Australia urgently needs a health workforce plan

May 2, 2022

Opinion editorial by Tom Symondson, CEO of the Victorian Healthcare Association. This article was first published in The Age on 2 May 2022.

As the weather turns colder and the nights draw in, we face our first winter since 2019 without significant COVID restrictions. After everything we have been through, that is undoubtedly something to celebrate. But the shadow of the pandemic still looms large over our health system.

Across the nation, emergency departments are overflowing, ambulances are ramped and waiting lists for elective surgery and specialist care are at record levels. In Victoria, we now have more than 89,000 people waiting for elective surgery, and last month four regional hospitals called a ‘Code Yellow’ because they didn’t have enough staff to meet emergency demand.

These are genuine problems and they are getting worse. But despite what our federal politicians may think, simply throwing more money at the system won’t fix our core problem, even if it does make for a good media announcement. While more infrastructure is always welcome, the main problem we have right now is workforce. We have never experienced such an extreme shortage of qualified health workers in Australia.

It’s a fair bet that every hospital in Australia is advertising jobs right now. There are thousands of positions available in Victoria alone, including many in rural and regional areas where the problem is compounded by the dearth of affordable housing options. On top of that, Victoria has about 1,500 healthcare workers furloughed every day due to COVID-19 and more workers than usual are burning out after two extraordinary years.

The tricky thing is, the problem is urgent – especially with so many people waiting too long for surgery and emergency care – but many of the solutions are complex and take time to deliver.

The National Skills Commission predicts Australia will require 250,000 more skilled health and social care workers just in the next five years. But do we know exactly who we’re looking for and where we need them to work? A Victorian parliamentary inquiry recently heard there was no public record of the total number, and type, of healthcare workers employed in our public hospitals in Victoria right now. So how are we meant to forecast what we need in five or 10 years’ time?

There are three main sources of skilled health workers, each with its own pros and cons. You can grow the domestic pipeline through funding more university and TAFE positions, but this takes time – it takes 10-15 years to train a doctor; you can upskill already qualified workers to help them take on more complex roles, but this can create gaps in the roles they leave behind; and perhaps the simplest solution, in theory, is to import qualified workers from overseas.

But even migration is problematic in a hot global market for workers. The Victorian Government has been offering incentives of up to $13,000 for overseas trained health professionals to migrate to Australia over the past year. But they have had limited success partly because Australia’s skilled visa system is letting Victoria down. It can take more than 20 months for an application to be processed and when workers do arrive, there can be even more challenges such as difficulty in finding affordable housing, and no pathways to permanent residency. All of this makes it a tough sell to get people to uproot their families and move them halfway across the world.

Other countries are moving quickly, and our federal politicians need to do the same to avoid Australia being left behind. The UK recently created a new visa class for health workers to tackle its shortages. The Health and Care Worker Visa allows qualified doctors, nurses, social care workers, and their families to settle in the UK for five years. Decisions are made in three weeks and applicants can ultimately become permanent residents. Why can’t Australia do the same?

These problems require immediate attention if our health system has any chance of recovering from COVID-19 and catching up on long waiting lists for care because demand will only continue to rise. An ageing population and more illness in the community was already increasing demand before the pandemic. In 2019, 40 per cent of Australians aged over 45 years had two or more chronic diseases – a trend likely to be even worse now.

So, if we value access to quality health care for ourselves and our loved ones, we need a workforce roadmap to deliver it that deals with domestic training, upskilling and migration amongst other things. Piecemeal policy announcements that overlook our dire workforce shortages will no longer cut it. We need a comprehensive plan to retain our precious health care workers and to recruit others to join them. At the end of the day, all of our lives may depend on it.