Regional and remote Australians continue to be disadvantaged in their access to health professionals compared to their urban counterparts. This audit has confirmed anecdotal evidence that there continues to be a maldistribution of health professionals relative to population in all states and territories, in all major health professions except perhaps for nursing.

Measures to increase the supply and distribution of medical practitioners in Australia have helped improve the distribution of medical practitioners over the last few years. However, the growth in the supply of medical practitioners has not kept pace with the general population growth over the same period. The significant increase in the number of medical school places agreed by COAG helps to address this issue.

Distribution mechanisms, particularly those relating to overseas trained medical graduates, have had some success in improving the distribution of medical practitioners. However, distribution remains uneven, with remote areas having less than half the ratio of GPs than major cities. The Northern Territory, in particular, appears to have a significantly lower ratio of GPs to population than other jurisdictions.

The gains in distribution in rural and remote over recent years have been in a large part due to the increased numbers of overseas trained doctors working in these areas. Indeed, the supply of medical practitioners will continue to rely upon the recruitment of overseas trained professionals in the immediate and medium term future.

By contrast, the nursing workforce appears to be relatively evenly distributed across regions of Australia with the ratios of nurses being estimated as approximately 1,100 per 100,000 population across major cities, regional and remote areas in 2005. National data, however, is not disaggregated by region for principal areas of nursing, such as aged care and mental health, to allow a better picture of whether there are shortages of nurses in particular sub-specialities. Anecdotal evidence suggests shortages of these particular sub-specialities and also of midwives in regional and remote Australia.

In addition, the nursing workforce is ageing, in common with the health workforce overall. However, given that nurses represent approximately half of the total health workforce, this represents a major challenge in ensuring adequate supply of the nursing workforce into the future. The recent decisions of the government to increase nursing undergraduate places and to encourage former nurses to return to the profession will have a significant effect on the supply of this profession.

Dental practitioners are primarily based in major metropolitan centres, and access to dental services outside these areas is very poor. This reflects, in part, that dental services are predominantly provided in a small business setting. Regional and remote areas of Australia equally show disadvantage in the supply of dental practitioners. However, the audit does not capture visiting services provided by state and territory health authorities and other special services.

Regional and remote Australia has less access to allied health professionals than people living in major cities. However, allied health professions are diverse and often small in number. As an example, there are around 12,000 physiotherapists in Australia, and around 3,500 optometrists. It is unrealistic to expect that these professions will be equally distributed across all regions of Australia, particularly as many of these professions operate in the private sector, often with financial disincentives to working in more remote areas.

Aboriginal health workers are an important component of the health workforce providing necessary services to many rural and remote communities. Lack of national data on the whole of the Aboriginal health workforce limited the ability of the audit to analyse the distribution of this workforce.

When the distribution of individual health professions is considered together, there is a relatively more even distribution of the total workforce across states and territories and there is less variation across Remoteness Areas. This indicates that, at least in part, alternative mixes of services and models of service delivery being employed across Australia by states and territories and the Australian Government are combining relatively effectively. They are, however, insufficient in total to provide the necessary access in response to services to meet current demands.