External Labour Market Factors Impacting on the Australian Health Care Industry - Literature review Example

EXTERNAL LABOUR MARKET FACTORS IMPACTING ON THE AUSTRALIAN HEALTH CARE INDUSTRY Student’s Name Course Tutor Date External Labour Market Factors Impacting on the Australian Health Care Industry Introduction The effective management of workforces is influenced by both external and internal factors. This is because the national and international factors shaping the labour market have implications on the ways that individual health-service organizations provide (Wilkinson, 2008). The factors impact on the supply and demand of health care staff at different levels. Australia is specifically facing a shortage in supply of healthcare professionals due to an ageing population, past policies that did not ensure sustainable generation of a labour force and changes resulting from globalization (Duckett & Willcox, 2011). This paper discusses the various external forces impacting on human resource planning and the labour force in Australia’s health care sector. An Ageing Population As a country, Australia is currently faced with the possibility of a worsening shortage in its health professionals in the next two decades. This is mainly because many of them are ageing and will have started retiring. For each group of 110 health professionals that will be retiring, there will be the likelihood of only be adequately qualified by 2025. The ageing of the workforce has only been partially dealt with through the increase of medical school intakes by double in the last four years, with the numbers of graduates likely to peak in 2014. Nursing as a profession is already faced with a shortage of skills, with New South Wales alone predicting a shortfall of approximately 10,000 by 2028 (Working-in News Team, 2011). Globalization and Technological Change Just like other sectors of the society, the Global Financial Crisis has had a considerable effect on the health labour markets. Buchbinder & Shanks (2011) explains that it has been among the significant unpredictable influencers that have led to uncertainty in various determinants of the Australian health workforce. In planning, its effect may take various forms. A decline in the value of the Australian dollar would imply that the health workforce will become more unattractive to international applicants. However, a rising rate of unemployment in the country might expand the employment pool that provides staffing for the health workforce. Technological change in health care provision has a significant impact on the supply and demand of labour. According to Townsend et al. (2011), technological changes in education and training can either raise or reduce differentiation between different groups of health workers’ relative productivity, specialization and substitutability. Slight improvements in the technology may cause a rise in demand as a larger number of people will be likely to gain from the technology. It also affects demand in alternative markets for the relevant health labour. For instance, online learning together with improved Information and Communication Technologies lead to expansion in the education and training markets. Changes in health related issues due to other factors can jointly with technological advancement raise demand for staff. Government Policies and Regulations Government policy and regulations are instrumental in determining the pattern of available healthcare labour. According to Barraclough (2008), Australia is facing a shortage crisis in its healthcare workforce due to various reasons. One of these is the small number of medical students that is trained, especially at postgraduate levels. Australia’s health education and monetary regulations, policies and legislations have together had the effect of creating the shortages. For instance, from the 1980’s and 90’s, government policies limited the medical school openings that would be available in Australia. The federal government in this manner was justified by the rising costs in Medicare because of a growing average number of Medicare related services per person. It also cited an attempt at balancing its fiscal policy. Willis (2009), explains that the 1996 Health Insurance Amendment Act (No2) arose as a response to the impression that the oversupply of doctors was among the main cost pressures on the economy. The legislation reduced intakes to medical school, numbers of staff and doctors from abroad being admitted to work and a reduction in the need for temporary staff from overseas. The resulting deficit in graduate numbers has enforced Australia’s reliance on labour from overseas to serve its health care system. There is the consolidation of six different territory and state recruitment schemes to create one. The single unit advertises thousands of vacancies and offer training to overseas staff in order to bring them up to the Australian standards and registration requirements. This aspect is significant to human resource planning as it offers a ready, qualified and an easily identifiable source of staff for health facilities in case of need (Duckett & Willcox, 2011). Socio-Cultural Change The autonomy of medical practitioners is a major external factor influencing health sector labour supply. It has specifically led to a shortage as new generations of doctors for instance are different from past ones in terms of an emphasis on lifestyle and family issues. This has affected retention and recruitment efforts within the sector. Many of the newer resident staff and trainees are willing to commit themselves to the long working hours or unpaid overtime that their predecessors did (Buchbinder & Shanks, 2011). According to Chen (2006), demand and supply of labour is the main issue in healthcare human resource planning. This is on its part dependent on factors such as the disease burden within the Australian population. This is leading to greater demand for health services. Its main causes are lifestyle, environmental and demographic patterns as the population ages. Chronic diseases for instance heart disease and type II diabetes and the complexity in care required for them lead to a rise in demand for services. They also raise the need for particular mixes of skill in the health workforce together with new care models. Barraclough (2008) further argues that a rising number of female medical staff is one of the factors that led to greater demand for traineeships, part-time work and an ability to get in and out of healthcare workforces. Medical practitioners need more self-determination, control and satisfaction within their personal lives. This had led to the reduction in the numbers of full-time hours that they work and therefore need to adjust Human Resource Planning in order to accommodate the trend. Connell (2008) argues that attempts at increasing the number of medical graduates trained in Australia have their own potential difficulties. They further strengthen the country’s reliance on medical migration. This is because first, there are not enough medical supervisors and educators in Australia. In addition, there are changes in patterns of service delivery. New treatment modalities, technologies and policy guidelines at institutional level have led to constant changes in health service delivery. This in turn affects the skill mix that is needed in the health workforce. For instance, there has been a notable increase in same-day admissions to hospital. This has raised the need for more attention to overnight admissions and therefore influenced the skills which are needed for the workforce. At the same time, a rise in the management of diseases that are chronic within primary care settings raises the demand for workers in the settings. According to Barraclough (2008), community expectations have an influential role in workforce composition and availability. The population in Australia has in the past been offered quality healthcare by the system. It therefore has expectations relating to ready access to services that they require whenever required. Shortages in qualified workforces are therefore a challenge to healthcare planners in their attempt to address the expectations, as there are long waiting times in emergency departments and hardship in getting appointments to see General Practitioners in case of workforce shortages. This creates an imperative for human resource planners to act. Workforce Expectations and Characteristics Workforce expectations relating to employment are an external factor. The expectation that exists among health workers, especially in relation to the hours they will be willing to devote are changing. This influences the overall worker supply as they tend to prefer fewer hours participating more in their social lives (Gollan, 2005). Willis et al. (2009) add that trends in workforce specialization are determinants of the appropriate planning approaches. With time, the Australian health workforce has tended to become more specialized and diversified as a response to various factors. These include technological and scientific changes, professionalisation and changes in healthcare models. The workforce has generally been fragmenting itself into several sub-specialties and professions, each of which defines and protects the role it plays through measures such as the control of registration, entry criteria, political influence and industrial action. The more control each of the group has, the greater potential it has in influencing the specific contribution that it makes in healthcare provision. According to Barraclough (2008), strategies that are developed to deal with staff shortages might in turn lead to the creation of new or more shortages, or move the shortage away from a given sector or region to another because of the interconnected and complex nature of health workforces. For instance, demand management strategies for a hospital might lead to a shift in demand from acute services to community health services. The employment of more nurses to general practice in order to deal with capacity shortages and manage demand might also lead to nurses moving away from the acute service sector. The attraction of international graduates to fill Australian job vacancies is also capable of increasing the supervisory burden in the workforce. Recommendations for Human Resource Development The main issues to be considered in workforce planning for the health sector include the development of a collaborative action between education, health, regulatory and vocational training sectors, in order to promote a health workforce that will be skilled, knowledgeable and competent. Importantly, it should be well distributed regionally so as to ensure equitability in health outcomes. At the national level, Australia will need to focus at least on the achievement of self sufficiency in its healthcare workforce, while still accepting that it belongs to a greater global market. Policies relating to the workforce need to be consumer and population-focused. It should also have a relationship with the planning of broader health systems and healthcare planning, basing on information which is best available (Willis et al., 2009). In implementing immediate term change, human resource planning needs to adjust recruitment and retention measures so as to cope with the external forces. Human resource planners would need to introduce mechanisms which will lower the attrition rates and promote the reentry of trained healthcare workers who may have left the sector (Gollan, 2005). The number of qualified personnel who may come back is however limited hence making this a short-term measure. In the middle term, more effort should be made at increasing the number of new graduates who enter into the different professions (Wilkinson, 2008). In line with the policy guidelines given by the government, opportunities for training have to be expanded. At the organizational level, this should be extended to employees. Training programs that can resolve the challenges posed by technological and environmental changes should be enforced (Townsend et al., 2011). In the long-term, the organization can establish alliances with recruitment firms that will ensure the acquisition of the best skills. There will be the need to ensure that potential employees have a chance to get appropriate skills mix so that the specialist areas’ long-term needs can be met. Ensuring adequate supply of well-qualified staff will be important by locality, for instance remote and rural Australia. To address the challenges in healthcare management, there is a need to emphasize workforce planning. Authorities should ensure coordination so that planning strategies are not ad hoc responses made by the territories and states, as this would make sure that there is the involvement of important primary inputs into the equation so as to generate meaningful and accurate results. The same approach should be taken at the organizational level so as to ensure that all organizational policies are aligned towards the most efficient and effective recruitment, retention and training of workforces. Conclusion In conclusion, Australia is part of an international system in which there is a shortage of the required health workforce. The present and projected future shortages in health-care staff in Australia is the result of various demographic, clinical, professional and socio-cultural factors which all impact on workforce supply and demand. The challenges are not distributed uniformly, but vary depending on specialty and profession. They also differ depending in geographical location for instance rural, metropolitan or remote areas. In the past, there have been strategies to manage the workforce. However, these have only had a partial focus. Human Resource Planning therefore has to be strengthened. 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