Is health workforce sustainability in Australia and New Zealand a realistic policy goal?
James M. Buchan A D , Lucio Naccarella B and Peter M. Brooks CA Queen Margaret University, QMU Drive, Edinburgh, EH21 6UU, UK.
B Australian Health Workforce Institute, University of Melbourne, 766 Elizabeth Street, Parkville, VIC 3010, Australia. Email: l.naccarella@unimelb.edu.au
C Australian Health Workforce Institute (AHWI), The University of Melbourne, Faculty of Medicine, Dentistry and Health Sciences, Parkville, VIC 3010, Australia. Email: brooksp@unimelb.edu.au
D Corresponding author. Email: jbuchan@qmu.ac.uk
Australian Health Review 35(2) 152-155 https://doi.org/10.1071/AH10897
Submitted: 5 March 2010 Accepted: 22 August 2010 Published: 25 May 2011
Journal Compilation © AHHA 2011
Abstract
This paper assesses what health workforce ‘sustainability’ might mean for Australia and New Zealand, given the policy direction set out in the World Health Organization draft code on international recruitment of health workers. The governments in both countries have in the past made policy statements about the desirability of health workforce ‘self-sufficiency’, but OECD data show that both have a high level of dependence on internationally recruited health professionals relative to most other OECD countries. The paper argues that if a target of ‘self-sufficiency’ or sustainability were to be based on meeting health workforce requirements from home based training, both Australia and New Zealand fall far short of this measure, and continue to be active recruiters. The paper stresses that there is no common agreed definition of what health workforce ‘self-sufficiency’, or ‘sustainability’ is in practice, and that without an agreed definition it will be difficult for policy-makers to move the debate on to reaching agreement and possibly setting measurable targets or timelines for achievement. The paper concludes that any policy decisions related to health workforce sustainability will also have to taken in the context of a wider community debate on what is required of a health system and how is it to be funded.
References
[1] WHO Global Code of Practice on the International Recruitment of Health Personnel. Sixty Third World Health Assembly WHA 63.16. Agenda item 11.5 21. Geneva: World Health Organization; 2010. Available at http://www.who.int/hrh/migration/code/practice/en/index.html [verified 7 March 2011].[2] Buchan J. Analysis: Challenges for WHO code on international recruitment. BMJ 2010; 340 c1486
| Analysis: Challenges for WHO code on international recruitment.Crossref | GoogleScholarGoogle Scholar | 20351078PubMed |
[3] A World Health Organization code of practice on the international recruitment of health personnel – Background paper. Geneva: World Health Organization; 2009: para 4.1.4. Available at http://www.emro.who.int/rc56/media/pdf/EMRC56INF08en.pdf [verified 7 March 2011].
[4] Negin J. Australia and New Zealand’s contribution to Pacific Island health worker brain drain. Aust N Z J Public Health 2008; 32 507–11.
| Australia and New Zealand’s contribution to Pacific Island health worker brain drain.Crossref | GoogleScholarGoogle Scholar | 19076739PubMed |
[5] Health at a Glance 2009. Paris: Organisation for Economic Co-operation and Development; 2009. Available at http://www.oecd.org/document/11/0,3343,en_2649_33929_16502667_1_1_1_37407,00.html [verified 7 March 2011].
[6] Medical labour force 2007. National health labour force series no. 44. Cat. no. HWL 45. Canberra: Australian Institute of Health and Welfare; 2009. Available at http://www.aihw.gov.au/publications/index.cfm/title/10723 [verified 7 March 2011].
[7] Nursing and midwifery labour force 2007. National health labour force series no. 43. Cat. no. HWL 44. Canberra: Australian Institute of Health and Welfare; 2009. Available at http://www.aihw.gov.au/publications/index.cfm/title/10724 [verified 7 March 2011].
[8] Buchan J, Seccombe I. Difficult Times, Difficult Choices: The UK Nursing Labour Market Review 2009. London: Royal College of Nursing; 2009. Available at http://www.rcn.org.uk/__data/assets/pdf_file/0010/271297/003554.pdf [verified 7 March 2011].
[9] Zurn P, Dumont J. Health Workforce and International Migration – Can New Zealand Compete? OECD Health Working Paper no. 33. OECD Paris; 2009. Available at http://www.oecd.org/dataoecd/46/41/40673065.pdf [verified 7 March 2011]
[10] Medical Training Review Panel. Thirteenth report. Canberra: Medical Training Review Panel; 2010. Available at http://www.health.gov.au/internet/main/publishing.nsf/Content/3431E8E659990C72CA2577490019113E/$File/mtrp13ex.pdf [verified 7 March 2011].
[11] Australian Health Ministers’ Conference, National Health Workforce Strategic Framework. Sydney: National Health Workforce Secretariat; 2009: 15. Available at http://www.ahwo.gov.au/documents/National%20Health%20Workforce%20Strategic%20Framework/AHMC%20National%20Workforce%20Strategic%20Framework%202004.pdf [verified 7 March 2011].
[12] Carver P. Self Sufficiency and International Medical Graduates. Melbourne: National Health Workforce, Taskforce, Australia; 2009: 3. Available at http://www.ahwo.gov.au/documents/NHWT/Self%20Sufficiency%20and%20International%20Medical%20Graduates%20-%20Australia.pdf [verified 7 March 2011].
[13] Productivity Commission. Australia’s Health Workforce. Productivity Commission, Melbourne; 2005. Available at http://www.pc.gov.au/__data/assets/pdf_file/0003/9480/healthworkforce.pdf [verified 7 March 2011].
[14] National Health and Hospitals Reform Commission. A Healthier Future for all Australians – Interim Report December 2008. NHHRC, Commonwealth of Australia, Canberra; 2008.
[15] Training the medical workforce 2006 and beyond. Wellington, New Zealand: Ministry of Health; 2006. Available at http://www.moh.govt.nz/moh.nsf/pagesmh/4791/$File/training-medical-workforce-06.pdf [verified 7 March 2011].
[16] Little L, Buchan J. Nursing Self Sufficiency/Sustainability in the Global Context. Geneva: International Centre for Human Resources in Nursing/International Center for Nurse Migration. International Council of Nurses; 2007. Available at http://www.ichrn.com/publications/policyresearch/SelfSufficiency.pdf [verified 7 March 2011].
[17] Dal Poz MR, Gupta N, Quain E, Soucat ALB, editors. Handbook on monitoring and evaluation of human resources for health: with special applications for low- and middle-income countries. Geneva: World Health Organization; 2009. Available at http://whqlibdoc.who.int/publications/2009/9789241547703_eng.pdf [verified 24 March 2011].
