Health Workforce Planning in Australia: Evolution or Devolution?
摘要
A capable, skilled, and empowered health workforce, large enough to meet the healthcare demands of the population, is essential in any high performing, sustainable health system. The OECD recommends the adoption of evidence-based, data-driven, consultative, inter-professional workforce planning processes supported by practical, adaptable implementation and financial plans that respond to changing health system contexts and demands. We describe the approach taken for workforce planning at the national level in Australia (1995–2024) while comparing two key strategies released in 2012 and 2021 against OECD recommendations. In Australia, at least seven different bodies have been responsible for medical workforce planning at the national level since 1995. With the establishment in 2008 of a dedicated independent body, Health Workforce Australia (HWA), and the release of Health Workforce-2025 in 2012, Australia moved towards adopting a more sophisticated data-driven, evidence-based, and inter-professional workforce planning approach to shore-up health systems of the future. However, HWA was abolished in 2014 and a replacement strategy, Medical Workforce 2021–2031 was released in 2021. Conducting a comparative policy analysis, we found that the earlier strategy aligned more fully with the OECD recommendations. Medical Workforce 2021–2031 failed to build upon Health Workforce-2025. It returns to a uni-professional approach focussing only on doctors, and it hardly mentions HWA or Health Workforce-2025, while calling for the establishment of a dedicated body responsible for medical workforce planning—a “back-to-the future” moment as Australia already had such a body in HWA. In August 2024, as Australia continued to face significant and ongoing health and medical workforce shortages, a new body, the Medical Workforce Advisory Collaboration (MWAC), was established. Only time will tell whether the new MWAC will have a positive influence and encourage the needed action while leveraging previous sophisticated data-driven strategies to ensure a stable, equitably distributed, and appropriately skilled health workforce for Australia.