A Comparison Of National Health Workforce Planning Strategies In Australia And Singapore

The Health Workforce in Australia

There are some definitions that have been put across by different bodies in regards to what workforce planning entails. The WHO refers to workforce planning as getting the right people that have the right skills in place to do what is required of them. There are different strategies that have been employed by various countries when developing their workforce to ensure that they get the right people in place in doing the duties assigned to them. This assignment compares the national health workforce of two countries which are Australia and Singapore.  Different reasons led to the selection of Singapore and of them are that the countries have the same status economically. A study by Australia GDP Growth Rate, (2018) indicated that the Australian economy is experiencing continued growth with decreasing unemployment rates which has led to the development of a robust financial system while Singapore has also been able to develop the successful free market economy that is corruption free with stable prices and higher GDP. This makes it easier for one to compare their workforce as economic factors have been found to greatly influence the type and amount of workers that the government institutions can support.

 The other factors that led to the selection of Singapore are that the health indicators in the two countries such as life expectancy and infant mortality rate are almost similar and this implies that their health status and indicators are almost the same for both countries. Just like Australia, Singapore offers a universal health care system that works to protect its citizens and also one that is universally affordable to everyone (Kalyani et al., 2017). It is this trends in the healthcare system that makes it easier for one to compare the two countries and develop a clear picture of the status of the workforce. The study focuses on the environmental scan of the two workforces, the data profiles of the health workforce and more so the critical issues that need to be addressed by each country. More so there is an in-depth analysis of the WHO ten recommendations to see if the countries are adhering to it as needed.

The health workforce of Australian is influenced by both external and internal factors that impact how service delivery is tailored to the country. The healthcare system is classified into three main categories among them being the primary health care, public health care and cooperate industries.

Factors That Influence the Health Workforce in Australia

In Australia, health care is given priority and encompasses a range of different healthcare providers and also services that may be from the private sector, the public and the NGOs in the country. The system involves a team of different professionals working together to offer holistic healthcare services to the public that are person-centered. Among the crucial health care providers includes the nurses, the allied professionals, midwives, pharmacist, dentist and aboriginal health worker. From a study that was conducted by the Department of Health | Primary Health Care in Australia, 2018 the Australia primary health care system has been expanding tremendously and improving on a daily basis. To begin with, the country has established a number of colleges and institutions that are geared towards training workers in the healthcare system. The different colleges and institutions offer studies in different professionals that enable the workforce to work effectively and to collaboratively offer appropriate care to the patients. There are numerous institutions that are dedicated to training the health practitioners in the country. However, the main challenge is the cost that is involved in training this particular workforce with an estimation of close to $451,000 for the general practitioners is estimated by a study conducted by Segal, Marsh & Heyes, (2016). This cost is due to some factors among them being the clinical placements that medical students have to undergo, the university fees and the cost of the internship. Due to this most of the institutions have experienced a high dropout rate which decreases the number of graduates. More so to improve the quality of healthcare professionals that are produced from the colleges and universities different institutions for accreditation and registration have been formed to cater for the same (Medical Board of Australia – Accreditation”, 2018). This board has set standards and regulations that need to be met for one to qualify as a professional. From a census that was conducted in 2011 by the census of population and housing in Australia , it was established that  there were close to 70200 medical practitioners in the country  in which among them included a total of 43,400 general practitioners and  while the remaining 25,400 were specialist (4102.0 – Australian Social Trends, April 2013″, 2018).

Studies have also indicated that the Australian workforce has been changing dramatically over the past years regarding composition and work patterns.  Unlike before some many other professions have developed in the workforce and also a change has been seen in the different ways that the health professionals interact with each other and with the patients to deliver quality services. More so the increased rate of specialized has resulted in improvements in regards to care delivery to the patients due to increased development of in-depth skills by the care providers (Duckett, 2013).  The workforce has also engaged in outsourcing of overseas medical practitioners in cases where a shortage is experienced (“Former editor: outsourcing puts Medical Journal of Australia at risk,” 2018).

The Health Workforce in Singapore

Apart from this, there are a number of ways in which the government has influence the health workforce in Australia. The most common ways are through policies laws and regulations that affect the operation of the workforce. The government is responsible for a number of ways through programs and policies that influence the way the workforce operates. The government has been on the forefront to promote activities that are geared towards improving the workforce in the country. One of the ways it has done this is through increased funding for different programs and also looking for alternative means to cope with the shortage of supply in such incidences. The government also makes an effort to develop a model that enhance the robust workforce planning to ensure that the recruited personnel can meet the demands of the country (Strasser, 2018).

Despite all this, there is a number of economic factors that affect the way the workforce operates in Australian and which to substantial extent impacts on the healthcare service delivery. The factor that is affected most by the workforce by the economic factors is the ability to retain workers in the public sector. Most of the health workers in Australia prefer working in the private sector for some reasons and among them is the compensation that the private sector is always willing to offer (Zurn, Dal Poz, Stilwell & Adams, 2004). This trend often leads to an imbalance in the country and thus the need that the economic factors are addressed to bridge the gap.

As indicated in a study by Long (2013), Singapore has made a number of milestones regarding healthcare, and also it has been able to achieve great control of the cost incurred in service delivery at the healthcare level. The country has been able to record the lowest health expenditures in their GDP as compared to other nations across the globe. To begin with, just like Australia, Singapore has a number of colleges and institutions that provide training to the different healthcare providers in the country. These institutions have set the minimum standard for entry into a particular program to ensure that only qualified candidates get into the programs. The ministry of health in the country projected an increase of over 30,000 health workers to join the workforce and between 2015 and 2020 as a strategy to meet the wants of the increased aging population. One of the ways through which the government endeavored to do this is to increase the number of local intakes in the institutions.

Factors That Influence the Health Workforce in Singapore

The healthcare professional conversion programs (PCPs ) are have been established to provide training to fresh school leavers in preparation to becoming nurses and allied health professionals.  Even though there are enough institutions in the country to provide training for the healthcare professionals, the entry cut-offs and the tuition fees are too high which then become had for most students to cope (“Healthcare Workers | Ministry of Health,” 2018). The composition of the workforce in the country is also changing on a daily basis to meet the new demands that come along with the change. The workforce is primarily divided into various branches whose primary focus is on healthy living and more preventive health programs.  Due to the increased aging population, there has been an increase in the number of healthcare providers as compared to previous years. Careers such as engineering have become a significant constituent of healthcare in the country as a result of emerging technologies and other digital transformations that are taking place (Howell, 2013). The government of Singapore has directed its effort in instituting policies and regulations that mainly focus on the improvement of the health and well-being of the society in general. These policies mainly concentrate on the public-private balance, sustainable financing to the system and also strong regulatory governance which gives room affordable health care system. This is according to the information that was offered by “The three factors that make Singapore’s health system the envy of the West – global-is-Asian” (2018).  There are a number of economic factors especially those that relate to the aging population in Singapore that affects the delivery of health services to the society.

The health report by the world health organization (WHO) reveals the following results for Australia.  

From the data provided above it is clear that the highest number of health personnel in the Australian workforces are the nurses and midwives. While the psychiatrist, have the lowest representation in the graph. It should, however, be noted that the nurses and midwives do most of the work, unlike the other professionals. The world health organization recommends a threshold of about 22.8 doctors, nurses, and dentist per every 10,000 population. When this threshold is measured against Australia, then there is a deficiency in the number of the dentist (WHO | Achieving the health-related MDGs. It takes a workforce, 2018)

From the WHO publication, the statistics for Singapore on the population density per 10,000 populations is as follows

Comparison of the Health Workforces in Australia and Singapore

Once again in Singapore, the highest number of health workers from the data provided in the nursing and midwifery. The dentistry once again has the lowest number of health practitioners and as compared to Australia Singapore has a gap to fill for both the physicians and the density’s since they do not meet the minimum threshold of 23 personnel per 10,000 populations.

 The density of hospital infrastructure for Australia and Singapore.

Hospitals and psychiatric beds are given for every 10,000 populations

Computed tomography, radiotherapy and mammography units are given for every one million population.

The WHO statistics did not indicate the hospital density of Australia. However, the World Health Statistics that is affiliated with WHO reported that there were 38 beds for every 10,000 populations in Australia (Gigerenzer, 2009). The data below is adapted from GHO | Global Health Observatory Data Repository (Western Pacific Region) | Health workforce. (2018).

The following trends have been observed in the various health professions in Singapore and Australia

 The data above shows that the number of physicians in both countries has been increasing tremendously over time.

Just like the number of physicians, the number of nurses and midwives has greatly improved over the years in the country as indicated by the data above.

 The data above shows that the dentistry personnel in Australia has been fluctuating but with a major decrease in the period between 2009 and 2011. These data indicate that there is a need for the ministry of health to take action about the same.

 In Australia since the year 2011 the pharmaceutical personnel has been growing intensely over time however once again there was a slight fall in the number of personnel between the years 2010-2011 as shown above. In Singapore, the number of personnel has been greatly increased over time.

There are a number of critical factors that have been identified that need to be addressed by both countries. One among these factors is that the key one is personnel in the health sectors do not meet the recommended threshold of WHO which is 23 per of 10,000 populations. Again the two countries need to improve the amount of infrastructure that is geared towards healthcare provision. Australia has a task to bridge the gap between the decreasing numbers of dentists to meet the requirements of the WHO. The quality of pharmaceuticals in Australia has been a major concern of the World Health Organization its commencement. Nonetheless, since according to the WHO constitution it demands that one of the primary healthcare organization’s responsibility should be to develop, establish and support multinational standards in respect to pharmaceuticals. As a result, both Singapore and Australia should allocate a substantial amount of money of its entre health budget to healthcare.   

1. One of the requirements to transform the health sector is through increasing the number of workforce in the healthcare sector and particularly in the department of dentist and the pharmaceutical because from the above statistics there has been a deficit in the personnel supply. The two countries need to focus on increasing the training facilities especially for the dentistry and the general practitioner’s category. In so doing this will help to ensure that there is sufficient supply of the healthcare personnel that will meet the ever skyrocketing demand from the public.
2. There is a need that the countries ensure that there is equality and rights so that more women are given a change to participate in the healthcare system. Accordingly, so that to see to it that the problem of equality in the allocation of carrier opportunities become a thing of the past, the administration of both nations should enact laws that support equality. In this sense, the law will help to advocate for equal participation among its citizens regardless of one’s gender in access to healthcare training thus, this will offer women an upper hand to take part in healthcare related courses.
3. The third recommendation is on Educations training and competencies where the two countries need to adopt appropriate training strategies that will enable them to have skills that match their health needs. Both countries should only allow those qualified for the healthcare courses to be allowed to train so that those who have not merited do not hinder those that have qualified to peruse their carrier with passion.
4. Singapore has gone a great mile in adoption of new technologies, but more needs to be done in Australia as the country has more changes of improving its technology. Technology is a major game changer in the healthcare department because it makes it easier in terms of record keeping, retrieval as well as diagnosis and analysis of patients.
5. Both countries should develop appropriately to be used in health service delivery and organization. That means that the two nations should invest more in the healthcare sector both in terms of personnel and healthcare equipment.   
6. The other recommendation is financial and fiscal space where there is a need for the countries to increase funding in the health sector and this is especially in Australia where studies have indicated that there is a shift from the public sector to the private where there is more compensation of the workers. That calls for the country’s government to increase their budget allocation for healthcare because health is an essential necessity that should be given priority.
7. Australia should endeavor to develop more partnerships and cooperation that can be done both at national and international level, this will see to it that the private and public sector works cohesively in service delivery. Accordingly, partnering with other healthcare organization provides a broader base for the nations to learn from each other and in so doing gain in various ways on how to boost their health care service delivery.  
8. The government should embrace policies that reduce international migration and more so take into consideration the advanced recognition of  health workers so as to maximum use their skills and increase the benefits while reducing the negative effects of health workers. Declining on international migration of health workforce will help to increase on the number of practitioners providing services to citizens of their nations. Therefore, both governments should improve on the working conditions for its healthcare workforce as well as the salary it offers since health workers opt for working outside their nations due to a better pay and supportive working environment.    
9. Data accountability policies based on research and analysis of the health labor market. Certainly, to improve on the healthcare service delivery, both countries should increase on their healthcare research. Similarly, the healthcare department of both countries should adopt WHO healthcare policies because these policies helps in terms of planning, healthcare decisions and actions that are taken by healthcare organizations with the society healthcare being given key priority.
10. Crises and humanitarian settings .The countries should ensure that they take time to invest in international health regulation in such areas as development of skills in the national and international workers. More so there should be proper protection of health workers and the health facilities as needed

References 

 4102.0 – Australian Social Trends, April 2013. (2018). Retrieved from https://www.abs.gov.au/AUSSTATS/[email protected]/Lookup/4102.0Main+Features20April+2013

Australia GDP Growth Rate | 1959-2018 | Data | Chart | Calendar | Forecast. (2018). Retrieved from https://tradingeconomics.com/australia/gdp-growth

Department of Health | Primary Health Care in Australia. (2018). Retrieved from https://www.health.gov.au/internet/publications/publishing.nsf/Content/NPHC-Strategic-Framework~phc-australia

Duckett, S. (2013). The Australian health workforce:facts and futures. Australian Health Review. 23. 60. 10.1071/AH000060.

Former editor: outsourcing puts Medical Journal of Australia at risk. (2018). Retrieved from https://theconversation.com/former-editor-outsourcing-puts-medical-journal-of-australia-at-risk-41160

GHO | Global Health Observatory Data Repository (Western Pacific Region) | Health workforce. (2018). Retrieved from https://apps.who.int/gho/data/node.main-wpro.HWF?lang=en

Gigerenzer, G. (2009). Making sense of health statistics. Bulletin Of The World Health Organization, 87(8), 567-567. doi: 10.2471/blt.09.069872

Healthcare Workers | Ministry of Health. (2018). Retrieved from https://www.moh.gov.sg/content/moh_web/home/pressRoom/Parliamentary_QA/2017/healthcare-workers.html

Howell, J. (2013). The Changing Meaning of a Health Care Workforce. Academic Medicine, 88(12), 1795-1797. doi: 10.1097/acm.0000000000000019

Kalyani, M., Ying-Qi, K., Rie, A., Shang-Chee, C., Serena, T., & YiongHuak, C. et al. (2017). Posting Feedback – a New Strategy in a Developmental Behavioural Pediatric (DBP) Posting in Post Graduate Medical Training in Singapore. Journal Of Advances In Education Research, 2(4). doi: 10.22606/jaer.2017.24004

 Long, L. (2013). Embracing Pluralism in Singapore Healthcare. Proceedings Of Singapore Healthcare, 22(2), 91-92. doi: 10.1177/201010581302200201

Medical Board of Australia – Accreditation. (2018). Retrieved from https://www.medicalboard.gov.au/Accreditation.aspx

Segal, L., Marsh, C., & Heyes, R. (2016). The real cost of training health professionals in Australia: it costs as much to build a dietician workforce as a dental workforce. Journal Of Health Services Research & Policy, 22(2), 91-98. doi: 10.1177/1355819616668202

Strasser, R. (2018). Will Australia have a fit-for-purpose medical workforce in 2025?. The Medical Journal Of Australia, 208(5), 198-199. doi: 10.5694/mja17.01169

The 3 factors that make Singapore’s health system the envy of the West – global-is-asian. (2018). Retrieved from https://global-is-asian.nus.edu.sg/index.php/3-factors-make-singapores-health-system-envy-west/

WHO | Achieving the health-related MDGs. It takes a workforce!. (2018). Retrieved from https://www.who.int/hrh/workforce_mdgs/en/

World health statistics. (2015). doi: 978924069443

Zurn, P., Dal Poz, M., Stilwell, B., & Adams, O. (2004). Imbalance in the health workforce. Human Resources For Health, 2(1). doi: 10.1186/1478-4491-2-13

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