Health workforce policy and industrial relations in Australia: ministerial insights into challenges and opportunities for reform
Silvana SgròSchool of Population Health, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia. Email: silvana.sgro@icloud.com
Australian Health Review 38(4) 471-475 https://doi.org/10.1071/AH14027
Submitted: 1 October 2013 Accepted: 7 April 2014 Published: 8 July 2014
Abstract
Since the Productivity Commission released its research report Australia’s Health Workforce in 2005, there has been a significant increase in government funding and policy capacity aimed at health workforce reform and innovation in Australia. This research paper presents the results of semistructured interviews with three key stakeholders in health policy formation in Australia: (1) The Honourable Lindsay Tanner, former Federal Minister for Finance and therefore 100% shareholder of Medibank Private on behalf of the Commonwealth; (2) The Honourable Daniel Andrews, former Victorian Minister for Health and current Victorian Opposition Leader; and (3) The Honourable Jim McGinty, former Minister for Health and Attorney General of Western Australia and current inaugural Chair of Health Workforce Australia. The paper examines key issues they identified in relation to health workforce policy in Australia, particularly where it intersects with industrial relations, and conducts a comparative analysis between their responses and theoretical methodologies of policy formation as a means of informing a reform process.
What is known about the topic? Australia is experiencing an increasing demand for ever-improving health services and outcomes from an increasingly health-literate public, coupled with significant workforce shortages across some key categories of healthcare professionals. Health costs are also increasing. As a result governments in all nine jurisdictions in Australia are seeking to rein in those costs without negatively impacting on quality, safety or continued improvements in health outcomes. They are simultaneously seeking to minimise any political controversy or negative electoral repercussions associated with health reform.
What does this paper add? This paper further informs an understanding of how health workforce policy is formulated and implemented by presenting the results of interviews with two former Ministers for Health and the former Federal Finance Minister on health workforce policy reform in Australia. It analyses their responses and their decision-making processes against theoretical frameworks of health policy formation, including agenda setting, and the political reality of policy formation at a ministerial level.
What are the implications for practitioners? This paper provides a unique and original analysis for practitioners of policy formation. It also illustrates and analyses ministerial insights into the current health workforce reform agenda being developed and implemented by the Council of Australian Governments and contributes to an evidence base of the reform process going forward.
References
[1] Productivity Commission. Australia’s health workforce, research report. Canberra: Productivity Commission; 2005.[2] Health Workforce Australia. Health workforce 2025: doctors, nurses and midwives. Adelaide: Health Workforce Australia; 2012.
[3] Australian Institute of Health and Welfare (AIHW). Australia’s health 2010. Health Series No. 12. Catalogue no. AUS 122. Canberra: AIHW; 2010.
[4] Australian Institute of Health and Welfare (AIHW). Australia’s health 2012. Health Series No. 13. Catalogue no. AUS 156. Canberra: AIHW; 2012.
[5] European Commission. Matrix insight with centre for workforce intelligence, EU level collaboration on forecasting health workforce needs, workforce planning and health workforce trends: a feasibility study. 2012. Available at http://ec.europa.eu/health/workforce/key_documents/study_2012/index_en.htm [verified 20 May 2014].
[6] World Health Organization (WHO). World health statistics, 2012. Geneva: WHO; 2012.
[7] Organisation for Economic Cooperation and Development (OECD). OECD health statistics 2013. Paris: OECD; 2013. Available at http://www.oecd.org/els/health-systems/health-data.htm [verified 2 June 2014].
[8] Council of Australian Governments. Five themes of strategic importance. 2011. Available at http://www.coag.gov.au/reform_agenda#Theme%204 [verified 21 December 2013].
[9] Australian Nursing Federation. Health workforce innovation. 2012. Available at http://www.anf.org.au/documents/submissions/ANF_Submission_Health_Workforce>Innovation.pdf [verified 6 September 2013].
[10] Walt G. Health policy: an introduction to process and power. London: Zed Books; 2007.
[11] Hancock L, editor. Policy, power and interests. Health policy in the market state. Sydney: Allen and Unwin; 1999.
[12] Buse K, Mays N, Walt G. Making health policy. Maidenhead: Open University Press; 2007.
[13] Bachrach P, Baratz M. The two faces of power. Am Polit Sci Rev 1962; 56 947–52.
| The two faces of power.Crossref | GoogleScholarGoogle Scholar |
[14] Kingdon J. Agendas, alternatives and public policy. New York: Harper Collins Publishers; 1995.
[15] Althaus C, Bridgman P, Davis G. The Australian policy handbook, 4th edn. Sydney: Allen and Unwin; 2007.
[16] Lewis J. Being around and knowing the players: networks of influence in health policy. Soc Sci Med 2006; 62 2125–36.
| Being around and knowing the players: networks of influence in health policy.Crossref | GoogleScholarGoogle Scholar | 16289737PubMed |
[17] Lewis JM, Considine M. Medicine, economics and agenda setting. Soc Sci Med 1999; 48 393–405.
| Medicine, economics and agenda setting.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1M7nsV2jtg%3D%3D&md5=c2694bfdf73173f0565e39307fbd285fCAS | 10077286PubMed |
[18] Lindblom C. The science of muddling through. Public Adm Rev 1959; 19 79–88.
| The science of muddling through.Crossref | GoogleScholarGoogle Scholar |
[19] Palmer G, Short S. Health care and public policy. Melbourne: Macmillan; 2000.
[20] Sabatier PA, Jenkins-Smith HC. Evaluating the advocacy coalition framework. J Public Policy 1994; 14 175–203.
| Evaluating the advocacy coalition framework.Crossref | GoogleScholarGoogle Scholar |
[21] Burch M, Wood B. Public policy in Britain, 2nd edn. Oxford: Basil Blackwell; 1989.
