Home - Claire Moore - Labor Senator for Queensland

BILLS: Health Workforce Australia (Abolition) Bill 2014 - Second Reading

Senator MOORE (Queensland) (19:47): It is a real pleasure to be able to speak tonight about my admiration for Health Workforce Australia. Even though we stand here tonight speaking with great passion about the worth of this group and the work that they have done, we know that the government has already disbanded them. Most of the work has already happened. I am sure the property is being sold. People have already moved. People know who has got their job and who has not. But regardless of that process it is still important to talk about the concerns that were shared with us in our committee about why the government has decided to make savings-and 'budget savings' is the only reason they are able to put forward as to why Health Workforce Australia is no longer with us. There were no questions about why Health Workforce Australia was set up. There were no questions about the efficacy of what they did. There were no questions about the importance of the work they did or indeed the fact that they had a forward plan already in place, already approved by their board, to look at work into the future. There were no questions about that.

We had a considerable discussion about the fact that this particular organisation was originally set up after a Productivity Commission report that talked about the need for a coordinated response to the health workforce in our nation. Again, this is an issue about which there is no debate. There is agreement that there must be a form of coordinating workforce in our nation so that we can effectively respond to the differing needs of our nation and so that we can work with people across state boundaries and professional boundaries and have a shared commitment to meeting those needs.

When Health Workforce Australia was put in place the terms of reference were very clear. It was set up to ensure that there was a coordinated response, it was there to plan into the future and it was there to ensure that there was an effective program that looked at innovative ways to look at training to make sure that we had the best trained workforce in our country.

In evidence to the inquiry that we held, a range of professional groups, consumer groups and people from the community all talked about how much they valued the services that were provided by this organisation. It is on the Hansard record. A number of submissions came through and we had very detailed Hansard processes. I would like to quote from a few of them because I think it is important to hear from the people who work in the industry about their concerns about this government decision and about losing this valuable process that we had. The Royal Australasian College of Physicians, in its submission to the inquiry, said:

The core functions currently performed by HWA are becoming more rather than less important. Driven by Australia's aging population, increasing levels of chronic disease and the emergence of new healthcare technologies, there will be a need for changing models of healthcare which in turn dictates changing workforce needs. Hence, there is a significant imperative for the timely collection and analysis of detailed and accurate health workforce data. This data needs to be able to be considered at a national, State and local level. HWA's health workforce data collection and analysis functions also need to be seen in the broader context of its role in facilitating and developing new models of care The continuation of these related functions needs to be assured following the abolition of HWA.

So the people who are involved in the area were also aware that the government was not going to be diverted from its publicly stated position that was announced rather than debated in this place. The government announced that Health Workforce Australia was going to close. My understanding and also the understanding that was presented at our Senate committee was that there had not been extensive consultation with the industry. There had not been engagement with the range of people who were all too willing to come and talk to us at our Senate inquiry. We had no problems, with the very short time frame we had, in having a range of people wanting to come and tell us about how much they had considered the roles which had been carved out by Health Workforce Australia, that they had worked with their board and had engaged with, as I have said, all states and territories and all professions and had come up with an analysis of what we needed in terms of an effective workforce to respond to the needs of our nation.

The best we could get from the department when they came to give evidence at our inquiry was that the roles would continue, only this time in the department. We thus heard from Senator Seselja about some of the key programs which will be maintained. We still do not have a full list and a commitment into the future. What would be very useful to see and what I asked for was some commitment around the forward plan that Health Workforce Australia had developed-to see a graph, to see all the work that was on that plan, which had been endorsed by the board and industry, and to see which of those were going to be fully funded and implemented by the government into the future. There are some and I think that needs to be acknowledged. Some of my personal favourites are the training aspects and the incredible work that Health Workforce Australia has done using simulated training. This is an area that is becoming particularly relevant across a whole range of professions in this nation where they can have training that can be done not necessarily in the actual workplace but whereby people can actually get their training in a simulated way, which is fully accredited and acknowledged and which uses the best possible development. That came up consistently as an important area that needed to be continued and my understanding is that the government will continue to do that. I sincerely hope so because of the considerable investment that has been placed in setting up that program, in having it there and ensuring the knowledge base. There is no reason why that workforce training should not continue into the future.

What I think is most distressing about the process is that the need was identified through the Productivity Commission and through the engagement of people in the community that the most effective and indeed engaging way to get the work, the analysis and the independence was to have a statutory body which was separate to the department but naturally cooperating with the department, because that is the way it operates. There would be work and tasks being undertaken by the department consistently but working with Health Workforce Australia, which was specially tasked and funded to do a range of jobs. They would be able to complement each other, work effectively together and fulfil the needs that had, jointly, been agreed to be undertaken.

Naturally, at times, there would be communication issues. I asked the department about communication issues, because the department in their submission quoted that a lot of the bases upon which they brought forward issues were on issues that were brought out in the Mason review of the structures which were done, completed and actually tabled in 2013-not that long ago-which had a range of recommendations about the best way that workforce planning could continue into the future in the medical area.

At no time did the Mason review, although quoted by the department to look at the way things had to improve-which I have read and it was an in-depth and extensive review of this area-recommend the abolition of Health Workforce Australia. In fact, when you read the department's submission, which I know is public, you might be excused for thinking that perhaps there was some recommendation of that kind. It was clear that there were issues about communication and no-one doubts that. When I asked the department at the inquiry about the communication processes around how it worked, they said that a mechanism was in place for interaction between, firstly, the department, the unit of the department which looked after workforce, Health Work Force Australia, and then the minister and the government. I would have thought that would have been an expected process out of an organisation which has only been around for a short time, working with the department from whence it came. However, it seems that, rather than working on ensuring that that communication process was better entrenched, rather than working on how you could best use the expertise and the resources that were in place with Health Workforce Australia working with the department, the government's decision for economic reasons-and I am willing to be told if there is any other reason to close down this organisation; clearly, it was a savings measure and it was a difficult decision that the government had to make-was not to look at streamlining or working in a way that would fit a model better but to wipe out Health Workforce Australia.

That process has been successful; it has already gone. That is what I find most frustrating about this process: it has already gone. Nonetheless, it is important to talk about what will happen in this area without this resource. Other senators have talked about the extraordinary work that Health Workforce Australia has been able to do in pulling together issues around the best use of the areas of nursing and midwifery. As you know, our community affairs committee has had a long relationship working with these professions to see how we can best look at the need and at the practice. The debate about the best way that we can use the professional skills of people who are well trained and skilled in our health workforce will continue and must continue.

The health workforce process could do an efficient analysis of where the jobs are at this point across the board in our nation and project forward what the needs would be into the future, looking at all those dynamics which we know about, with our changing population, our regional needs and also the way that Australians are seeking to use their health system, which I think has differed in a great way. The skills of Health Workforce Australia could look at that and produce what I think is a well-acknowledged series of documents which now has provided a benchmark for future planning in this area. That was a huge task and was one that took a great deal of time and needed to be there. It also needed to be maintained, because out of that work came planning for the future about how we would best meet the needs of our community.

We cannot have a body of work of that type completed and then shelved. This has got to be a dynamic process. Again, this is looking at the issues of having a work plan, meeting the milestones of that work plan and then planning into the future, using the same people who have the dedication and engagement in the process. The difference with Health Workforce Australia was this came out of the COAG process, it has engagement from the states and territories, and this was seen as an independent organisation. So rather than having individual organisations in states and state governments and state departments working with the Commonwealth department, they were able to meet and work-and I keep using the word but it is such an important word, it is a value-added word-'engaging' with the process. With an independent statutory body, they are going to be back to the process of working with the Commonwealth department.

Consistently, Acting Deputy President Smith, as you would know from our experience in Western Australia, there is tension in terms of the relationship between state bodies and Commonwealth departments. That is not laying blame in terms of process; it is a reality. It was an issue identified in the Productivity Commission report out of which Health Workforce Australia was created. It continues to be an issue because of the whole feeling of ownership and effective respect.

I have no doubt that there will be absolute commitment and professionalism by the officers in the Commonwealth department who will take back the full responsibility of workforce planning in the process. I have no doubt about that. What I do actually acknowledge, though, is that there will be competing demands, there will be competing tensions and also in terms of the people with whom they can meet and interact there will be limitations in having a Commonwealth department dealing with agencies across states and also with professional organisations across a whole range of areas.

Out of this debate we need to salvage the good work of Health Workforce Australia. When you go into the last annual report of Health Workforce Australia-and I am determined not to use the abbreviation in this contribution; I will continue to spell it out in full-you actually see the pride with which the organisation had mentioned what had happened; their highlights of 2012-13. They actually put on record the third and final volume in Health workforce 2025. That is the one to which I was referring to earlier. It was the doctors, midwives and nurses series, which was completed and released in November 2012-again, to be a dynamic document to be worked on into the future.

I mentioned earlier the simulated learning environment. I know we have had contributions about the Clinical Training Funding Program. Again, our committee has been involved over many years with issues about the clinical training programs and access to clinical training by a range of medical professions not just medicine but in terms of other groups which desperately need an effective clinical training program. It absolutely must be coordinated effectively nationally. At the moment so much of it is reliant on states, and we have seen at the end of academic years the loss-I think the absolute waste-of people who trained effectively in their professions and could not then get an effective clinical placements. This was another area that Health Workforce Australia had identified and looked at working cooperatively into the future to ensure that we did not waste the very valuable resources that we have in the workforce.

I know that I am getting close to running out of time, but I just want to mention two of the things that I think have not been picked up as much as they could have been in this contribution. I do ask people who are interested in this area to have a look at the annual report of Health Workforce Australia, to have a look at the contributions that came through to our Senate Community Affairs Committee about what people in the profession, consumer groups and organisations valued about the work. One of the areas that we worked a lot in over the last few years has been in the area of Indigenous workforce across the board but in particular in the health workforce. This organisation had done work about planning into the future about how we respond to the need to have more well-trained Indigenous operatives across-the-board across professions. This is something that governments of all kinds have been struggling with over a large number of years, not just providing people in place but ensuring that they have the skills necessary, again, to look after their communities in the best possible way and to ensure that there is that effective placement particularly in remote regions but not only there. It is looking to ensure that we have people who are best trained and best placed to serve their local communities. This will continue to be a challenge for all of us. This was a program that Health Workforce Australia had put in place which needs to be picked up by the department, and I am sure it will. It must not be lost.

The other area was the National Cancer Workforce Strategic Framework, which was published in June 2013. This is another area where there has been considerable interest and engagement. This was an area that was particularly mentioned by consumers in Australia. There are so many opportunities now in the cancer workforce. We have seen great discussion about pharmaceuticals in this area but also different training and access to services. Rural and regional people still, to our shame in this country, are not being able to access their best care in cancer services, and there have been numerous papers put out, including one by Health Workforce Australia, about the issues around that. That is another program that I would hope that would be able to be brought forward into the future.

I do not believe, even though we will be strongly arguing the case in this place, that we will be able to turn the government's decision around, particularly as they have moved most of the staff and that has already concluded. However, I think that we cannot lose the investment and the commitment that we had, and shared, in setting up the organisation in the first place. We cannot lose the investment and the interest that determined why it was needed. We know the work continues to be needed. We know it must not be lost. So, in the rush to make the difficult decisions, in terms of the process, keep in mind what was achieved by Health Workforce Australia, value what was done and, please, do not forget this period in our history, because what we have done we can learn from and it will be a better place.