Jan McLucas (Queensland, Australian Labor Party, Shadow Minister for Mental Health) Share this | Hansard source

I rise to speak on the Health Workforce Australia (Abolition) Bill and I want to indicate that the Labor Party will be opposing this bill.

In the explanatory memorandum of this bill, it describes the purpose of the bill:

It will enable more efficient and effective delivery of policy and programme activities related to the health workforce, to ensure Australia continues to have a high quality, capable and well distributed health workforce, delivering frontline health services for all Australians.

That is simply not true. The word that I am offended by is the word 'continues'. We do not have a 'high-quality, capable and well-distributed health workforce' in this country. We do have a high-quality and capable health workforce, but frankly it has never been well distributed; that was why Labor in government established Health Workforce Australia.

We received no substantial evidence at the Senate Community Affairs Legislation Committee inquiry that would support the contention that was included in the explanatory memorandum. In fact, the overwhelming evidence points to the success of Health Workforce Australia and its success into the future. Many witnesses who came before our committee said that the work had not yet been completed. So Labor will oppose this bill here in the Senate. In saying that, can I say that the motivation from the government is purely political and frankly spiteful.

Labor established Health Workforce Australia through legislation in May 2009. This was partly in response to a Productivity Commission inquiry that was established in 2006. That was before Labor came to government, so the current government knows well and truly that our country has a problem in the distribution of our workforce. The Productivity Commission concluded that a more sustainable and responsive health workforce was needed. The report went further and highlighted the complexity of Australia's health workforce arrangements—the numerous organisations and agencies involved in health workforce education and training.

What we had at the time were many smaller agencies. There were inconsistencies between the states and territories. There were many different committees. Frankly it was a mess when it came to health workforce planning for the future. It was getting better, in terms of GPs. It was still not so great with specialists. In terms of nursing and allied health it was literally a mess.

So in 2008 it was an agenda item for COAG. The states and territories agreed that there was a need for a national independent health workforce agency to work across the Commonwealth, and states and territories. It was agreed that we needed an agency designed to deliver more effective, streamlined and integrated clinical training arrangements. But it was also agreed that this was not simply the province of state and territory governments or Commonwealth governments. We needed to include higher education providers, the training sector and the health sector. We needed to include employers, professional bodies and regulatory bodies, with the goal of building a sustainable health workforce for our country.

The key responsibilities of Health Workforce Australia were to include: funding, planning and coordinating clinical training across all health disciplines—funding simulation training, supporting health workforce research and planning, and progressing new workforce models and reforms. That was what health workforce was tasked with.

It began in 2010. It has been well supported by all the partners, and it has achieved results in its short lifetime. One example is the document 'Health Workforce 2025—Doctors, nurses and midwives'. It delivered evidence-based planning and avoided the peaks and troughs of workforce availability into the future. It was intentionally established as an agency independent from the Commonwealth but partnered by the Commonwealth, states and territories, and by a number of partners which I mentioned earlier.

There were a number of reasons it was agreed by everyone that an independent agency was required. Independence underlines and confirms that health workforce planning is not the province of the Commonwealth Department of Health alone. It has to include the states and territories, universities, health professionals et cetera. Recommendations could be made outside the culture, operations and political directions of the Commonwealth government of the day. It was agreed that we needed to have an independent agency to improve the evidence collection capability to best inform recommendations that were to be made to all stakeholders.

So it begs the question: why is this government so intent on bringing Health Workforce Australia functions into the Department of Health? In fact, the Mason review—quoted from so often during the inquiry established in 2013—recommended refinements rather than wholesale abolition and absorption or Health Workforce Australia into the department.

Outside of the real long-term benefits, we are seeing benefits happening right now. We are seeing improved clinical training. We have seen 8,500 new quality clinical training places across 22 disciplines. We have seen simulation training improve by 115 per cent. Health workforce research and planning has delivered a number of pieces of work—particularly Health Workforce 2025but there are many other pieces of research that are informing decisions that states and territories, universities and training organisations are making, so that we will achieve a better distributed health workforce and improved clinical training.

Let me go to the distribution of the workforce. The misdistribution of the health workforce in our country has been an ongoing problem for many years. It is a problem that has had a number of policy responses over those years, mostly around financial incentives and scholarships programs. Success has been patchy. I have said that there has been improvement in the distribution of our doctors, particularly our general practitioners, but there is much more to be done.

Health Workforce Australia has undertaken some great work to provide the policy basis for health ministers to respond to. The Geographic Distribution: Medical Workforce project has had real potential to truly address some of the misdistribution issues. Further, the Rural Health Professionals Program aims to attract, recruit and retain nursing and allied health professionals from metropolitan Australia and approved overseas locations into rural and remote areas including into Aboriginal medical services and Aboriginal and Torres Strait Islander community controlled health services.

The expanded scope of practice program, while primarily intended as a strategy to boost productivity has also got potential to provide more services for people in regional, rural and remote areas. It is recognised that these are early days in the delivery of programs to address the health workforce distribution challenges that we have. There is so much more to be done. To that end, I do encourage senators with an interest in regional, rural and remote health to read the Hansard of the Community Affairs Legislation Committee inquiry into the health workforce bills and, particularly, the evidence from the National Rural health Alliance. Mr Gordon Gregory, when he was talking about his opposition to the abolition HWA, said:

The main reason for being concerned about the integration of the two agencies into the Department of Health is the impact this will have on the political importance and resources that will be attached to the work they have been undertaking to good effect.

He went on to say, 'Health workforce shortages are worse in rural and remote areas.' And he said, 'Data are harder to find.'

So I say to the minister and to the department, the flippant statement in the explanatory memorandum is simply not a good start. And the evidence from the department to our committee can only be described as dismissive and defensive. This is not a good start to incorporating an agency which relied on its independence to provide evidence based advice to all the relevant governments and also to industry and education.

Health Workforce Australia's reliance on evidence based policy and its preparedness to consult are to be commended. I commend those principles to the department given they are going to take on this work.

In conclusion, Labor does not support the abolition of Health Workforce Australia. In its short period of operation, significant gains have been made, gains that Labor is concerned will be eroded by its absorption into the Department of Health.

Finally, I do thank the staff of Health Workforce Australia. They have done some marvellous work. Labor certainly values the work that they have done. We thank them for it and wish them all the best in the future.