • The nursing workforce appears to be relatively evenly distributed across Australia and continues to grow with a 9.8% increase in the number of registered nurses from 2001 to 2005.
  • The numbers of nurses in proportion to the populations varies considerably across jurisdictions, with the lowest ratios in Queensland and New South Wales.
  • Although the distribution is relatively even when considered at the national level, there are variations within jurisdictions. In particular, 'inner regional' areas of Western Australia and South Australia, 'remote' areas of Queensland, and 'outer regional' and 'remote' areas of Tasmania are significantly lower.
  • The steady growth in the number of nurses is anticipated to continue with greater availability of training places and other recent initiatives, however, current sources of data are insufficient to determine if there will be enough nurses in the medium to longer term.
  • Although the supply of nurses is relatively evenly distributed evidence from stakeholders suggests that there is a shortage of midwives in regional and remote Australia, and there have been similar concerns expressed about the numbers of nurses working in some other clinical areas.

Dental workforce

  • Dentists in the main operate as private businesses and three-quarters are located in metropolitan areas.
  • Access for public sector patients is largely dependent on access to public sector dental hospitals and services, which are largely also based in metropolitan areas.

Allied health workforce

  • There is no agreed definition of allied health, which contributes to the wide variation in the numbers cited working within the allied health workforce.
  • Many allied health professionals operate as private businesses and are based within major cities, with low numbers working in regional and remote areas.

Aboriginal health workers

  • The Aboriginal health workforce is relatively small, predominantly working in 'outer regional' and 'remote' locations.