Building on the previous four Rural Health Stakeholder Roundtable (Roundtable) meetings, the 9 February 2018 meeting was chaired by the Minister for Rural Health, Minister for Sport and Minister for Regional Communications, Senator the Hon Bridget McKenzie MP.
Agenda Items - 9 February 2018 meeting
- the role and priorities of the National Rural Health Commissioner;
- rural health workforce pathways, particularly rural generalism;
- an update on the work of the Distribution Working Group;
- support for the Indigenous rural health workforce;
- the work focus of the Rural Workforce Agencies; and
- Workforce Policy Challenges.
National Rural Health Commissioner (the Commissioner)Minister McKenzie introduced the recently appointed Commissioner, Professor Paul Worley, as a member of the Roundtable and requested an update on his work to date and priorities going forward.
Professor Worley outlined his role in working collaboratively with regional, rural and remote communities, the health sector, universities, specialist training colleges and across all levels of government to build a better health care system in regional and rural Australia. The Roundtable considered the statutory requirements of the Commissioner and discussed how the rural health sector can assist the Commissioner to achieve these outcomes. Minister McKenzie noted that the Commissioner will participate as a member in future Roundtable meetings.
It was outlined that the first priority of the Commissioner, as specified in legislation, would be to develop a National Rural Generalist Pathway. Additionally, the Commissioner will provide advice to the Minister on rural health reform whilst considering the needs of the nursing, dental health, pharmacy, Indigenous health, mental health, midwifery, occupational therapy, physical therapy and allied health sectors in rural and remote Australia.
Rural Health workforce pathwaysThe Commissioner discussed the current pathways that are available for General Practitioners and Specialists, and noted there is not a separate distinct pathway for Rural Generalists. Whilst the initial focus will be developing a national pathway for medical professionals he acknowledged the need to look at pathways for other health professionals as well.
Minister McKenzie announced a landmark agreement to develop a national framework for the Rural Generalist medical specialty. The Collingrove Agreement, brokered by the Commissioner, brings together the Royal Australian College of General Practitioners and the Australian College of Rural and Remote Medicine to build a strong, sustainable and skilled national medical workforce to meet the needs of Australia’s rural and remote communities.
Representatives from both colleges noted the different models that have already been developed by jurisdictions and agreed that a nationally consistent approach would support improved rural health outcomes.
Distribution Working Group (DWG)The Roundtable was updated on the progress of the DWG and discussed the review of the district of workforce shortage (DWS) and the principles of the DWS system.
The Department of Health provided roundtable members with a presentation on workforce data and demonstrated a tool that is being developed to better capture workforce activity in each region to assist in determining areas of need. It was noted that the ongoing work of the DWG will provide a framework for reviewing current incentives and programs so they can be better targeted to meet the needs of communities.
The need to consider the distribution of allied health and nursing staff (not only doctors) was raised during this discussion.
The Minister noted that the DWG is chaired by the Commonwealth Chief Medical Officer, Professor Brendan Murphy, and the Deputy Chair is the Commonwealth Chief Nursing and Midwifery officer, Adjunct Professor Debra Thoms.
Members welcomed the update of the DWG and supported the work plan going forward.
Indigenous Rural Health WorkforceThe Roundtable discussed rural health workforce issues that are unique to the Indigenous workforce, and explored areas where services provided by Commonwealth and jurisdictions were working well and where there was potential to improve outcomes.
Members discussed the need to prioritise the allied health workforce in rural and remote Australia and the lack of robust data in this area.
Mr Craig Dukes, Australian Indigenous Doctors’ Association, discussed the increase in the Indigenous health workforce in recent years.
The importance of Aboriginal Health Workers and the need for appropriate training and support was also highlighted.
Members were supportive of continued development and implementation of the National Aboriginal and Torres Strait Islander Health Workforce Strategic Framework 2016-2023, which provides a mechanism to guide national Aboriginal and Torres Strait Islander health workforce policy and planning. Progress on the Framework is reported annually to the Australian Health Ministers’ Advisory Council.
Rural Workforce Agencies (RWA)The Minister invited Rural Health Workforce Australia to present to the Roundtable on the RWA Program and what the priorities will be going forward. Members noted that under the new RWA Program, RWAs in each state and the Northern Territory are funded to deliver a range of activities aimed at improving the access, quality and sustainability of the health workforce.
A key component of the RWA Program is the establishment of jurisdictional Health Workforce Stakeholder Groups, ensuring that stakeholders will play a key role in the governance of the program and will provide a forum for feedback.
Roundtable members noted that the RWA Program is in its infancy and will therefore have more to report at the next Roundtable meeting.
Workforce Policy ChallengesChallenges with the current distribution of the health workforce were discussed, including the lack of rural and remote placement opportunities for students in all health professions and the lack of access to appropriate pathways for doctors seeking a rural generalist career.
The variance in clinical guidelines between jurisdictions was also highlighted as a problem, as well as the lack of locum support or appropriate supervision in rural communities.
Roundtable MembershipThe Roundtable membership includes a number of peak bodies representing the rural health workforce and the National Rural Health Commissioner.
Members in attendance for the 9 February 2018 meeting were:
- Allied Health Professions Australia
- Australian College of Rural and Remote Medicine
- Australian Dental Association
- Australian Indigenous Doctors’ Association
- Australian Medical Association
- Australian Rural Health Education Network
- Federation of Rural Australian Medical Educators
- Indigenous Allied Health Australia
- National Aboriginal and Torres Strait Islander Health Worker Association
- National Rural Health Alliance
- National Rural Health Commissioner
- National Rural Health Student Network
- Royal Australian College of General Practitioners- Rural Faculty
- Rural Doctors Association of Australia
- Rural Health Workforce Australia
- Services for Australian Rural and Remote Allied Health
- Pharmaceutical Society of Australia
- Congress of Aboriginal and Torres Strait Islander Nurses and Midwives