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Tuesday, May 17, 2022

Securing Australia’s medical workforce will avert pending health crisis: Go8

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The Group of Eight (Go8), made up of the University of Western Australia, Monash University, the Australian National University, the University of Adelaide, the University of Melbourne, UNSW Australia, the University of Queensland and the University of Sydney, has called on an incoming government to move quickly to avert a looming medical crisis as Australia’ depleted healthcare workforce copes with increasing demand and pressure in a post pandemic world.

Essential Decisions for National Success: Securing the Future of Australia’s Medical Workforce is one of a series of policy papers from the Go8 in the lead-up to the federal election.

The papers aim to support the development of government policy to meet the challenges ahead.

Go8 chief executive Vicki Thomson said COVID-19 has exacerbated the burn-out rate among healthcare workers, Australia can no longer rely on international medical graduates (IMGs) to fill workforce gaps, and it takes 10-15 years to fully train a medical professional.

“Addressing medical workforce issues is complex, however complexity must not be a barrier or an excuse not to reform,” Thomson says.

“We have taken advice from a wide range of stakeholders, including experts from state, territory and Commonwealth health departments, public and private health services, medical profession and student peak bodies, rural, regional and remote health bodies.

“They agree that delivering Australia’s future medical workforce will require a step change and bold reform.

The Go8’s starting point is an immediate increase in the national supply of domestically trained medical practitioners, Thomson says.

“The Australian community needs certainty around health services and a secure supply of domestically trained medical practitioners will assist this greatly.

“To increase our sovereign capacity – even without increasing the total number of doctors in Australia – requires at least an additional 1000 domestic graduates per year.”

“We also need to adopt a formal sovereign capability charter for Australia’s medical workforce.”

International medical graduates will always play a critical role in Australia’s medical workforce, particularly in regional areas, Thomson believes.

“Australia currently recruits as many international medical graduates annually as there are domestic graduates from Australian medical schools.

“This is not sustainable. Nor should it ever be a preferred option of any government.”

Australia’s major political parties are aware of the impending crisis.

The Morrison Government announced 80 new Commonwealth Supported medical school places attached to medical schools with rural campuses in the 2022-23 Budget, and more recently $146 million in new funding for more doctors and allied health professionals in regional and rural communities.

Opposition leader Anthony Albanese said in The Australian on April 26 that action is required.

“Australia’s severe shortage of nurses and doctors [is an issue]… We should be training up Australians to meet our medical workforce needs,” he said.

Thomson says the Go8 is definitive in stating that securing the future of the nation’s medical workforce requires a serious long-term commitment, which has at its core a National Medical Data Strategy and a commitment to address the geographic maldistribution of the medical workforce.

She says health and access to healthcare are top issues of concern for Australians.

“The demand on Australia’s medical workforce will increase as Australia’s population is growing older, faster than expected, putting increased pressure on our health system,” she says.

The AMA says while it welcomes the contribution of the Go8 to the current debate over medical workforce supply, more medical school places doesn’t necessarily mean more doctors where they are needed.

Its call for 1000 extra Commonwealth-supported medical school places is premature, the AMA says, and potentially diverts funding away from where it is desperately needed.

AMA President Dr Omar Khorshid says while medical workforce shortages, including of specialist and GP services, are having a real impact on patients in some parts of the country, a return to a boom/bust approach to medical workforce decisions was not the answer.

“Australia has increased medical school intakes dramatically over the last 15 years and now graduates medical students at a rate well above the OECD average,” Khorshid says.

“For example, in 2019 in Australia there were 15.9 medical graduates per 100,000 inhabitants, compared to the UK with 13.1, Canada 7.1, and the USA 8.1.

“Unfortunately, Australia is not doing enough to encourage these record medical graduate numbers to work in the locations and specialties where they are most needed, and this is where most policy effort should be focused.

“The Go8 report gives this very little attention and its upfront call for 1000 extra medical school places is lazy policy that ignores the need for proper medical workforce planning to inform how these shortages should be addressed,” Khorshid says.

He says Australia can deliver much better patient access to medical services right now by looking more closely at opportunities to bolster prevocational and specialist training places around the country.

He says the AMA has set out a comprehensive strategy for this including:

  • Promoting a career in general practice by growing prevocational training opportunities in general practice and improving employment conditions for General Practice Registrars so they match their hospital-based colleagues.
  • The expansion of the Commonwealth Government’s Specialist Training Program (STP) to 1700 places over the next term of Government, giving priority to rural areas, generalist training and specialties that are under-supplied.
  • Investment in regional teaching hospitals to ensure they have sufficient capacity to host STP-funded non-GP specialist registrars.
  • Implement the National Rural Generalist Pathway nationally, and a commitment to ongoing funding.
  • Encouragement of end-to-end rural medical training programs, with a view to ensuring they provide positive rural exposure and lead to retention of rural medical practitioners.
  • Expansion of capacity for remote learning (training and educational opportunities, especially for trainees in regional/rural sites, and potential remote supervision); and
  • Promotion of regional training and research teaching hospital hubs to grow non-GP specialist capacity outside metropolitan areas.

Khorshid says the AMA’s policy proposals were comprehensive and dealt with medical workforce shortages with the detail required.

“Australia now has a National Medical Workforce Strategy.

“We agree with the Go8 that this must be funded and implemented as a matter of urgency, with data driven medical workforce supply and demand modelling being an urgent priority.

“If these processes recommend changes to medical school intakes, we should follow them.

“Medical training does not stop when someone graduates from medical school with several years of prevocational and specialist training beyond.

“If Australia is to increase medical student numbers, it must be based on planning that includes consideration of the whole medical training pipeline from medical school through to College Fellowship.”

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