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representatives vote 2014-06-04#1
Edited by
mackay staff
on
2014-06-05 11:43:32
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Title
Bills — Health Workforce Australia (Abolition) Bill 2014; Second Reading- Health Workforce Australia (Abolition) Bill 2014 - Second Reading - Read a second time
Description
<p class="speaker">Shayne Neumann</p><p>I rise today to speak on the Health Workforce Australia (Abolition) Bill 2014. I do so as a member of parliament but also as shadow minister for ageing. We know that this is a particular challenge in the aged-care sector. We have about 350,000 workers in the aged-care sector—doctors, nurses, allied health professionals—and by 2050 we will need a million or more people working across that sector, so it is crucial that we get the health workforce right. At Federation about four per cent of Australians were over 65 years of age; currently 14 per cent are over 65. By 2050, at the latest, it will be 25 per cent. Dementia is a major problem facing this country. We currently have about 300,000 people suffering from dementia and we will have nearly a million by 2050. More doctors, more nurses, more allied health professionals and more carers will be required to meet those challenges.</p><p>We have many ups and downs with respect to workforce development but, when the former Labor government was first elected in November 2007, about 74 per cent of Australians were suffering as a result of a workforce shortage with respect to general practitioners. So we set about trying to address this issue. Sadly, the legislation before this House, which abolishes Health Workforce Australia, is a retrograde step with respect to getting rid of that cycle of boom and bust in the development of the workforce.</p>- The majority voted in favour of a [http://www.openaustralia.org/debate/?id=2014-06-04.20.11 motion] to read the bill for a second time.[1] This means that the majority agree with the main idea of the bill and that the House can now discuss it in more detail.
- ''Background to the bill''
- The bill was introduced to abolish the [https://www.hwa.gov.au/about-us Health Workforce Australia] ('HWA'), which had been introduced by the [http://en.wikipedia.org/wiki/Council_of_Australian_Governments Council of Australian Governments] "to address the challenges of providing a skilled, flexible and innovative health workforce that meets the needs of the Australian community".[2]
- ''References''
- * [1] Read more about the stages that a bill must pass through to become law [http://www.peo.gov.au/learning/fact-sheets/making-a-law.html here].
- * [2] Read more about HWA [https://www.hwa.gov.au/about-us here].
<p>Health workforce planning is absolutely crucial. It is essential for the demographic challenges we face in the future across the health sector and across the aged-care sector. The crucial need for more funding for health and aged care was recognised by the Queensland Treasurer yesterday in his budget speech in the House in George Street in Brisbane. He actually mentioned the fact that the current federal government is 'turning its back on the challenges of health funding.' He said, 'The federal government thinks that the states can survive with less' and we see in this legislation before the House that the government thinks that workforce development can survive with less as well. This is a tragedy and a shame.</p><p>After the federal election last year, we saw the first hint of the Abbott government having a closer look at HWA and other health agencies when the now health minister said ominously on Sky's <i>Sunday Agenda</i>:</p><p class="italic">… we want to be complemented by the Commission of Audit, but I’ve already started to look at the composition of some of those agencies.</p><p>At Senate estimates on 20 November 2013 the Assistant Minister for Health, Senator Nash, confirmed that HWA was under a funding freeze which affected its support for clinical placement funding. But it was not until the Abbott government finally released National Commission of Audit report—delayed surreptitiously and obviously until after the Griffith by-election and the WA Senate re-run were over—that it became clear that HWA's days were numbered. The Commission of Audit argued that there were too many government bodies in Australia and that this leads to duplication and overlap, unnecessary complexity, a lack of accountability, the potential for uncoordinated advice and avoidable costs.</p><p>The commission recommended that five of the 22 agencies within the health portfolio be consolidated into the Department of Health. Shamefully and tragically, Health Workforce Australia was one of those agencies. Apparently the commission believed it was appropriate that HWA be amalgamated and considered a clinical training unit. So it was no surprise that in the budget we saw this vital agency abolished by the Abbott government.</p><p>The government claims that getting rid of HWA is a simple streamlining of officialdom. It is simply untrue. It is instructive to recall, as I said, the state of the Australian health system we inherited in 2007 after 11 years of neglect from the Howard government. The Australian Institute of Health and Welfare made it crystal clear on the eve of that federal election that the Howard government had abdicated its responsibilities by cutting funding consistently compared to the states and territories across the board, particularly in health and hospital funding, and in primary health care.</p><p>At the time that Labor came to power in 2007, Australia was experiencing a grave shortage of doctors, nurses and other health professionals. This was keenly felt in my community where the then Ipswich and West Moreton division of general practice had reported a shortage of doctors and nurses after a study on the health issues in my community.</p><p>The report indicated that in the Ipswich region there was one GP for every 1,609 people. Worryingly, the report suggested this problem was likely to worsen as this workforce aged, and many local doctors were reaching retirement age. Within five years we would have a critical shortage of GPs at the front line of health services in the Ipswich and West Moreton region. The report highlighted some of the major health challenges in the areas as preventable and chronic diseases such as obesity, diabetes and heart disease—the challenge of smoking rates and alcohol abuse.</p><p>This budget cuts funding for preventative health strategies, cuts and abolishes so many agencies dealing with those problems, including the one that is before the chamber today—the workforce agency that deals with the development and planning for our future workforce challenges—is a backward step. It will leave that obligation to the states and territories. It is an abdication of national responsibility and is a federalist model gone mad.</p><p>The Howard government left us with that cycle of boom and bust. The problems were identified by the Productivity Commission in its 2005 report, <i>Australia's </i><i>health workforce</i>. The commission recognised that there were health workforce shortages across the country and that some shortages may be potentially short term—for example, shortfalls in nursing and allied health professionals could be rectified relatively quickly, but others were long term such as retention and re-entry.</p><p>These shortages remain persistent, and the commission confirmed what Australians in rural and regional areas, such as my area, knew already: that they were being affected badly by the shortfall. As the report neatly put it:</p><p class="italic">In particular, apart from nurses, the relative number of health professionals diminishes for communities located further away from major centres.</p><p>referring to places like Brisbane, Sydney and Melbourne.</p><p>In the area of education and training, the commission referred to 'rigidities, fragmentation and disconnects in the system.' The report highlighted:</p><p class="italic">… a lack of coordination between health planners and those responsible for allocating the number of university places across the various health professional areas, resulting in gaps between health service needs and the numbers of appropriately trained professionals.</p><p>So the commission was scathing about what had happened under the Howard government, and we saw that in practice in my community. The commission was quite clear about one of the major reasons for the health workforce shortage. They said:</p><p class="italic">The health workforce is planned, educated, deployed, funded and regulated by a myriad of different public and private entities. This can be advantageous in a number of respects. For example, it provides for the development and application of specialised knowledge in specific areas.</p><p class="italic">But the number of entities involved, and especially the division of responsibility for the various parts of the health workforce system between and within governments, results in conflicting objectives, inefficiencies and cost and blame shifting</p><p>That is what we are going to experience and see in the future with this legislation.</p><p>At this time health workforce planning was the domain of two committees: the Australian Medical Workforce Advisory Committee which was responsible for medical workforce planning; and the Australian Health Ministers' Advisory Council responsible for non-medical workforce planning, including nursing and allied health. So it was a hodgepodge—an alphabet soup. The Productivity Commission recommended the Labor government's commitment, strategy and funding, and the creation of Health Workforce Australia.</p><p>Faced with these challenges, we set about doing it. In a national partnership agreement we directly committed $1.38 billion to a package and the states and territories put aside $540 million. We introduced the Health Workforce Australia Bill in 2009, fairly soon after we are elected, to establish this new agency. It was agreed across COAG—Labor and Liberal states and territories agreed to this. The stakeholders expressed some concerns at the time, and we responded by accepting amendments to the bill so that the functions of the agency would not include responsibility for the accreditation of clinical education and training. We made amendments; we listened to the stakeholders. We put people such as medical academics, nurses and experts in rural recruitment and rural workforce in the agency. We did that in consultation with the states and territories. They were precisely the kinds of experts you would want and expect to have in an agency that deals with health workforce planning. We acted in response to the need of the Australian population. We did it on the recommendation of the Productivity Commission and we did it with the concurrence, consent, approval and approbation of the states and territories. Through this legislation this government is doing exactly the opposite. The work that has been done by Health Workforce Australia is crystal clear—evidence based health workforce planning, capacity building, targeted reforms, innovation and reform of the health workforce in this country, international recruitment and retention programs—the list goes on and on. We received an interim program report from them for approval by AHMC. We announced further funding of $425 million for clinical training and we provided it for 83 agencies across 470 projects on workforce planning, for everything from simulated learning environments to integrated regional clinical training networks to clinical supervision projects—all with the concurrence of the states and territories. Health Workforce Australia produced a groundbreaking report, <i>Health </i><i>workforce </i><i>2025</i>, analysing trends, providing recommendations, setting forth strategies. We listened to what they had to say.</p><p>It takes no imagination to understand why those opposite want to get rid of this. They say they are in favour of good evidence based policy but with this legislation they are showing exactly the opposite. They are going back to the pre-Rudd government period. They going back to the mid-2000s, when there were ups and downs in workforce development. What the government are doing has been criticised by the Royal Australian College of General Practitioners. Its president, Dr Liz Marles, has been very critical. She said:</p><p class="italic">Investment in a well-trained general practice workforce is the key to delivering a high quality, cost efficient and accessible healthcare system.</p><p>The chair of the Public Health Association labelled the plan to get rid of the agency 'short-sighted'. Former president of the AMA Dr Steve Hambleton reported that at a meeting with the minister on 9 October 2013 he had:</p><p class="italic">… emphasised the important contribution the HWA had made to improved workforce planning, and the need for such work to continue.</p><p>But the Abbott government are continuing regardless. They are not listening to the stakeholders. They are not listening to the Productivity Commission. They are not listening to the states and territories. The minister obviously has not read the Productivity Commission's 2006 report <i>Australia's </i><i>health workforce</i>, which recommended the creation of HWA. He may not have read the report <i>Health </i><i>workforce </i><i>2025</i>. He is certainly not listening to the states and territories in relation to this. This is a short-sighted, ideological decision made because they do not like anything that involves the word 'planning'. As if the market works in this area! It does not work and has been shown not to work. Even Liberal states and territories agreed that what we did was the way to go.</p><p>This legislation is not the way to go for the future development of our workforce. We face enough challenges in health and ageing in the future, in getting doctors, nurses and allied health professionals in our public and private hospital systems, in our nursing homes and in community care. You do not meet those challenges by abolishing the agency that is doing the planning, running the projects and doing the investment across this area. The government are not listening to the experts on climate change. They are not listening to the experts on education. They are not listening to the experts on health. They are certainly not listening to the experts across this field. They are not even listening to the states and territories owned and run by their own side of politics. <i>(Time expired)</i></p> <p class='motion-notice motion-notice-truncated'>Long debate text truncated.</p>
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