Editorial

Abstract

A couple of years ago (Cross, 2009) I wrote about some of the policy directions influencing nurse education and what I saw as the response needed by universities and health services in addressing them. One of the important policy changes was related to health workforce. When I wrote in 2009, the National Health Workforce Taskforce (NHWT) was coming to an end and transitioning to Health Workforce Australia (HWA, 2010). HWA's remit involves:national workforce planning, policy and research advice; access to quality clinical education placements across all health sectors through extended capacity, improved quality and variety in learning opportunities; a national network of simulated learning environments (SLEs); a national program of health workforce innovation and reform; interprofessional practice and a nationally consistent approach to international recruitment of health professionals to Australia.In recent times there again have been initiatives affecting universities and health services as they work toward educating the future health workforce. These schemes include the many HWA calls for submissions related to clinical placements, simulated learning environments, scoping/mapping data and inter-professional education.Moreover, in Victoria we have also seen the introduction of clinical placement networks (CPN) that have the objective of 'streamlining' and 'equalising' the placement of health workforce students within public health services. Networks of this type will be rolled out across all states in due course. Funding has flowed as a result. However, the funding that has been attached to these initiatives does not address the fundamental underfunding of clinical-based courses. Moreover, the assumptions underpinning average clinical hours and the dollar value attached as a 'subsidy' to universities has been seen by many health services as the yardstick by which additional charges will be made based on the assumption that this is the standard amount per student per day. Previously 'free' or 'low-cost' placements are now being paid for out of already stretched clinical budgets.Despite long-term relationships between universities and health services, the real possibility of having these relationships destabilized exists as the market players jostle for their share of the places and the funds available.Important work being undertaken involves workforce training. HWA will develop a national training plan specifically for the dominant professions of medicine, nursing and midwifery practice proposing the most advantageous entry numbers for each professional group over the next 14 years. This will be undertaken to achieve self-sufficiency in health professional supply by 2025. HWA acknowledges that Australia is part of a global market for health professionals and continues to investigate the recruitment of overseas trained health professionals (HWA Workplan December 2010).A statistical resource (database) is being compiled to amass a range of national data relevant to workforce planning, including data from the Australian Health Practitioner Regulation Authority (AHPRA). Further, a National Health Workforce Planning Tool is also in development whereby high-level simulation modeling will permit supply and demand projections of the health workforce into the future to be calculated, concurrently providing a facility to analyse various supply and demand scenarios (HWA Workplan December 2010).Using the numbers modeled, HWA will develop a training plan for each profession signifying the number of undergraduate, post-graduate and specialist training positions required each year until 2025 that will be required to meet the goal of self-sufficiency across various geographical locations. Importantly, HWA will also need to address the retention issues of the health workforce and these also need to be modeled.One assumes that funding will follow though this is not overtly stated. Given the scramble for funds during the last round by both education providers and health services, it is understandable that as scenarios are modeled and tested, there will need to be 'testing stations' that are adequately resourced to either confirm or negate the model. …