Health Workforce Shortages
Inherently related to the issues related to the ageing population and increase in chronic disease is workforce. With the first baby boomers turning 70 years of age in 2015, their health care demands are going to be exponential at precisely the time that it is predicted that there will be a 20,079 sum gap in the nursing workforce (Health Workforce Australia [HWA], 2012). When HWA (2012) data is compared with the Hardes Data projections where a 190% increase in separations in 2026 versus a 109,490 sum deficit in nurses, the current scenario is highly concerning.
Maintaining the training pipeline to deliver adequate nurses and doctors is essential
Whether in primary care or the acute care sector, it is clear that the health care system is radically unprepared for the demand that is coupled with the chronic diseased state of the population and ageing status of the demographics. At present, the World Health Organisation’s report (2006) has determined that there is a world shortage of 4.3 million health care workers. While the Australian nursing density compares favourably when compared with the average for OECD countries at 10.1 nurses per 1,000 population versus the average of 8.6 (HWA, 2013), HWA (2012) have set out a multi-pronged approach to managing the workforce shortage: health care reform, current workforce retention, immigration and the training pipeline. For example, implementing productivity re-engineering strategies, health care reform to reduce burden and retention strategies would results in a supply of nurses of 318,578 to meet a demand of 316,715 (HWA, 2012).
The training pipeline may not the needs of the increased demand relating to the ageing population and increased prevalence of chronic disease
It is clear from this report that the HWA acknowledge that self-sufficiency if unlikely and that there will therefore be a continued reliance on immigration to meet the demands on the changing face of health care in this country (HWA 2012). This is generally an unpopular strategy. The complexities that are inherently related with integration with the Australian health care delivery system, language issues, scope of practice differentials and cultural integration are cited as challenges to international recruitment. HWA quote that nursing is the greatest user of immigration when compared with medicine, pharmacy, dentistry and physiotherapy with the major source countries including UK, the Philippines and India for nursing recruitment. This report discusses that the nurses from Singapore, South Africa, Ireland and the UK integrated quickly into the country and workforce with long term employment within the professional demonstrated while those from countries such as North Africa or the Middle East did not demonstrate the same long term employment statistics. English language integration has been a significant issue amongst the nursing profession for some time and this report shows some issues with this regards when comparing with the major source countries. For example, Philippines is one of the largest source countries for nursing, but their English language testing failure rates is quoted to be one of the highest at 86%. However, HWA (2012) acknowledged that this is the greatest opportunity to meet short term health workforce needs as well as the very real possibility that this strategy will continue to meet a proportion of our supply needs well into the future. For the international recruit, there are some very real advantages to migrating to Australia including financial security, job security, additional income to support extended family, improved workplace conditions, improved educational opportunities as well as greater career opportunities. Given that acceptance that some degree of reliance on this strategy will be necessary, it is time to put mechanisms in place to transition these practitioners in to the workplace to secure long term retention. HWA (2012) have realised that Australian Health Practitioner Regulation Agency [AHPRA] has a significant role to play in governance, notably english language testing, recency of practice, criminal history checking and evidence of continued profession development. However, retention strategies cited by the report for the long term include foreign credential recognition, limiting racism that can be encountered and programs aims at transitioning into the international nurses new social and cultural environment will be key.