Objectives of Health Workforce Planning in Australia

In order to develop a health workforce which can offer primary to tertiary sector services needs a well-established infrastructure for governance. In this regard proper assessment of the health workforce, development of the policy, regulating and supervising requires dialogue amongst the stakeholders ranging from government to non-government partners who are dedicated to create a responsive and sustainable workforce.

In this regard, WHO responses to the challenges by providing a range of policies and strategies to its member states in the West Pacific Region for developing a workforce which is competent, responsive, sufficiently supported and to meet the health needs of the population. The strategy comprises of five objectives which focus around three areas viz. development, positioning , supply and retaining of an effective and efficient workforce .Governance and management of the workforce and thirdly , developing a workforce which is responsive to the health needs and demands of the population residing in those countries (World Health Organization ,2013).

So, in this report, the health workforce plans of Australia and Philippines would be compared and contrasted to analyze the strategies adopted by both the countries in formation of their health workforces. For this purpose, the environmental scan of the health workforce of both the countries would be evaluated through assessing the policy and planning documents of both the countries. The data profile of each country would be evaluated using the data provided by WHO in this context. On the basis of the evaluation, the issues to be addressed in each   country would be identified and using the framework of recommendations, it would be determined if each of them is addressing and adopting the priorities developed by WHO in their health workforce plans.

The purpose of comparing the health workforce planning of Australia and Philippines is that the former belongs to the high income group whereas the latter belongs to the lower middle income group. It will assist in comparing the health workforce strategies adopted by both the countries and the disparities of distribution of the health workforce facilities especially in the lower middle income group countries in particular.  It will also assist in finding solutions to fill the gaps in the supply and demand of the health workforce in both the countries.

Over 60% of the nurses in Australia are employed by facilities which are financed, administered and managed by the governments of state and territories.  However, many of them have been placed under severe restrictions regarding the increase in their wage structures through imposing stricter legislations on them or by negotiating for their salaries. The employers in the private medical care sector continue to follow the wage structure and conditions for nurses as per the public sector and the nurses employed in the aged care amenities in the residential areas receive wages and are employed at standards which are comparatively below in the hospital sector (Finnish Nurses Association, 2015).

Challenges faced by the Health Workforce in Australia

Apart from this, the new federal government has formulated a policy targeted to cut the budget of the health facilities which will severely impact the universal health system of Australia and shall reduce the accessibility of the primary health care services to the low middle income groups and the sick in Australia. It will also result in reduction of funding to be provided to the states and territories which were previously committed to meet the growing demands of health care services and workforce.

However, the federal governments still continues to instill major reforms for delivering major reforms for consumer centered and market driven aged care system of Australia.  A code of conduct was developed for the health care workers so that occupational standards can be followed to inculcate   safe and ethical practices by the health workforce. In this context another reform which is introduced in the health care sector is transforming the enrolment model and installing the personally controlled electronic health record in the health care system.  A set of consistent and authoritative health workforce framework has been evaluated for the planning of health workforce planning. It provides a means for planners to supervise the impact of the significant changes on the health systems and the supporting social and economic environment (Commission on Filipinos Overseas, 2012).

The health workforce of Philippines is influenced by the international migration of nurses. Between 1992 and 2004, about 100000 nurses left the country to work because they were getting better employment opportunities abroad as a result there was a great rise in the annual departure of nurses from the country. The emigration of nurses has depleted the workforce dramatically with its severe impact on the rural areas of the country. It has also resulted in the loss of medical practitioners who have been retrained as nurses so that they can secure their jobs in other countries.

According to a research by Health Alliance for Democracy (HEAD), it was found that 80% of the medical practitioners have applied for working in other countries while 90% of the municipal health officials were planning to settle abroad due to better working opportunities.

The increase in private sector health workforce education    has increased the number of institutions to provide medical training to the students but they are often confronted by quality issues. Most of them lack in efficient regulatory mechanisms. The graduates applying for the Nursing Board examination has tripled almost every year between the years 2000 and 2005. But the according to a study , 60% of the nursing schools saw a deterioration in their quality since only 50% of the graduates passed the Nursing examinations .Amongst 20 of the schools were not  produce even a single graduate who had passed  in the examinations( HRH Global Resource Center ,n.d.).

Objectives of Health Workforce Planning in Philippines

However, the Philippines Commission on Higher Education in nursing has applied certain measures to discontinue the nursing programs and institutions which are showing no improvement in their performance or do not abide by the standards issued in this regard.

A Human Resource for Health Master Plan 2005-2030 in Philippines has been developed and 17 governments and agencies have been listed in this regard who are accountable for influencing the health workforce.  The Ministry of Health and the nursing leaders in Philippines have begun to increase the accessibility to health services in the rural areas through employing and training the nurses (McCarty & Fenech, 2013).

According to Laurence & KarnonI (2016) the  objective of health workforce planning in Australia is enable to have the right skills at the right time at the right place and to provide right services to the right patients. It comprises of predictions for the necessities of health care services and the supply of resources for providing the services. It also aims at testing the policy framework and addressing the disparities between the demand and supply of  the health care services.

The  reports on Australia’s Future Health Workforce provides the national workforce planning  estimations regarding the identification of the gaps between the supply and demand of the workforce in future which would be impacted by a range of scenarios. These scenarios depict a vision of future health care delivery and reflect the probable government policy decisions, the employer practices, activities related to higher education, training of the workforce and trends of the services and the current health workforce.

As shown in the graph, in the year 2012, there were about 331,804 registered and enrolled nurses in Australia which shows a significant investment in the Australian economy. This comparison scenario shows an oversupply in the nursing sector till 2015 but afterwards the supply is less than the demand having the undersupply of 41,000 nurses in the year 2030.

As per Liu et al., (2016) in the low and middle income group countries like Philippines , the health development targets are restricted by lack of skilled health professionals for delivering health services.

As seen in the figure, the low middle income group countries such as Philippines is experiencing the  greatest and most rapid increase in demand  and shortages over a period of time. The average annual growth of supply of health work force is less as compared to its demand . The supply of the health workers shall be slowest in the low middle income group countries .There is a shortage of 7 million workers in 2013 which has increased to 8.3 million by 2030.

Challenges faced by the Health Workforce in Philippines

The growth of demand and supply is predicted to be slowest in the low middle income countries like Philippines and these are estimated to be below the WHO threshold of 4.45 workers amongst the population of 1000 persons. As a result, Philippines might face a contradictory situation in which it faces the shortage of health workers required for providing the  health services , though there will be unemployed health workers because of  the restricted capacity of the government to employ them (WHO,2018).

One of the major issues in terms of health workforce planning in Australia is that there are less number of health workers particularly, the medical specialists, general practitioners and some associated professions. The nurses and the medical practitioners are not available for the communities which are located in the remote areas of the country.

In the remote areas, the ratio of the general practitioners to the population is half as compared to cities and for physiotherapist, it is even less than half and for specialists the ratio is less than one fifth. To add on to the misery, the accessibility to the primary health care services might be hours away. The more specialized services are available only at large population centers involving larger travelling times. In addition to this, the accessibility to the health services can  result in huge financial costs which can impact the income and result in disruptions in careers and education of the population (World Health Organization ,2015) . 

The limited access to the specialized health services depicts the disincentive of the workforce operating in those areas. It also projects that the medical practitioners does not have the mass which is necessary to assist the residential specialists in terms of required infrastructure and population.

According to Asia Pacific Observatory on Health Systems and Policies (2011) the major issues confronted by  Philippian’s Department of Health is that some of the  categories of health workers do not correspond to the international classifications as they arose as a result of the demands of the health care system of the country. Moreover, there is no proper statistical record available of the active health workers in this context.

The largest category of the health care workers comprises of nurses and midwives due to their increasing demands in other countries.   Contradictory to this, most of them are unable to find employment in their own country. So, the insufficient number of government jobs is due to the incapability of the government to create the job positions in the bigger health care centers.

Also , there are so many vacant positions in the rural  and low income group areas but the doctors find these unappealing  due to inflexible and long working areas, lack of incentives to stay in there and seclusions from their counterparts while the newly trained doctors are confronted with the issues of where and how to practice . They are not inclined towards solo practice and more interested to take the salaried jobs.

 According to World Health Organization (2016) there are certain recommendations given by High-Level Commission on Health Employment and Economic Growth which was established by UN Secretary-General Ban Ki-moon in the month of March 2016. These pertain to creation and investments in the health care sector jobs specifically for youth and female section of the society.

In the Australian context, there are around 1 million health care workers who are employed for the delivery of health and welfare services across the country. In the Philippian context, there are more migrations of the nurses to the other countries, so it should develop appropriate job opportunities for the workforce in the domestic country to avoid their migration (Cometto et al., 2013).

Secondly, the commission has recommended that women should be allowed to participate and avail the employment opportunities in the health care sector. In the Australian context, the number of females working in the health care sector has decreased from 79 % in 2011 to 78.5% in 2016(Australian Bureau of Statistics, 2017).

Whereas in Philippines, the number of women employed in the health care sector is increasing as compared to men.

The third recommendation is development of the education and training skills of the health care workers to match the necessities of the population. In the Australian context, the health care providers have received the education and training to work as primary health care providers in the rural and remote areas. In Philippines, the quality of training provided by the institutions is of low standard so policies for strengthening of the training framework should be adopted.

The fourth recommendation is to introduce reforms by transforming the service models and focusing on providing high quality and affordable health care services. In Australia , the  reforms pertaining to the health insurance facilities to the public are  introduced(Dixit &  Sambasivan,2018).

While Philippines is confronted with the difficulties in introducing the various health care reforms in the public sector.

The fifth recommendation is adopting cost effective technologies to  develop people centric health care services and information systems. Australia has adopted cost effective technologies to facilitate capability building, strengthening the education infrastructure improvements and resource sharing. Philippines have also begun to increase the health care services through adopting the modern technologies but it is on the initial stage and requires further research.

The sixth recommendation is investing in the development of the skills of the health workers in relation to cope up with the health emergencies of the public. Australia is working towards the evolution of the health care policies which will help to cope up with the health emergencies. In this context, Philippines been greatly working in this area (WHO, 2018).  

The seventh recommendation is raising appropriate funding from the domestic and international resources to consider wider health financing reforms. Australia has been collaborating with the national and international agencies to support certain health programs. Philippines have initiated to focus on UN Sustainable Goals of health and wellbeing for its citizens.

The eighth recommendation is promoting cooperation amongst the various stakeholders for supporting investments in the health work force. Australia has been coordinating with its international counterparts to make contributions to facilitate improvements in the health care sector. Philippines is much behind than Australia in this context (World Health Organization, 2014).

The ninth recommendation is to mitigate the adverse effects of migration in the low middle income countries .In this regard, the international agreement on the workforce health migration should comprise of provisions to enhance the benefits.  The health care workers migrate to Australia and it has signed bilateral agreements with the regional countries for   resettlement of the immigrants (Larking, 2017).

Philippines is much behind than Australia in this regard. It has to implement certain reforms to mitigate the negative impacts of migration (Marcus, Quimson &  Short, 2014).

The tenth recommendation being undertaking research and analysis by using harmonized metrics and methods to empower evidence, responsibility and action. Australia has been implementing certain research programs for empowering accountability in the various stakeholders. Philippines have made investments for the growth and development of the health care sector in the recent scenario (World Health Organization, 2017).

Conclusion

Hence, to conclude, it can be said that Philippines being a low income group country needs to introduce many reforms for the development and growth of the health acre sector and health workforce planning. It needs to introduce certain policies and reforms to lessen migration of the health care workforce so that the domestic population can be benefited by the s services provided by medical personnel. Furthermore, accessibility to the health care services should be enhanced through providing  the availability of the necessary resources to all the stakeholders.

References 

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