DoHA engaged an independent consultant, Kristine Battye Consulting, in 2011-12 to evaluate a number of Aboriginal and Torres Strait Islander health workforce initiatives, with a final report provided to the Department in April 2012. The evaluation included two components. The first component considered the Training Package, including the funding provided to the WIPOs and peak organisations (AIDA, IAHA, CATSIN, NATSIHWA and LIME network). The Committee of Presidents of Medical Colleges (CPMC) Indigenous Health Subcommittee Program and Indigenous Transition to Medicine Pathways Program (ITMPP) were not included in the evaluation because they were funded after the announcement of the Training Package and not formally part of the Package. The second component of the evaluation covered the RTOs, which included the four RTOs currently funded under the HWF.
The purpose of the RTO evaluation was to:
- provide an overall assessment of the effectiveness of the Training Package in reaching its key goals;
- ascertain if organisations have met the required deliverables of the funding agreements developed as part of the Training Package;
- provide recommendations to inform future activities under the Training Package; and
- provide the Department with a report and recommendations detailing:
- possible sustainable business models aimed at supporting RTOs;
- standard reporting measures that could be used in the future across all community-controlled RTOs measuring organisational effectiveness; and
- possible strategies for implementing the RTO recommendations in an effective way.
There are many crossover points in Aboriginal and Torres Strait Islander health workforce funding, not only within DoHA but also between other Commonwealth agencies. It is important to take a more collaborative approach to the training of the Aboriginal and Torres Strait Islander health workforce.
This review supports the recommendations outlined in the Training Package Evaluation and the Registered Training Organisation Evaluation of the Battye Review (refer to Appendix ix). The recommendations put forward by the Battye Review for each of the two components should be pursued as a priority. In summary, the Battye Review recommended:
- DoHA implement a process to ensure stronger collaboration across divisions, particularly between HWD and OATSIH, in the development of Aboriginal and Torres Strait Islander health workforce policy and program development. Issues around funding workforce program implementation roles and advocacy roles for peak organisations need to be resolved, with the different groups subsequently funded on a clear and sustainable basis for the full range of activities they are expected to perform.
- DoHA work more closely with DEEWR, FaHCSIA and DIICCSRTE rather than taking on responsibilities that are outside of the Health Portfolio.
- To achieve stronger collaboration both internally and with key whole of government partners, an Intradepartmental Committee within DoHA could be established which would then actively work with DEEWR, FaHSCIA and DIICCSRTE. This committee should then work to address relevant recommendations made by the Battye Review in relation to RTOs.
- HWD, in consultation with OATSIH, continue to work with organisations to identify the activities that are required under the funding agreements of the Training Package and/or the funding allocated to the RTOs.
|Recommendation number||Recommendation||Affected programs||Timeframe|
|Recommendation 5.1||There must be better coordination of activities aimed at increasing the capacity of the Aboriginal and Torres Strait Islander health workforce, across the Department of Health and Ageing and across other Commonwealth agencies working in this area including Health Workforce Australia, the Department of Families, Housing, Community Services and Indigenous Affairs, the Department of Education, Employment and Workplace Relations and the Department of Industry, Innovation, Climate Change, Science, Research and Tertiary Education. This should include the formulation of clear implementation plans, timelines and reporting processes to avoid the current potential for policy stalemates.||All Aboriginal and Torres Strait Islander health workforce programs||Short term – enhanced coordination should commence as soon as possible.|
|Recommendation 5.2||The Commonwealth should continue to fund peak Aboriginal and Torres Strait Islander bodies/networks (under the Training Package) to help drive progress in Aboriginal and Torres Strait Islander health education and training for both health students and the health workforce.||Aboriginal and Torres Strait Islander Health Workforce Training Package||Short term – ongoing.|
|Recommendation 5.3||The Commonwealth should continue to consult with the National Congress of Australia’s First People’s National Health Leadership Forum, as the collective and consultative forum of peak Aboriginal and Torres Strait Islander health workforce bodies. This forum should continue to assist in collaboration and coordination within and between these organisations.
The Commonwealth should also ensure that it continues to work closely with the National Health Leadership Forum on the ongoing implementation of strategies arising from community consultations and the recommendations of this review of health workforce programs.
Engagement between the National Health Leadership Forum and cross-jurisdictional consultative groups such as the Health Workforce Principal Committee should also be considered in this context.
Complementary consultative arrangements, through a regular working group similar to those of the Coalition of National Nursing Organisations, may be beneficial in achieving implementation of identified strategies.
|Discussions between HWD and OATSIH on consultation activities.||Medium term – allowing appropriate time for consultation with key groups.|
|Recommendation 5.4||The Commonwealth should build on the success of the Leaders in Indigenous Medical Education (LIME) Network by extending its reach or reconfiguring this group to include support and mentoring for all Aboriginal and Torres Strait Islander tertiary level health professional students, including nurses and midwives, dentists and allied health professions.
Alternatively, activities of the LIME Network could be adopted by other networks in their specified health discipline.
|Aboriginal and Torres Strait Islander Health Workforce Training Package||Short term|
|Recommendation 5.5||The Commonwealth should develop and implement a new national program specifically aimed at:
Alternatively, there may be an opportunity to extend the existing workforce and support component of the Indigenous Chronic Disease Package to achieve the above aims.
Possible mechanisms to achieve the program outcomes should be further explored including options for delivery such as virtual support and/or support units with physical office locations.
Extending the Aboriginal and Torres Strait Islander support units which are currently in place in various universities should be considered rather than duplicating current efforts. Support units will need to vary from location to location, taking into account the service delivery environment and, where appropriate, encouraging collaborative regional support hubs. These regional support hubs should incorporate partnerships between universities.
The program should extend to all tertiary health professional courses (as opposed to medicine only). Program targets should have key performance indicators, such as the percentage of students entering or graduating that are of Aboriginal and Torres Strait Islander background relative to the Aboriginal and Torres Strait Islander population at either a national or geographic regional level.
Partial funding for this Aboriginal and Torres Strait Islander health program could be redirected from the current Rural Clinical Training and Support (RCTS) program.
Indigenous Chronic Disease Package
Funding source to be identified through cross-portfolio discussions.
Medium term – this reform and extension of the current RCTS targets should be considered when existing agreements with universities expire. Additional funding beyond the RCTS program is likely to be necessary to achieve a sustainable investment across health disciplines.
Longer term – subject to the availability of funding and engagement with both Aboriginal and Torres Strait Islander groups and the university sector.
|Recommendation 5.6||Recommendation 5.5 should be complemented by the development of Aboriginal and Torres Strait Islander academic leaders/champions and Aboriginal and Torres Strait Islander student support networks that would provide culturally appropriate mentoring, counselling and, if appropriate, pastoral care type activities to all Aboriginal and Torres Strait Islander health students. This may also include providing support to students’ direct family members, which may assist the student to remain in study and graduate.
This could be achieved by further developing the “Health Heroes” (part of the Indigenous Chronic Disease Package).
Funding source to be identified through DoHA and cross-portfolio discussions.
“Health Heroes” (Indigenous Chronic Disease Package).
|Longer term – as above.|
|Recommendation 5.7||The Commonwealth should take action to implement those recommendations directed to Registered Training Organisations as outlined in the Battye Review. There does not appear to be any compelling reason to further postpone implementation of these recommendations, which were well considered.||Aboriginal and Torres Strait Islander Health Workforce Training Package.||Medium term – implementation should commence on a case-by-case basis as existing funding agreements expire.|
|Recommendation 5.8||The Commonwealth should consider options for the establishment of an Aboriginal and Torres Strait Islander Nursing and Midwifery Policy Adviser role within one of the nursing peak bodies.||Aboriginal and Torres Strait Islander Health Workforce Training Package.||Short term|
|Recommendation 5.9||The NT Medical Program’s Indigenous Transitions Pathway program should be further evaluated to assess its outcomes before considering future options for mentoring Aboriginal and Torres Strait Islander students.
If the evaluation demonstrates positive outcomes in terms of increased students graduating and increased retention of these students in the surrounding communities, an increase in numbers and funding should be considered.
|Aboriginal and Torres Strait Islander Health Workforce Program, NT Medical Program||Medium term|
|Recommendation 5.10||The Commonwealth should further investigate activities related to the connectivity of the education and training sectors from school, through the vocational education and training (VET) sector and on to undergraduate studies, with multiple entry points supported for younger and mature students. This will encourage more Aboriginal and Torres Strait Islander students studying health professions (over 7000) in the VET sector to progress to tertiary-based study programs by building on their success in prior health education and training programs.||Nil
This is in part a DEEWR program responsibility.
|Short term – this policy work should commence following this Review.|