Commentary Interventions to facilitate health workforce restructure

There are recognised shortages in most health professions in Australia. This is evidence that previous attempts at health workforce planning have failed. This paper argues that one reason for such failure is the lack of appropriate structures for health workforce planning. It also suggests that Australia needs to move beyond planning for particular professions and that health workforce planning needs to be based on identifying skill shortages as much as shortages in particular named professionals. The paper proposes specific policy suggestions to facilitate workforce flexibility and health workforce planning in Australia. Background Health workforce reform is clearly on the agenda of health policy makers in Australia. It has been the focus of discussion at the Council of Australian Governments which requested the Commonwealth to initiate further research in this area, operationalised by the Treasurer commissioning the current research study by the Productivity Commission http://www.pc.gov.au/study/healthworkforce/ index.html. There are a number of immediate causative factors for this heightened policy attention, most notably contemporary perceived shortages of most categories of health professionals. Increasingly, health policy makers and health service managers are also recognising that the current structure of the health workforce is probably not suitable for 21st century healthcare delivery. [1] Australia is not unique in facing workforce shortages [2,3], nor in recognising the inadequacy of current workforce structures [4]; the World Health Organisation is highlighting workforce issues internationally by making them the focus of its 2006 World Health Report http:// www.who.int/hrh/whr06_consultation/en/. Although the headline problem is usually couched in terms of workforce supply, problems in flexibility of the workforce and workforce planning also confront policymakers. The focus on workforce flexibility is in part a response to perceived overspecialisation of the health workforce. Specialisation, which in part was seen to be associated with higher quality, is now seen as possibly detracting from continuity of care and hence may have a deleterious impact on quality, especially in the context of the increased salience of chronic diseases in the health sector. Although all the benefits of specialisation should not be lost, the current assignment of roles for health professionals is perceived to be inefficient either because more staff are employed than would be required in an efficient organisation of roles, or staff at higher pay classifications being used to perform tasks which could be performed by staff at lower pay levels. The inflexibility of contemporary workforce structure also inhibits service delivery because of shortages of staff to perform key roles. Policy attention Published: 29 June 2005 Australia and New Zealand Health Policy 2005, 2:14 doi:10.1186/1743-8462-214 Received: 10 May 2005 Accepted: 29 June 2005 This article is available from: http://www.anzhealthpolicy.com/content/2/1/14 © 2005 Duckett; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.