Fiona Nash (NSW, National Party, Assistant Minister for Health) Share this | Hansard source

The Australian government is meeting its commitments to cut red tape, repeal unnecessary regulation and stop waste caused by duplication in government services. The Health Workforce Australia (Abolition) Bill 2014 will repeal the Health Workforce Australia Act 2009 and legally abolish Health Workforce Australia or HWA. The government has committed to streamline and better coordinate the health workforce planning efforts that were spread across two Commonwealth government agencies and remove duplication and unnecessary costs. Accordingly, HWA's health workforce activities have been transferred to the Department of Health. This legislation recognises this change made by the government.

This bill will not reduce or weaken national efforts to improve health workforce planning and development. On the contrary, the coalition government is committed to supporting our highly skilled health workforce and to ensuring that all Australians have access to high quality health services. This government is committed to improving the capacity, quality and mix of the health workforce to provide front-line health services. This bill frees resources spent on bureaucracy and duplication to support health workers to deliver vital services to the community.

The coalition government has a long history of supporting and developing the Australian health workforce. It was the coalition government that supported innovative approaches to train more health workers in rural and regional areas, and we are justifiably proud of our network of rural clinical schools and university departments of rural health right around Australia. The rural training network is supporting thousands of health students—future doctors, nurses, dentists, psychologists, physiotherapists, and many others—to complete practical training in rural areas of Australia. Evidence is now showing that these students are choosing to stay and work in rural areas at much higher rates than their counterparts training in metropolitan areas. This approach has been an enormous success. It was a coalition government that acted in 2006 to increase the number of Australian-trained doctors by increasing medical student numbers at Australia's universities. In fact, the previous coalition government established nine new medical schools, including in rural and regional Australia. We are now seeing those newly qualified doctors entering practice and delivering essential services around the country. Many of these will be undertaking work and training in rural areas.

The coalition will continue its efforts to train and support the health workforce through better, more efficient programs delivered across both the health and education systems. We will work with the private sector and state and territory governments to provide opportunities for health professionals to train and work in all sectors and settings where front-line health services are delivered.

A strong approach to health workforce development has several components, including: critical analysis of data and effective planning, and consultation with employers and the community to ensure that we are developing and implementing policies that will produce the right numbers of health professionals with the right skills for the future; supporting educational and training opportunities for health professional students to meet the standards required for registration to practice; providing opportunities for ongoing clinical education, not only for those seeking to specialise in a particular field of practice but for all health professionals, to ensure that they keep abreast of the latest developments in their fields; and supporting our experienced clinicians to remain in productive practice and to pass on their skills and experience by supervising students and mentoring the next generation of the health workforce.

The government is committed to ensuring that this important work continues. Forecasts of Australia's health workforce needs will be updated regularly as new data becomes available for analysis. This work will be undertaken within the Department of Health in collaboration with key stakeholders and other data experts, including relevant government agencies and the Australian Health Practitioner Regulation Agency.

The department continues to support the important work of the National Medical Training Advisory Network to produce national medical training plans. It will be given a very high priority by the department.

Through the Department of Health and the education portfolio, the government invests hundreds of millions of dollars every year in training doctors on behalf of the community, and we must ensure that this investment is targeted to the types of medical services and the areas of medical practice that the community most needs, now and into the future.

But the department will not just focus on the medical workforce, and the government will maintain a multidisciplinary approach to supporting the health workforce. The single largest annual expenditure under the department's Health Workforce Fund is over $300 million a year, supporting practice nurses to deliver primary care services to patients in general practice. The department also operates programs supporting nursing and allied health scholarships, which have been expanded through this government's election commitments. The government is also making improvements to our support for experienced supervisors. We want more GPs to be training our new doctors in general practice. The government is doubling the practice incentive payment for teaching from $100 to $200 a session. This will encourage more GPs to train medical students, and there is an extra loading for training in rural areas.

The government is strongly committed to continuing to deliver health workforce data, analysis, policies and programs. What this bill will do is to ensure that this work is delivered more efficiently with less bureaucracy and waste. We will achieve efficiencies by having Commonwealth health workforce policies and programs delivered together in a division of the department rather than through a separate agency with its own executives, accommodation leases, IT systems, and legal and human resource departments.

Taxpayers want more health workers and health services, not more Public Service overheads. The Commonwealth and states and territories continue to work collaboratively through established fora such as the COAG health council. However, the national partnership agreement under which HWA was established expired on 30 June 2013. It clearly indicates that it was intended that HWA would be a joint agency managing Commonwealth, state and territory investment in developing the Australian health workforce. As it turned out, the states and territories did not contribute any funding to HWA.

Since its inception, no state or territory has directly provided funding to Health Workforce Australia for its clinical education and training activities or in fact any of its work program. Instead, Health Workforce Australia has been solely funded by the Commonwealth, essentially creating an additional separate Commonwealth agency as well as the Department of Health which continue to have overlapping responsibilities. Additional staffing and administrative costs have been required to run HWA for functions that can be effectively performed by the Health portfolio's lead department. The HWA joint agency model never eventuated, but we ended up with a high-cost agency with board meetings, directors' fees, a CEO and a large CEO support office and high travel costs, all entirely funded by the Commonwealth. The Commonwealth has now taken action to ensure that taxpayers resources are spent more efficiently.

Some of the duplication between HWA and the Department of Health that we have seen over the last four years include staff from both agencies being represented on the same project steering committees for health workforce planning, education and training projects; both agencies running slightly different programs supporting the recruitment and retention of internationally trained health professionals; and both agencies funding overlapping workforce distribution projects and programs. This has led to a fragmented approach and waste through duplication of administrative policy and program functions.

The passage of this bill will produce a more coherent and streamlined approach to health workforce funding programs, provide a central point of liaison for health workforce stakeholders, produce a joint approach with state and territory governments on health workforce activities through the COAG Health Council and formalise the responsibility of the Department of Health to manage health workforce activities. The Australian government through the Department of Health has long played a national leadership and advisory role in supporting the development of the health workforce in both the public and private sectors, and in implementing a range of innovative programs to support clinical training for health workers.

The Labor government created an unnecessary and costly increase in the number of portfolio agencies, increasing the bureaucracy at great cost but with no change of outcome and no real benefits. The passage of this bill will reduce administration so more resources are available for programs which support Australia's health workforce. Shifting responsibility for these activities back to the department will ensure a clear policy focus into the future with no loss of commitment in this space.

This bill will support the efficient delivery of functions. It does not change the government's support for nationally coordinated, effective and efficient health workforce planning. The government continue to provide support for the education and training of a highly skilled and mobile health workforce for Australia. The government inherited a legacy of $123 billion of projected deficits and debt that was projected to rise to $667 billion. It is imperative that we find ways to deliver programs as efficiently as possible so resources can continue to be available for important front-line initiatives.

The bill enables the official wind-up of HWA as an entity separate from the Commonwealth. Essential ongoing functions have been integrated with the department's existing work program to plan for and deliver our future health workforce. The department's existing work program includes more than $5 billion in health workforce investment over five years, invested in strategies to train, support and develop the health workforce. A longstanding component of the department's work program are strategies to improve distribution of the health workforce so all Australians, including those in rural and regional Australia, can access appropriate health services in their local communities.

All existing funding agreements and commitments entered into by HWA will be honoured. The government has already announced its commitment to continue funding clinical training under the clinical training funding agreements with universities for the 2015 academic year. The coalition government remains committed to improving the capacity, quality and mix of the health workforce to meet the requirements of health services now and into the future.

The Australian government can continue its focus on priority health workforce activities without the unnecessary costs of an additional Commonwealth funded agency. I reiterate: the new streamlined arrangements will improve not diminish the government's focus on workforce planning and policy development and implementation to ensure we have the right mix of health professionals on the ground delivering services to the Australian community now and into the future. The bill will enable essential actions to continue under more appropriate arrangements without the inefficiencies, confusion and costs associated with maintaining a separate Commonwealth agency.