A Comparison Of Health Workforce In China And Australia

Policies implemented by China and Australia to increase access to health services

Discuss about the Medical Workforce Policies.

China is one of the most developed and highly growing nations in the world today. By far, China has some of the best policies when it comes to different sectors of the economy. One of the most important areas that the Chinese economy seems to give attention is the health sector, and in specific the health workforce. There has been several plans in this nations that have been developed to try and enhance access to health services through developing an effective health workforce. Some these plans have worked excellently, but some of them have shown little success. Compared to Australia, there is a lot to learn and observe that has been reported in this paper.

China’s rapidly growing economy has enabled the nation to emerge as one of the best destinations for medical services around the world. In the period between the years 1985 and 2011, the nation has developed a series of polices to help increase access to medical services by decreasing inequalities in delivery of heath services and increasing the number of health workers in the nation’s most rural areas. This strategy seemed to work, since there were observable reductions in inequalities and an increase in the density of health workers in the rural areas between 1985 and 2000, but this trend took a turn for the worse from then on until 2011 (Tanget al, 2013). the economic structure of China where there are visible inequalities in incomes and standards of living make the nation an interesting place to study. Surprisingly, despite the fact that China is among the few largest economics in the world today, it still has a struggling health care sector, and is, therefore, an excellent nation to study.

In the Chinese economy, there is a huge economic disparity between the rural areas and the urban areas. This disparity is larger than what is observed in the case of Australia. The existence of such a large disparity is attributed to the fact that in China, most of the money is concentrated among the cities, and is held by a few people who are very wealthy. The policies for sharing economic resources are not very well structured. As a result, when it comes to resource distribution, the cities with the bulk of the national wealth benefit more than the rural areas.

While China is struggling to stabilize its medical workforce, Australia is complaining of an excess of its medical workforce. For the past two decades, Australia has been having increased oversupply of medical workforce for some periods of time, with frequent under-supply. This resembles the situation in China between 1985 to 2000 when there was an increase in medical workforce, followed by a decrease between 2000 to 2011. These constant fluctuations have led the two nations into coming up with programs where they have controlled the inflow and outflow of medical workers in order to normalize medical workforce supply (World Health Organization, 2015).

Economic and medical workforce disparities in China and Australia

According to the 2005 Productivity Commission report in Australia, the areas with highly reduced workforce in the medical sector were the nursing, dentistry and general practitioners. This shortage in the availability of medical workforce was also echoed in the year 2008 by the Australian Department of Health and Aging where it was reported that the medical workforce that was mostly inadequate were the gynaecology and obstetric practices. On the same note, the Australian Institute of Health and Welfare Medical Labour Force pointed out the disparity in the distribution of the medical workforce between the major cities and rural areas throughout the nation in the year preceding 2009 (Australia’s medical workforce , n.d).

Although both nations seem to have great shortages in local staff, they both share low numbers of medical expatriates. In both China and Australia, the governments are working towards educating and training their very own through policies approved by relevant authorities. Some of the ways through which these nations have tackled the problem of low medical workforce include increase feminization of core careers in the medical sector. Increased employment of women in the bid to comply with the new millennium goal of gender parity and women empowerment has not only helped to increase the number of women employed in the different sectors of the economy, but it has also helped to increase the number of the medical workforce in the nation.     Another way through which Australia is tackling shortage of medical workers is through recruitment of the international medical graduates from other nations who, although comprise a small number of the medical workforce, contribute greatly to creating diplomatic and professional relations between Australia and other nations. Since the mid to late 1990’s, Australia has been working tirelessly to try and increase the number of international medical graduates that work and live within its borders. Recent reports indicate that international medical graduates comprise around 39 percent of the medical workforce in Australia (Australia’s medical workforce , n.d).

The Australian Department of Health and Aging has also been involved in implementing a policy where the international medical graduates are encouraged to work within Australia by making their entry and registration more efficient. Australia’s Rural Workforce Agencies have been mandated with the responsibility of identifying prospective international medical graduates who are funded to enter, register and settle in Australia in order to be deployed to districts of workforce shortage (DWS) (Australia’s medical workforce , n.d). To enable these medical practitioners to feel more comfortable, they are assisted with visas, medical registration and even the registration and recognition of their medical services.

Gender distribution in the medical workforce

The nation has also come up with a policy where medical practitioners as well as the international medical graduates are encouraged to work in the areas that experience difficulties. This policy is implemented through a strategy where incentives and other benefits are given to those medical employees who decide to work in such areas. The incentive include higher salaries and increased allowances. The increased salaries as well as bounty allowances for housing among other issues has greatly helped to reduce medical workforce disparity (Xueet al., 2007).

.In China on the other hand, there are several specific policies that are targeted at increasing the medical workforce in the nation. First and foremost is the re-legalization of the private medical practice in the nation. In the period before 1985, the government had banned private medical service providers (Chenet al., 2014). However, with increasing pressure from worker’s and welfare groups, the government was forced to give in and re-legalize the private medical practice. With this in place, there has been several incentive aimed at encouraging growth of the private medical sector in order to grow the general medial workforce in the nation (Tanget al, 2013).

China has also legalized and recognized herbal medical practice in a bid to increase the medical practitioners that the nation owns. Before the 21^st century, a great number of the herbal medical practitioners were not allowed to practice. As a matter of fact, it was illegal and unacceptable for medical practitioners to include herbal medicine in their treatment. However, with the turn of the new century came the legalization of herbal medicine. As a result, there has been an increase in the number of qualified medical practitioners, most of them having bachelor’s degrees and recognized diplomas as well.

In the year 2009, China introduced effective and comprehensive medical reforms where the nation listed community health services as one of its top five priorities in 2009. In order to achieve this top priority, the nation as embarked on building numerous community-base health systems through a three-tier health system. The central and local governments have a clearly demarcated role in terms of their financial contribution towards supporting the medical services with the former taking more control. Between 2009 and 2011, a total of 32,860 community health service organizations have been established in a bid to meet a target of having at least 2, and at most 3 medical practitioners per every ten thousand people by 2020.

Fluctuations in medical workforce supply

	Australia	China
Women employed	34 %	46%
Total expenditure on health per capita (Intl $, 2014)	4,357	731
Probability of dying between 15 and 60 years m/f (per 1 000 population, 2016)	77/45	93/67
Total expenditure on health per capita (Intl $, 2014)	9.4	5.5

Some of the critical issues that both nations need to look into include the gender distribution in the medical workforce. Generally, women have lesser opportunities of being employed as compared to men. This menace of gender disparity in employment has affected the number of women who are in active workforce in the medical sector. Although there has been significant increase in the gender disparity reduction, there has not been enough strides yet to ensure that all genders are treated the same, and the more women are employed in the medical sector. Increasing the number of women will help tackle both gender inequality as well as unemployment (Zhou et al., 2015).

The other issue that requires immediate attention in the two nations is economic and hence medical workforce disparity. As explained earlier, in both nations, a trend was discovered where most of the medical workforce is concentrated in the cities and other urban areas where as only a small number of medical workers are located in the rural areas. China and Australia have tried to address this issue in different ways, but there has not been an effective solution. The increasing economic disparity needs to be stopped in order to build a bridge that will promote workforce equality.

Finally, the use of technology, although impressive in both nations is still wanting. There has not been significant efforts to promote innovation in the medical workforce in order to enhance the quality of services offered to people. Both nations are capable of funding innovation in the medical workforce sectors. Such technological interventions could include workforce management such as hiring and training. In addition, the general use of technology has the capability of increasing the productivity of the medial workforce. It is absolutely necessary that both nations put more effort into incorporating more technology in their medical workforce and general medical practices.

Both China and Australia are comprehensively trying their level best to comply with the recommendations that the World Health Organization has put forwards in order to help increase the medical workforce within the world. Some of the strategies that are being implemented by both nations include respect for gender and human rights in general. Both nations have strong anti-discrimination rules that try to promote easier integration of minority groups in the mainstream society. The impact of such policies such as introduction of harsh disciplinary actions in the public as well as private corporate sectors has helped to reduce workplace discrimination for women and other persons who belong to the minority groups. As a result, there has been an upsurge in the number of people willing to explore in the different sectors of the economy (World Health Organization, 2016b).

Steps taken to address the issue of medical workforce supply

In the medical workforce, there has been a drastic increase in the number of women that are gaining licenses as practitioners. With over 50 percent of the whole Australian population being women, there has been an outcry to increase their presence in the job market. Currently, women and girls constitute a whooping 47 percent of the workforce in the nation In China, the compliance to this recommendation has been tangible. The government has helped in forming agencies that are responsible for looking out for women rights and ensuring that women gain fair representation in all sectors of the economy, including the medical workforce. Such agencies include the National Working Committee on Children and Women (NWCCW)(World Health Organization, 2016a).

The other recommendation that both nations are following keenly is the education, training and skills. This recommendation proposes that governments support skill empowerment through lifelong learning and provision of high-quality education. This has been seen through the construction and equipping of several research centers in both nations to support the medical research in a bid to empower the medical staff to make them competitive both locally and internationally. In China, the government has shown its resolve to empower the local medical practitioners by introducing courses such as herbal medicine which has become one among the core areas of attention in the medical profile of the nations. Currently, it is possible to acquire a bachelors degree as well as a diploma in herbal medicine. Such degrees and the institutions that offer the degrees are established by the government while the private ones have been accredited and are fully or partially supported by the government.

In Australia, the government has shown its commitment to empowering the local practitioners as well as enhancing their aces to modern training through its program with the international medical graduates. The Australian government through its local agencies provides easy access and training to international medical practitioners wiling to work in districts of workforce shortage within Australia. These graduates are supported in many ways which includes recognition of their skills which motivates them as well as other other practitioners. These international graduates are also trained on local practices to help them boost their services by understanding their local Australian patients.

Other recommendations that are applicable to both nations include the use of enhanced technology in medicine to help enhance the level of services that the local people are getting. The two nations have displayed acute sense of technology by purchasing and even funding research that has helped in the discovery of modern interventions to medical problems. In China, surgery has been conducted through use of robotics in order to enhance efficiency of service delivery among the workforce. In the same manner, computerized medical services as well as nanotechnology has been well adopted in Australia, showing compliance with WHO medical intervention recommendations (World Health Organization, 2016b).

References

Australia’s medical workforce , n.d

Chen, R., Zhao, Y., Du, J., Wu, T., Huang, Y., & Guo, A. (2014). Health workforce equity in urban community health service of China. PLoS One, 9(12), e115988.

Tang, C., Zhang, Y., Chen, L., & Lin, Y. (2013). The growth of private hospitals and their health workforce in China: a comparison with public hospitals. Health     policy and planning, 29(1), 30-41.

World Health Organization. (2004). World report on knowledge for better health: strengthening health systems. World Health Organization.

World Health Organization. (2010). Increasing access to health workers in remote and rural areas through improved retention: global policy recommendations.             World Health Organization.

World Health Organization. (2015). World health statistics 2015. World Health Organization.

World Health Organization. (2016a). Deepening Health Reform in China.

World Health Organization. (2016b).Working for health and growth: investing in the  health workforce

Xue, C. C., Zhang, A. L., Lin, V., Da Costa, C., & Story, D. F. (2007).                  Complementary and alternative medicine use in Australia: a national population-based survey. The Journal of Alternative and Complementary  Medicine, 13(6), 643-650.

Zhou, K., Zhang, X., Ding, Y., Wang, D., Lu, Z., & Yu, M. (2015). Inequality trends  of health workforce in different stages of medical system reform (1985-2011) in  China. Human resources for health, 13(1), 94.