Opinion Piece: Growing your own health workforce

Friday, 13 June 2014

Tim Kelly, Chairperson, NRHA

The long-standing commitment of the National Rural Health Alliance to overcoming the shortages of health professionals in rural and remote areas is well recognised. Although significant shortages still exist across all professions, the yield from the wide range of programs to improve the situation is set to increase. There are much greater numbers of nursing and medical graduates, including a fair number who come from rural areas.

The Alliance has settled on three fundamental principles for growing the rural and remote health workforce:

  • the lessons learned from recruitment and development programs for the general practice workforce should now be applied across the board to all members of the multidisciplinary team;
  • the current work of clinicians in rural and remote areas and the broader contributions they might usefully and safely make to healthcare locally should receive greater support;
  • a 'lifecourse' approach should be adopted as the framework for health workforce education, training, recruitment and retention programs and transition to retirement.

The application of these principles begins with work to attract more rural students to health professions, continues through rural placements and vocational training, to appropriate support for clinicians who are mentoring early career professionals, and goes right through to making better use of experienced rural clinicians who are willing and able to have some part-time involvement in professional practice or support for those in their early career.

In practice, the ‘lifecourse’ approach begins with inspiring young people at high school to train as health professionals and includes work experience and placement opportunities within the region as part of their education. It is followed up by making sure they have every opportunity and incentive to return to their rural or regional area for some or all of their time as a practising clinician. This approach is often characterised as having a particular town or region 'grow its own' health professional.

The Alliance recently had the opportunity to be directly involved in such a plan - a 'health industry pathway', in the Wheatbelt of Western Australia. A roundtable was held in Northam on 22 May, convened by Trevor Saunders, for Regional Development Australia (Wheatbelt) and Sorcit Ltd., together with the Commonwealth Department of Employment and the Wheatbelt Workforce Development Alliance.

The aim of the Roundtable was to bring together key stakeholders in the health industry to address regional youth employment attraction and retention issues. Representatives from across the public sector in health, education and workforce were in attendance.

The WA Wheatbelt covers an area of over 150,000 square kilometres with a population of 72,000 people. It has an extremely dispersed population, the largest centre being Northam with approximately 16,000 people. This distribution leads to the usual challenges of coordination of health care and access faced by other rural and remote regions, as well as specific difficulties in developing and selling a consistent region-wide strategy for youth transition into employment and the health sector locally.

The event was a great concept and had a successful outcome. It considered some of the systems required to incorporate the socioeconomic determinants of health into planning – like education, transport, infrastructure and employment.

At the meeting a new understanding was developed of the shared challenges across sectors, resulting in a real opportunity to contribute to developing integrated solutions for the region.

Stakeholders agreed to take a leadership role in helping young people to see if they have an interest in the health industry, and to work together to broaden the range of training or entry-level pathways, as well as increase the numbers of these available. When this is achieved there will be a better 'framework of opportunity' for regional young people and families.

Importantly, the process would not be limited to people under 25 years of age, but would also include older members of the community. Regional centres and country towns have many people who would be prepared to take on training at Certificate 2 level in Community Services, for example, in order to gain local employment in the health, community service, aged or disability sector. This training is not only beneficial for what it can provide the local community but may also make the people concerned more productive members of the community and provides them with improved quality of life.

Providing a range of career exploration activities, and a range of entry level pathways for regional youth and families, will help to address regional skill shortages and minimise the tendency 'to press the 457 or immigration button'. And with a greater number of regional employment opportunities , it will help attract people to and keep families (including their youth) in regional communities.

This can help to diversify the economic base of country towns and make them less susceptible to the impacts of adverse weather and international prices. The health and community services sector is a major and growing source of regional employment opportunities and training pathways for regional people - particularly young people. As populations age the demand for workers will grow still further, and not just in health but also health-related activities such as for administrative and maintenance staff. The sector provides employment to males and females, young and old, and the skills obtained have universal relevance, not just in country towns.

The roundtable in Northam in May will hopefully prove to have been a catalyst for country towns in the Wheatbelt and elsewhere in Australia to develop further confidence in their ability to grow their own health professionals. The Alliance stands ready to be involved, directly or indirectly, in further such activities around the nation.

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