Review of Australian Government Health Workforce Programs

5.4 Health workforce recruitment into Aboriginal and Torres Strait Islander communities

Page last updated: 24 May 2013

Remote Area Health Corp

The Remote Area Health Corp (RAHC) program commenced in 2008 under the Expanding Health Service Delivery Initiative, which was part of the Closing the Gap in the Northern Territory measure. The RAHC program now operates under the Stronger Futures in the Northern Territory National Partnership Agreement (NPA). The RAHC aims to address critical health workforce shortages in remote Indigenous communities in the Northern Territory by attracting and recruiting urban-based health practitioners and placing them in short-term placements in those communities where there is demand.

A total of $36.6 million has been committed for the RAHC program from July 2008 through to June 2014, with funding identified through to 2021-22. However, from 2014-15, funding delivery will be informed by an evaluation of the Stronger Futures in the Northern Territory measure.

The administrator of the RAHC, Aspen Medical Services, provides data to DoHA on a weekly basis, showing the number and type of practitioners placed. However, this data does not capture how the practitioners are utilised as part of their placements.

A cost comparison between the RAHC Funding Agreement and the Nursing and Allied Health Rural Locum Scheme (NAHRLS), which is operated by Aspen Medical Services, who also administers the RAHC, shows that the cost per placement of the two schemes is comparable, with the RAHC costing $13,222 per placement and the NAHRLS costing $12,781 per placement.

The independent review of the RAHC in 2009-10 found that the program complements other government initiatives by providing a mobile health workforce, which can be deployed at short notice to fill short-term gaps. This in turn enables better delivery of all government programs that are administered in remote Indigenous communities in the Northern Territory.

The RAHC program also increases the exposure of urban-based health professionals to working in remote settings with Aboriginal and Torres Strait Islander people. The experience gained from working in these environments can provide vital on-the-job training that health practitioners can extend to their work with Aboriginal and Torres Strait Islander people in urban areas. Some of these health practitioners may also choose to stay on in remote communities in a permanent capacity, thus increasing the size of the permanent workforce in remote areas.

The RAHC is considered to be successful in providing health practitioners who are motivated, effective, culturally sensitive and clinically competent to Aboriginal and Torres Strait Islander communities in the Northern Territory. It is important to monitor the outcomes of the evaluation of the RAHC as part of the Stronger Futures in the Northern Territory measure, as the future of RAHC funding will be determined as part of that evaluation.

Aboriginal and Torres Strait Islander Health Workforce Training Package

Funding support of $50.9 million is allocated from 2012-13 to 2015-16 under the HWF to promote and improve pathways for Aboriginal and Torres Strait Islander people into the health workforce.

Funding for the National Aboriginal and Torres Strait Islander Health Workforce Training Package (Training Package) constitutes the bulk of HWF funding. Funding of $37 million over five years has been committed to implement the Training Package which includes support for the following organisations (some of which have been referred to already within this chapter):

  • Australian Indigenous Doctors Association (AIDA);
  • Congress of Aboriginal and Torres Strait Islander Nurses (CATSIN);
  • the Medical Deans Australia and New Zealand for the LIME network;
  • the Workforce Information Policy Officers (WIPOs) in each National Aboriginal Community Controlled Health Organisation affiliate;
  • the Aboriginal and Torres Strait Islander Health Registered Training Organisation National Network (ATSIHRTONN);
  • Indigenous Allied Health Australia (IAHA); and
  • National Aboriginal and Torres Strait Islander Health Worker Association (NATSIHWA).

DoHA also funds a number of Aboriginal community-controlled registered training organisations (RTOs) under the Training Package. Some of this funding is provided through OATSIH state and territory offices whilst other RTOs are funded directly. The funding is historically‑based, and like much grant and application based funding, there is a possibility that it is not being deployed strategically or in an equitable manner across regions or communities. In addition, the quantum of funds is not proportional to the student load of the RTOs, the range of qualifications they are able to provide, or the level of remoteness.

The HWF allocates funding to four Aboriginal community-controlled RTOs, including:

  • Central Australian Remote Health Development Services;
  • Kimberly Aboriginal Medical Services Council;
  • Nganampa Health Council Registered RTO – located in the APY lands; and
  • Aboriginal Health Council of South Australia.

Funding to RTOs has not been reviewed until recently (as part of the Battye Review). In line with the Battye Review’s recommendation (discussed below), the provision of funding to RTOs would be better aligned with the expertise of education portfolio(s).

Several of the organisations/networks funded under the Training Package existed for some time prior to its implementation in 2009. Prior to the Training Package, funding was allocated to organisations and networks from various divisions across DoHA. The organisations are not funded for the broader work that some are currently attempting to undertake (e.g. broader advocacy activities in international fora) and this is said to have created some difficulties for the funded organisations in achieving the required activities set in their respective funding agreements. However, advocacy is not an activity that is currently specified as part of the Training Package and therefore is not set out in the organisations’ funding agreements. Further investigation into the best way that DoHA can assist these organisations with resources for appropriate advocacy work, whilst not impeding the current activities funded through the Training Package, should be explored in discussions between HWD and OATSIH.

Table 5.3 outlines the funding provided to the peak bodies/networks and RTOs under the Training Package, as well as the broader activities they are currently undertaking.

Table 5.3: Peak bodies/networks and RTOs under the Training Package

* Figures include GST

Organisations/NetworksFunds Committed 2012-13*Activities
Peak bodies/networks
Congress of Aboriginal and Torres Strait Islander Nurses (CATSIN)
$440,000
CATSIN provides support to Aboriginal and Torres Strait Islander nurses with an aim of increasing the recruitment and retention rates of the nursing workforce.
Australian Indigenous Doctors Association (AIDA)
$2,436,291
AIDA represents Aboriginal and Torres Strait Islander medical graduates and students in Australia. It provides support to Indigenous doctors and medical students, whilst providing advice to government, medical and education sectors on Indigenous health issues.
National Aboriginal and Torres Strait Islander Health Worker Association (NATSIHWA)
$1,323,300
NATSIHWA is the peak body for Aboriginal and Torres Strait Islander health workers and practitioners in Australia. The aim of NATSIHWA is to achieve recognition of this workforce as a vital and valued component of a strong professional Aboriginal health workforce.
Indigenous Allied Health Australia (IAHA)
$1,540,000
IAHA is the peak body for Aboriginal and Torres Strait Islander allied health professionals in Australia. IAHA contributes to improved knowledge and competencies of allied health practitioners working with Aboriginal and Torres Strait Islander peoples and their communities.
Aboriginal and Torres Strait Islander Health Registered Training Organisations National Network (ATSIHRTONN) Secretariat
$572,530
The ATSIHRTONN secretariat provides a mechanism for a consistent, streamlined and collaborative approach between Aboriginal RTOs in the planning and delivery of culturally relevant education and training in Aboriginal and Torres Strait Islander health.
Medical Deans Australia and New Zealand for the Leaders in Indigenous Medical Education (LIME) Network
$500,483
The LIME network seeks to promote collaboration between medical schools to support the implementation of high quality development, delivery and evaluation of Indigenous content in medical curricula. It also seeks to build multidisciplinary and multi-sectoral linkages. It recognises and promotes the primacy of Indigenous leadership and knowledge.
Committee of Presidents of Medical Colleges –Indigenous Health Subcommittee
$80,084
Develop and report on the National Aboriginal and Torres Strait Islander Medical Specialist Framework to improve Indigenous health in specialist training.
Workforce Information Policy Officers (WIPOs)
$1,221,089
WIPOs are funded in each of the state and territory NACCHO affiliates to work with key stakeholders to encourage recruitment into the Indigenous health workforce.
Registered training organisations
Central Australian Remote Health Development Services
$330,000
Community-controlled RTOs providing formal (under the VET sector) and informal education and training to Aboriginal and Torres Strait Islander health workers.
Kimberly Aboriginal Medical Services Council
$372,267
Community-controlled RTOs providing formal (under the VET sector) and informal education and training to Aboriginal and Torres Strait Islander health workers.
Nganampa Health Council Registered RTO – located in the APY lands
$261,320
Community-controlled RTOs providing formal (under the VET sector) and informal education and training to Aboriginal and Torres Strait Islander health workers.
Aboriginal Health Council of South Australia
$298,100
Community-controlled RTOs providing formal (under the VET sector) and informal education and training to Aboriginal and Torres Strait Islander health workers.