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Challenge to continue planning despite Health Workforce Australia loss

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With the closure of Health Workforce Australia in August, Australia is at risk of losing significant momentum in understanding, measuring and planning for development of Australia’s future medical workforce.

Health Workforce Australia, established in 2010 as an agency reporting to the Council of Australian Governments but beholden to none of them, had been providing useful policy advice on medical workforce planning.

Created with a mandate to produce a National Training Plan to end the boom-bust swings in medical school intakes on the basis of short-sighted politics, the agency was making good progress in shaping workforce development, such that all stakeholders in this complex system play to a similar (even if not always the same) score.

Although medical workforce planning will always be an imprecise science, not least because of the significant assumptions involved, the Health Workforce 2025 reports released in 2012 are considered the most robust national workforce planning data produced for the Australian health system. Initially slated for annual reviews, however, the Health Workforce 2025 reports are now showing some signs of age, and are well overdue for refreshed data.

Since the budget announcement, the AMA has been warning of the need to retain the medical workforce planning expertise built within Health Workforce Australia during the past four years. We have been continually reassured that the National Medical Training Advisory Network is to continue with its work plan, and that this would be appropriately supported in its new home at the Commonwealth Department of Health.

Sadly, it is emerging that much expertise has not been carried across from Adelaide to the Department in Canberra, which now bears responsibility for national coordination of medical workforce planning alongside its many other responsibilities and priorities.

Doctors-in-training continually raise training capacity and workforce planning as the most important issues affecting their current and future practice. With the loss of HWA, where to now?

It’s clear that coordination of our medical training pipeline is poor, with little known about the number and intentions of doctors completing their prevocational training. It’s unbelievably difficult to source public data on how many prevocational doctors work in Australia, and how many prevocational training posts they are competing to fill.

Collecting and analysing this prevocational workforce data must be a priority, not just for the Commonwealth, but for all jurisdictions so they can better understand the risk they face as the crunch of increased graduate numbers and limited vocational training capacity hits the prevocational space.

A large number of issues arise from the complexity and lack of coordination of prevocational position offer and acceptance systems across and within states. There is an increased churn of offers and acceptances that jurisdictions and trainees both find expensive and tiring. Coordination of these systems exists for the internship year, at low cost, and should be examined for other prevocational years.

The next meeting of the National Medical Training Advisory Network is scheduled for 3 December in Melbourne. At this meeting, we need to see significant progress on a work plan for NMTAN, including further development of a meaningful National Training Plan with measurable benchmarks and specific guidance on training numbers that can influence sensible training expansion and reform.

Ultimately, in the wake of the loss of such a large organisation with responsibility for medical workforce planning, governments and stakeholders alike cannot afford to lose momentum on this work, which is of great importance to doctors-in-training and our future Australian health system.