Review of Australian Government Health Workforce Programs

8.1 Dental and oral health workforce

Page last updated: 24 May 2013

This section has been informed by constructive discussions at the Dental Workforce Roundtable as part of this review, as well as an analysis of the Final Report of the National Advisory Council on Dental Health, 2012 (NACDH Report).

Dental and oral health workforce programs

It is difficult to overstate the importance of dental and oral health services, and the risks posed to remote, rural and disadvantaged populations by the scarcity of affordable dental health services.

The Department of Health and Ageing (DoHA) allocates funding for a number of initiatives to improve the adequacy, quality and distribution of Australia’s dental workforce. These programs provide training opportunities and support for dentists and other oral health disciplines. The dental workforce is comprised of dental practitioners who are categorised by registration into dentists, dental hygienists, dental therapists, oral health therapists and dental prosthetists.173 In addition to these registered practitioners, this workforce also includes dental assistants.

Health Workforce Division (HWD) is responsible for a number of dental workforce initiatives which include:

  • Dental Training Expanding Rural Placements (DTERP);
  • University Departments of Rural Health (UDRH) Program;
  • Voluntary Dental Graduate Year Program (VDGYP);
  • Oral Health Therapist Graduate Year Program (OHTGYP);
  • Dental Relocation and Infrastructure Support Scheme (DRISS); and
  • Education and training support schemes, including the Nursing and Allied Health Scholarship and Support Scheme (NAHSSS), Nursing and Allied Health Rural Locum Scheme (NAHRLS), Rural Health Continuing Education (RHCE) Stream Two, Puggy Hunter Memorial Scholarship Scheme (PHMSS) and the Australian Rotary Health Indigenous Health Scholarships (Rotary scholarships) program.

In addition, a number of dental projects are managed in other divisions of DoHA which complement the HWD dental workforce initiatives as well as various dental workforce infrastructure projects.

DTERP, the UDRH program and the relevant scholarship programs have been in place for a number of years. The first cohort of participating dental graduates under the VDGYP commenced in January 2013, while the OHTGYP and DRISS are still in the development phase and will commence in 2013-14. Of these initiatives DTERP, the UDRH program and the scholarship programs are funded through the Health Workforce Fund (HWF), with the VDGYP, OHTGYP and DRISS funded under separate allocations within HWD.

There are also other Commonwealth initiatives that have assisted in supporting and developing the dental workforce such as the National Oral Health Plan and the National Advisory Council on Dental Health (NACDH). These initiatives support a high level collaborative approach and have informed HWD on current and future oral health issues, including issues related to the dental workforce. Most recently the OHTGYP and DRISS (as well as an expansion of the VDGYP) were developed, informed by the NACDH report.

Dental Training Expanding Rural Placements

As part of the broader Rural Health Multidisciplinary Training (RHMT) program, the Commonwealth funds the DTERP program, which has a current allocation of $8.3 million from 2012-13 to 2015-16 through the HWF. DTERP commenced operation in 2007-08 and is designed to help address the shortage and maldistribution of dentists, especially in rural and remote areas. DTERP provides longer-term rural clinical placements for dental students studying at six universities throughout Australia. Capital funding to establish training sites has been provided to participating universities.

The universities participating in DTERP are: University of Sydney, University of Adelaide, University of Melbourne, University of Western Australia, University of Queensland and Griffith University. The rationale for this program is based on evidence showing that, as with other health professionals discussed elsewhere in this report, graduates are more likely to consider rural careers if they have had an opportunity to undertake clinical training in a regional or rural community setting.

The universities funded under DTERP are required to develop and support extended rural training placements (in nominated ASGC-RA 2–5 areas) for at least five Australian dental students (full-time equivalent) for each full academic year of participation. Individual placements must be for a minimum of one month to a maximum of 12 months. Placements are designed to provide students with a positive experience of rural dentistry with a view to encouraging future rural service provision.

To date, dental clinics have been established in rural New South Wales (Brewarrina, Ballina and Dubbo), Victoria (Morwell), Whyalla (South Australia) and Western Australia (Bunbury). There are also other clinics due for completion in rural Queensland (Warwick, Dalby and St George). Most universities are exceeding their placement targets and it is believed that this will continue as more rural dental teaching clinics are established.

The University of Sydney has undertaken two reviews of its dental rural placement program (funded by DTERP). The review of the initial pilot program of 2008-09 indicated that 96% of the students who volunteered to participate had been encouraged to consider working in a rural setting after graduation.174 The follow-up report in 2012 indicated that of the University of Sydney dental graduates in 2009, a significantly greater number of students who had participated in the University's Rural Placement Program (45% of participants) went on to work in a rural location (RRMA 3+) compared to those graduates who had not participated in the Rural Placement Program (of whom 17% were working rurally).175

On review of forward budgets provided by universities participating in the DTERP program, it is apparent that operational costs (of supporting five full-time equivalent (FTE) student rural placements per year) outweigh the recurrent funding provided through the program. Operational costs to meet the program targets appear to be in the vicinity of $419,000 to $780,000 per dental school, while universities only receive $331,000 per year plus indexation under the scheme.

The Australasian Council of Dental Schools (ACODS) has provided advice that economies of scale would allow them to increase their FTE from five to ten with additional funding, creating greater opportunities for increased student numbers and longer rotations. Longer term placements in rural areas have been shown to support retention in the medical study programs and an increase to eight weeks under DTERP may have similar beneficial effects. As such, it is suggested that a modest expansion in support for DTERP, funded either through HWA’s clinical training funding or through a re-profiling of the RHMT program, could significantly increase the level of rural training delivered through this initiative.

The University Departments of Rural Health program

The Commonwealth funds 11 UDRHs, as part of the RHMT program. The UDRH program provides rural and remote communities with improved access to appropriate health services, by promoting professional support, education and training of the rural health workforce. Recruiting urban professionals to the country is also a focus, as is encouraging students to undertake supported clinical placements in rural and remote areas (this is further discussed in Chapter 4). Dental placements are supported as part of this program, although the level of activity varies between UDRHs. A number of UDRHs are keen to expand their activities in supporting dental training.

A submission provided by the Australian Rural Health Education Network (ARHEN) as part of this review outlines a proposal to expand the UDRH service learning model into dental training. This proposal outlines the benefits that the service learning model will have on dental training and education in rural locations. This proposal is further discussed under the Education and Training section of this chapter.

Voluntary Dental Graduate Year Program

The VDGYP was announced as part of the 2011-12 Commonwealth Budget with funding of $52.6 million over four years. The purpose of this Budget measure is to provide dental graduates with a structured program for enhanced practice experience and professional development opportunities, whilst increasing the dental workforce capacity in the public dental system and other areas of need. The first cohort of graduates commenced their placements in January 2013.

The VDGYP was developed in recognition of workforce limitations in the public dental sector, partly due to the maldistribution of the workforce. Supporting dental graduates during the first year of their career is an effective way to increase recruitment into the public sector, increase workforce capacity and reduce waiting times and potentially help improve health outcomes and reduce the burden and costs to the broader health system.

The original budget measure incorporated placements for up to 50 graduates each year from 2013. However, as part of the 2012-13 Commonwealth Budget, the program was expanded providing additional funding of $35.7 million over three years from 2013-14. The expanded program will accommodate up to 100 dental graduate placements from 2016 (with 25 additional placements in 2015 and 50 additional placements from 2016).

The VDGYP curriculum was developed by ACODS and is currently being administered by AITEC Pty Ltd. Although it is too early to establish the program’s level of success, as of January 2013 there has been 100% uptake of placements in the first cohort.

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Oral Health Therapist Graduate Year Program (OHTGYP)

The OHTGYP was announced in the 2012-13 Commonwealth Budget, providing funding of $45.2 million over four years from 2012-13 to 2015-16. Similar to the VDGYP, the OHTGYP will provide participating oral health therapist graduates with a structured one year program for enhanced practice experience and professional development opportunities, whilst increasing the oral health therapist workforce capacity. The first cohort of participating oral health therapist graduates will commence their placements from early 2014.

The program will encourage graduates to work in the public sector and will provide opportunities to utilise their full range of skills in multidisciplinary teams, ongoing professional development and support, and access to mentors.

Program design is currently being undertaken by HWD with advice sought from a reference group of key dental stakeholders including state and territory dental services, the Dental Board of Australia (DBA), the Australian Dental Council (ADC), the Australian Dental Association (ADA), the Australian Dental and Oral Health Therapist Association and ACODS. The program will seek proposals from experienced organisations to develop the OHTGYP curriculum, conduct an evaluation of the program and administer the program on DoHA’s behalf.

Dental Relocation Infrastructure Support Scheme

The DRISS was announced as part of the 2012-13 Commonwealth Budget and provides $77.7 million over four years. The scheme will offer infrastructure and relocation grants for dentists to relocate to more remote areas, and assist them to establish new practices or expand existing practices. Relocation grants, ranging from $15,000 to $120,000 (depending on the location) and infrastructure grants of up to $250,000 to help with the purchase and fit-out of dental facilities, will be available from July 2013. This is likely to be welcomed by the profession, given the capital intensive nature of dental practice.

Eligibility and selection criteria are yet to be finalised within DoHA. However, it is expected that applicants will need to be registered as a dentist with the DBA and be applying to relocate to an area in an ASGC-RA location that is more remote than their practice location in the previous 12 month period. Support for rural health academics within DRISS may need to be further explored, particularly to encourage development of the service learning model discussed elsewhere in this report.

Education and training support

The HWF allocates funding for a variety of allied health education and training support schemes which are inclusive of dentistry and oral health disciplines. The schemes include the NAHSSS, NAHRLS, RHCE Stream Two, PHMSS and the Rotary scholarships program (for further detail refer to Chapter 3).

Acute Care Division oral health programs

ACD is supporting a number of initiatives that will affect the demand for the dental workforce and assist to improve the supply of dental services. These include:

  • $2.7 billion for around 3.4 million Australian children who will be eligible for subsidised dental care under Medicare;
  • $1.3 billion for around 1.4 million additional services for adults on low incomes, including pensioners and concession card holders, and those with special needs, who will have better access to dental care in the public system;
  • $225 million for dental capital and workforce will be provided to support expanded services for people living in outer metropolitan, regional, rural and remote areas;
  • $11 million for the establishment of mobile dental infrastructure projects to service priority Indigenous communities in rural and regional areas;
  • $8.2 million in dental infrastructure projects that will boost dental services in regional Australia as part of the regional priority round of the Health and Hospital Fund;
  • $10.5 million in funding for national oral health promotion activities; and
  • $450,000 over three years to help organise professional pro bono dental health services, to assist those in greatest need.

In addition to these initiatives the Health and Hospital Fund, which is managed by ACD, has provided capital funding for 11 dental infrastructure projects with funding of more than $132.6 million since the 2009-10 Commonwealth Budget.

Key Issues

Workforce distribution

There is currently a significant maldistribution of the dental workforce in sectors (private and public) and geographically. In relation to sector distribution, the vast majority of the dental workforce is employed in the private sector (84.2% of dentists, 92.7% of dental hygienists, around 62% of oral health therapists and 90.5% of dental prosthetists). Similar figures are evident in relation to the geographic spread of the dental workforce with 81% of dentists, 87.4% of hygienists and 62.2% of dental therapists practising in metropolitan areas.176

The ADA has voiced some concerns that there is now a potential oversupply of dentists in Australia due to the introduction of new dental schools, growth of the number of students graduating from dental programs, increases in the number of overseas trained dentists passing the ADC exam and the ease of migration through the Trans-Tasman Mutual Recognition Arrangement.177 Growth in dental graduates will increase from 228 in 2006 to an anticipated 581 graduates in 2013.178 This apparent oversupply, however, has not corrected dental workforce maldistribution – that is, shortages in rural and remote areas continue.

Interestingly, stakeholder consultations at James Cook University indicated that because of a supply of new graduates in dentistry from that university, dental locums were now available in the region at an affordable price for the first time in recent memory.

The NACDH report highlighted the need to focus on providing an appropriate distribution of the dental workforce across sectors and geographical locations. The current state of the workforce can impede timely and affordable access to services for certain groups including rural and remote communities, Aboriginal and Torres Strait Islander Peoples, low socio-economic groups and those with special needs due to the predominance of metro-centric private practice models of service provision. Increased support and incentives for the public sector and additional support for academic and clinical staff was identified as key factors in addressing this maldistribution.179

All of the HWD dental workforce initiatives currently in place, as well as those under development, have a central objective of addressing the maldistribution of the dental workforce both in terms of sectors and geographic spread. The OHTGYP, DRISS and the expansion of the VDGYP were developed and informed by the NACDH report to specifically address the maldistribution of the dental workforce issues. Appropriate data capture prior to and during the program implementation stage will be pivotal in determining the success of these measures over time.

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Collaborative approach

Collaboration across the key dental stakeholders is vital if dental workforce reforms are to be successful. At the government level, collaboration between the Commonwealth and jurisdictions on current health workforce programs and future initiatives is also of critical importance. This includes being clear about funding responsibilities and distribution in relation to the oral health workforce.

A collaborative approach across dental education and training providers also has potential to increase the dental workforce in areas of need such as the public sector, rural and remote areas and services for people with special needs.

At the operational level, it is also important for oral health practitioners to have a team approach to oral health care (prevention and treatment), particularly in relation to the referral pathways. Participants at the Dental Workforce Roundtable had the viewthatthe use of a team is better entrenched within the culture of dental practice than in many other health workforces. However, improvements could be made within the public sector by further embracing the flexibility of the dental, oral health therapist and hygienist workforce and ensuring that their skills are utilised to their potential. There is scope to improve the utilisation of oral health therapists in the general public sector which will improve service delivery capacity, promote prevention and early intervention, encourage multidisciplinary approaches to care and enable dentists to focus on more complex dental service needs of the community.180

Two Commonwealth initiatives which have improved collaboration regarding dental workforce issues are the National Oral Health Plan and the NACDH.

National Oral Health Plan

The National Oral Health Plan 2004–2013 was developed in 2004 as a high level national framework aimed at integrating oral health into the health agenda and setting an overall direction for oral health, with measurable process and outcome indicators. The plan was developed in a coordinated approach with representation from the Commonwealth, state and territory governments, the oral health care professions and consumer groups. The Oral Health Monitoring Group provides regular progress reports to AHMAC on the progression of the Plan’s eight key action areas.

Workforce development is one of the key action areas in the plan. The plan has provided valuable insight into the oral health workforce and its development at a national level and has been a valuable resource in policy and program development and monitoring. A coordinated approach to developing and monitoring the oral health workforce is vital, particularly in regard to the maldistribution of the oral health workforce.

The Oral Health Monitoring Group is in the early stages of developing the new National Oral Health Plan 2014–2023.

National Advisory Council on Dental Health

The NACDH was established as part of the 2011-12 Commonwealth Budget, as a time-limited group to provide strategic, independent advice to the Government on dental health issues.181 The NACDH report was provided to the Minister for Health outlining dental policy options and priorities for consideration including in relation to the dental workforce. Aspiration Seven – Building workforce capacity for better service delivery and improved access outlined the importance of dental workforce supply and distribution.182

Data and research

Consultations as part of this review highlighted the importance of reliable data and research in developing and maintaining an efficient and effective oral health workforce. One of the main topics of the discussion at the Dental Workforce Roundtable was the need for increased funding for oral health data and research collection.

The data collection and research done by the Australian Research Centre for Population Oral Health (ARCPOH) and the Australian Institute of Health and Welfare (AIHW) Dental Statistics and Research Unit (DSRU) has proven to be a valuable resource in HWD’s policy formulation and program development and implementation.

An issue raised in the course of consultations related to the collection of accurate dental workforce figures is that overseas trained dentists are not at present included in national workforce figures. Historically, international student numbers were not significant in data collection. However, with the increase of International Dental Graduates (IDGs) in recent years, it is believed that up to 15 to 20% of dentists in the Australian workforce are overseas trained.183 Continuing to exclude these graduates will have a significant impact on the reliability of workforce data.

HWA also provides valuable insight into the dental workforce through their research and data analysis. For example, dental practitioners (dentists, dental hygienists and oral health therapists) have been included in the next release of HW2025 for workforce planning purposes, more specifically examining the training implications of the dental workforce under a range of workforce scenarios (this is further discussed in the summary of the HW2025 findings at appendix ii).184

Aspiration Eight – Enhancing data collection, research and analysis of the NACDH report outlines the importance of reliable data and research to inform on policy decision-making and program development. The report states that additional resources are required in this area, in particular there needs to be a focus on consistent data collection amongst dental stakeholders.185

Inquiry into Adult Dental Services in Australia

The House of Representatives Standing Committee on Health and Ageing is currently undertaking an inquiry into the provision of adult dental services. Part of this inquiry will focus on workforce issues relevant to the provision of dental services in jurisdictions. This inquiry will directly inform the National Partnership Agreement for adult public dental services which is a significant component of the Commonwealth’s Dental Care Reform Package.186

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Education and training

Scholarship support available for dental and oral health students is limited to generalist allied health schemes. Dental stakeholders have advocated for the Commonwealth to introduce a specific dental scholarship scheme. The NACDH report supports a specified scholarship scheme for dentistry and other oral health fields and further suggests that dental scholarship schemes could be refined to target groups with special oral health care needs. For example, scholarships for dental therapists and oral health therapists to work in aged care facilities, with a particular emphasis on working in rural and remote facilities.187

Supporting the academic dental workforce

Dental schools in Australia are currently experiencing a shortage of academic dental personnel. A key reason for this shortage is the current disparity between the salaries received by academics and those received by dentists working in the private sector. This shortage will become even more evident, given the predicted increase in students undertaking dentistry courses over the coming years. In addition, the academic dental workforce is ageing. Incentives for experienced dentists to join academia and strategies to retain current academics (for example, ensuring flexible employment conditions) are vital considerations in the recruitment and retention of high-quality academics.188 This is especially acute in rural and remote areas.

In relation to education and training, it is important to note that upon graduation dental students are fully qualified health practitioners and are eligible for registration with the ability to practise independently. This is an advantage in terms of the immediate boost to health care services newly graduated dentists can provide. However, it is obviously important that dental graduates acquire the full complement of skills and competencies during their studies and are fully prepared to practise at the time of graduation.

One of the innovations within dental education is the use of simulation training. In particular, dentistry university courses within Australia have successfully implemented a simulated learning environment into training and this plays an important role in a student’s education. HWA has acknowledged the usefulness a simulated learning environment can have in providing enhanced knowledge, skills and performance of dental students.189 The Dental Workforce Roundtable also noted that simulation training leads to better outcomes for students and therefore decreases patient risk.190

Enhancing rural dental training

Final year dental placements in rural and remote locations have shown to significantly increase the oral health outcomes for people in these communities. This was evident in the recent study of the School of Dentistry and Oral Health, Griffith University, Clinical Placement Program, which provides placements in rural, remote and Aboriginal and Torres Strait Islander communities.191

The study highlighted that dental placements in rural and remote areas not only better the oral health outcomes of the community directly but the experience may also lead to more dental graduates choosing to take up positions as fully qualified dentists in these locations. However, appropriate clinical supervision is required for students to complete a successful placement in these areas. Supervision is a key contributing factor affecting the lack of clinical training placements in rural and remote locations, particularly in very remote and Aboriginal and Torres Strait Islander communities.192

Box 8.1: Building the Rural and Remote Workforce through a Rural Oral Health Academic Program - submission193

A submission by the Australian Rural Health Education Network (ARHEN) seeking funding for a Rural Oral Health Academic Program to strengthen the oral health workforce in rural and remote areas has been considered as part of this review.

ARHEN’s submission proposes a new program which would provide supervised clinical training for final year dental students on placement with a UDRH for 12 or more weeks throughout the academic year. Clinical training would occur in the public dentistry service and students would deliver services supervised by a qualified dentist. The program model is based on principles of community-engaged learning and teaching and service learning.

The program would be delivered in partnership with the regional public dentistry services, participating Faculties of Dentistry and UDRHs. It is envisaged that funding would be provided to each participating UDRH to employ a rural Oral Health Academic (Dentist) to develop the service learning program, supervise students as well as contribute to service delivery in their own right. Access to infrastructure funding to expand public dentistry facilities for the program and to meet the relocation costs for the Oral Health Academic would also form part of the program package. The proposal further outlines that the program could be extended to other registered oral health fields.

A key objective of this proposal is increasing access to public dental services in rural and remote areas. The submission points out that final year dental students are major contributors to public dental services in metropolitan areas. However, there are questions over the capacity for final year dental students to have a positive impact on public dental services in rural and remote areas due to a lack available, appropriately qualified supervision. This issue was also identified in consultations as part of this review.

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ARHEN’s submission is supported by HWA and ACODS. The submission also directly supports aspiration seven, Building workforce capacity for better service delivery and improved access,of the NACDH report, by delivering increased support for rural clinical placements and support for dental academics within UDRH and rural clinical schools.

As mentioned in the dental workforce program section of this chapter, both DTERP and the UDRHs are providing education and training opportunities for dental students in rural areas. It is therefore important to take into account the current program activities and the relationships of the applicable universities in regard to the two programs.

In consideration of any expansion of DTERP and/or the development of the Building the Rural and Remote Workforce through a Rural Oral Health Academic Program proposal, the Commonwealth should explore how they can further complement each other, as well as any potential duplication. As DTERP and the UDRH programs are part of the broader RHMT program there may be opportunities to better align the two through a re-profiling of the broader RHMT program to significantly increase the level of rural training delivered through this initiative.

DoHA has indicated that university dental schools support the current activities undertaken by the UDRHs to increase dental education and training in rural locations. This may allow for greater crossover between dental schools and UDRHs, with an increased number of dental students taking up rural training placements. These partnerships are effective ways of meeting the needs of a broad range of dental students, but can be complex to manage and bring associated costs.

Any increase or allocation of funding should be based on capacity of the dental schools and UDRHs. The relative capacity of each UDRH to implement the program is not discussed in this submission and would need to be considered. Detailed arrangements with dental schools for facilitating student placements, as well as issues around curriculum design, require further exploration. Collaboration with key stakeholders involved in the two programs is also vital if an expansion and/or additional monies for DTERP and the Building the Rural and Remote Workforce through a Rural Oral Health Academic Program proposal are considered by the Commonwealth.

The Commonwealth should also take into account other funding allocations that are aimed at enhancing rural dental training. For example, DoHA has funded the Charles Sturt University School of Dentistry, at a capital cost of over $50 million, which commenced student intakes from 2009. A key element of the Charles Sturt model is that dental clinics at five key sites throughout rural NSW provide core training, delivering activities through an innovative public/private mix and providing high quality training and much needed dental services to these rural communities. The James Cook University dental school, which was funded through the Education portfolio, is performing a similar role in northern Queensland.

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Regulatory requirements

Since July 2010, the dental workforce has been regulated by the National Registration and Accreditation Scheme (NRAS). DBA is the national board for dental professions under the NRAS.

There are a number of issues for the dental workforce in relation to the current regulatory environment. For instance, at the Dental Workforce Roundtable there was discussion that some oral health therapists and hygienists have experienced restrictions working in public and private sectors due to varying jurisdictional and service provider interpretations of the national oral health practitioner registration requirements.194

Participants at the roundtable also raised concerns in relation to restrictions placed on the dental workforce by other pieces of legislation such as state and territory drugs and poisons legislation. HWA is close to completing a Health Professionals Prescribing Pathway (HPPP) project with the goal of harnessing the expertise of the non-medical workforce in a manner that will promote productivity and flexibility, whilst ensuring consumer safety. Integral to this project is the promotion of quality use of medicines in the context of the National Medicines Policy (addressing regulatory issues and potential barriers is also discussed in Chapter 3 of this Review).

The Australian Health Workforce Ministerial Council (AHWMC) tasked HWA to review the roles and scope of practice of dental therapists and dental hygienists. The HWA report was provided to AHWMC in April 2012. The AHWMC requested the DBA to provide advice on the scope of practice and new models of care and training as part of the impending review by the DBA of the Scope of Practice Registration Standard.

In addition to the review of the Scope of Practice Registration Standard, the DBA will review all registration standards, codes, guidelines and policies that were developed prior to the establishment of the NRAS. The DBA has commenced the consultation process with key stakeholders in relation to these reviews.

The NACDH report supported the review of the scope of practice of dental practitioners, arguing that the scope of practice of oral health therapists, dental therapists and dental hygienists should be expanded to allow for treatment and services to broader population groups. The report notes that extending the scope of practice of oral health therapists, dental therapists and dental hygienists may relieve the time and cost pressures associated with dentists.

Recommendations
Recommendation numberRecommendationAffected programsTimeframe
Recommendation 8.1The Commonwealth should closely monitor the current work being undertaken by Health Workforce Australia (HWA) and the Dental Board of Australia (DBA) in relation to the scope of practice for oral health therapists, dental therapists and dental hygienists to inform the design of future health workforce programs.NilMedium term
Recommendation 8.2The Commonwealth should continue with the implementation of the Oral Health Therapist Graduate Year Program (OHTGYP), the Voluntary Dental Graduate Year Program (VDGYP) and the Dental Relocation and Infrastructure Support Scheme (DRISS). While implementation for these relatively new programs appears to be on track, it will be important to monitor outcomes.OHTGYP, VDGYP, DRISSOngoing
Recommendation 8.3The Dental Training Expanding Rural Placements (DTERP) program has potential to provide increased numbers of student placements for a modest additional investment. Funding could be identified from within the existing Rural Health Multidisciplinary Training (RHMT) program, or through HWA. This program is strongly supported by the dental schools and appears to be delivering useful outcomes for the distribution of the dental workforce and to expand the service learning model.DTERP, RHMTShort term – dental schools have advised that this program is ready to be expanded almost immediately, subject to receiving extra funding.
Recommendation 8.4The Australian Rural Health Education Network (ARHEN) proposal for a rural oral health academic program has merit and should be explored further in close consultation with dental schools, as a way of supporting the dental workforce in rural locations. The alignment of this potential new investment with the existing DTERP program needs to be carefully considered to avoid potential overlap, noting that some University Departments of Rural Health (UDRH) have the potential to act as new training sites for dental and oral health students. UDRH programMedium term – subject to available funding.
Recommendation 8.5The Commonwealth should encourage key agencies (e.g. HWA and the Australian Institute of Health and Welfare) to improve data collection to inform policy development of the dental and oral health workforce. This should include better data on workforce distribution and the academic dental workforce.NilLonger term

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173 Dental Board of Australia webpage on registration, accessed at www.dentalboard.gov.au/Registration

174 G. Johnson and A. Blinkhorn, Report of the evaluation of the rural placement program, University of Sydney, 2010

175 G. Johnson and A. Blinkhorn, An Evaluation of a Clinical Rural Placement Scheme for Universities of Sydney Dental Students - Evaluation Report 2: A look at the Second Year of the Scheme’s Implementation, University of Sydney, 2012

176 Final Report of the National Advisory Council on Dental Health, 2012

177 ibid.

178 Figures provided by ACODS at the Dental Workforce Roundtable of the Review of Commonwealth Health Workforce Programs, 2012

179 ibid.

180 National Advisory Council on Dental Health, Report of the National Advisory Council on Dental Health, 23 February 2012, p. 63

181 Commonwealth of Australia, Budget Paper No. 2, 2011-12, Commonwealth of Australia, 2011, p. 216

182 National Advisory Council on Dental Health, pp. 62–63

183 Review of Commonwealth Health Workforce Programs - Dental Workforce Roundtable, 2012

184 Health Workforce Australia, 2011-12 Work Plan Progress Report, Summary of Progress from 1 July 2011 to June 2012

185 National Advisory Council on Dental Health, pp. 63–64

186 House of Representatives Standing Committee on Health and Ageing, Terms of reference of the Inquiry into Adult Dental Services in Australia, 2013, accessed at http://www.aph.gov.au/Parliamentary_Business/Committees/House_of_Representatives_Committees?url=haa/dental/tor.htm

187 Final Report of the National Advisory Council on Dental Health, 2012

188 ibid.

189 Health Workforce Australia, Use of Simulated Learning Environments (SLE) in Professional Entry Level Curricula of selected professions in Australia, Health Workforce Australia, Adelaide,2010

190 Review of Commonwealth Health Workforce Programs - Dental Workforce Roundtable, 2012

191 R. Lalloo, J.L. Evans and N.W. Johnson “Dental care provision by students on a remote rural clinical placement”, Australian and New Zealand Journal of Public Health, Vol 37(1), 2013

192 ibid.

193 Australian Rural Health Education Network, “Building the Rural and Remote Workforce through a Rural Oral Health Academic Program”, submission to the Independent Review of Australian Government Health Workforce Programs, 2012

194 ibid.