Programs to support students on placement need careful design
We need to sound the alarm on a looming critical shortage in the health workforce or Australians will suffer an increase in avoidable deaths from many illnesses including cancer, mental health problems and heart disease.
Already those living in rural and remote areas are 1.5 times more likely to die of many conditions than those in major cities, due to several factors including longer wait times to see doctors, nurses and specialists.
We have a growing and ageing population, and the聽聽estimates more than 500,000 new healthcare and social assistance jobs will be needed by 2033, only nine years away, to meet our needs.
So how do we ensure we are training this workforce pipeline?
The Accord proposes that part of the solution to the skills shortage can be found by addressing the financial burden, or聽, faced by students.
鈥淧lacement poverty鈥� should be addressed as an equity measure, providing means-tested financial support for students who face 颅severe financial pressures when undertaking compulsory training placements.
The financial support could include a bursary system as well as a bonded scholarship scheme for 颅allied health, dental, oral health, nursing and pharmacy students which could help address the critical health workforce needs in rural and remote areas.
But we should not mistake these placements as 鈥渦npaid work鈥� and require that all placements be paid.
They are not employment, but a mandatory part of a health student鈥檚 education and training. They are practice-based training completed in a supervised setting.
Known as 鈥渨ork-integrated learning鈥�, they ensure students develop the technical skills and knowledge required for registration in their health profession and are compulsory to ensure that when health professionals graduate they are safe practitioners 鈥� able to deliver care at the standard required by the Australian public.
Introducing across-the-board 鈥減aid placement鈥� threatens the 颅integrity of the training 鈥� raising potential conflicts of interest when it comes to assessment of healthcare students and conflict between the priorities of the 鈥渆mployer鈥� and the learning needs of the students.
A better financial support model would be a bursary system 鈥� jointly funded by the commonwealth and the states 鈥� similar to the UK鈥檚 National Health Service-Learning Support Fund. That fund applies to specified healthcare courses and includes training grants, funding for travel and temporary accommodation, and a fund for students experiencing 颅financial difficulties.
Employers should also make reasonable contributions to the costs of supporting placements as they benefit from the pipeline of qualified graduates. And universities can play their part, such as through top-up university bursaries to help get more low SES 颅students to university in the first place.
There is a place for government policies to encourage financial support from philanthropy, as well as from business, to address student placement poverty across the health professions.
Such co-ordinated action under a new decade-long national health workforce strategy can ensure our universities continue to train a health profession workforce of excellence, as well as diversity in the numbers and in the areas necessary to meet the needs of all Australians, wherever they live.
But we should be careful not to misdiagnose the problem and 颅develop the wrong solution and treatment plan.
This article was first published as an opinion piece in on 3 April 2024. It is authored by Professor Robyn Ward,聽Executive Dean and Pro Vice-Chancellor of Medicine and Health at the University of Sydney.