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

2.4 Mapping the total health workforce

Page last updated: April 2008

To address the question of where and what workforce shortages occur requires a layering of information on all the various health service providers within any one geographical area or region, together with local knowledge of whether allocated positions are indeed filled. In any one geographical area or region the following basic services could be operating and need to be considered to form a complete picture of the available health workforce. Unfortunately, national data is not available at the area level on all of these services.

Hospitals: At June 2006, Australia had 755 public hospitals and 536 private hospitals. These vary in size, the range of services they offer and the extent to which they engage in teaching and research. Public hospitals can be found in all areas with 194 in 'inner regional' areas, 224 in 'outer regional' areas, 93 in 'remote' areas and 72 in 'very remote' areas, compared to 172 in 'major cities'. Attachment C provides maps of all public and private hospitals around Australia.

Community health services: Community health services provide a range of primary care health services, including nursing and allied health. These are state and territory run services. The numbers overall are unknown.

General practice: Australia has approximately 25,000 GPs providing primary care across the country. The bulk of these are providing services under Medicare.

Specialist services: There are some 49 specialist areas identified under the Medical Labour Force Survey 2005 and 34 peer groups under the Medicare Schedule. Services are provided privately, but also through public and private hospitals.

Dentist services: The majority of the dentists work within the private sector, operating as small businesses. Access for public sector patients to a largely private sector dental workforce is low and primarily through public sector dental services.

Other allied health: Many allied health professionals, such as pharmacists and chiropractors, operate predominantly through private small businesses. Others, such as physiotherapists, psychologists and radiographers work privately and also are employed in significant numbers in the public sector while others, such as occupational therapists are employed primarily in the public sector. The exact number of professionals is unknown.

A number of other specific programs are also funded to provide additional services to rural and remote areas. The Australian Government alone has more than 60 of these programs, including the following:

Aboriginal medical services: At June 2007, there were 248 organisations funded by the Australian Government to provide direct service delivery (primary health care, substance use and mental health services), of which 198 are Indigenous community controlled organisations. A map of all Office of Aboriginal and Torres Strait Islander (OATSIH) funded community-controlled organisations around Australia is provided at Attachment C.

Multi-Purpose Services: MPS are integrated health and aged care services that provide flexible and sustainable service options for small rural and remote communities where stand alone mainstream services are not viable. The program is jointly funded by the Australian Government and state and territory governments. At June 2007, there were 101 MPS operating throughout Australia, providing 2,492 flexible aged care places. A map of all MPS around Australia is provided at Attachment C.

Royal Flying Doctor Service of Australia: The RFDS provides emergency aero-medical and primary health care services for people who live, work and travel in rural and remote Australia. At June 2007, the service had 52 planes flying 190 full-time and 95 part-time clinical staff, mainly comprised of doctors and nurses. A map of all RFDS primary care sites around Australia is provided at Attachment C.

Regional Health Services: This program funds allied health and primary care services in 1000 small communities with populations of less than 5000 across all states and the Northern Territory. Some 121 regional health services were approved in 2007-08.

More Allied Health Services: This program provides funding for clinical care by allied health workers in rural and remote communities and is administered by 67 Divisions of General Practice with at least 5% of their population living in RRMA 4-7. In 2005-06, 97,000 services were provided and 178.7 full time equivalent allied health professionals employed across 18 professions in all states and territories.

Medical Specialist Outreach Assistance Program: The MSOAP provides funding to increase visiting specialist services in areas of identified need. At 2006-07, there were 1,375 specialists working through the program.