According to Australian Institute of Health and Welfare (AIHW), 2013 reported that the Australian clinical health workforce also comprises of the skilled migrants that has recently grown in the country (Hawthorne, 2012). The clinical healthcare workforce is majorly divided into six categories like nurses, medicine, general practitioners, midwives, dentists and pharmacists. The maximum migrant healthcare professionals are from United Kingdom, India, Malaysia, China, South Africa, Egypt, Singapore and Ireland. It also comprises of the general skilled migrants with health qualifications and those who have the initial health qualifications from overseas. . Australia is trying to recruit and retain the medical migrants so that the workforce supply is maintained. However, there are negative impacts of this clinical healthcare migration in Australia. There is requirement of reformation of existing migration policies that might help to reduce the impact of clinical health workforce migration in Australia.
Australia’s current health workforce is largely dependent on the immigrants comprising of doctors, nurses, midwives and other allied health professionals. In 2014, there were around 610,148 health practitioners in Australia (Willis, Reynolds & Keleher, 2016). This workforce comprises of the doctors, nurses, midwives, dentist, pharmacists and general practitioners. The migration of the healthcare professionals to Australia had increased in the recent years to compensate the shortage that has occurred due to huge exodus of the healthcare professionals to overseas for emerging opportunities. The skilled migrants comprises of the 68 % of the total health workforce in Australia (Weller et al., 2012). The overseas health professionals qualify through multiple choice questions for training and studying according to the Australian Medical Council. Currently, the employed medical practitioners in Australia increased from 323.2 to 355.6 from 2008 to 2012 according to the 2014 AIHW reports. The nurses and midwives in Australia increased from 269,909 to 290,144 during the years 2008-2012 (Buchan, O’may & Dussault, 2013). This shows an increase from 6.8% to 7.5%. The dental workforce comprises of 19,462 dental practitioners out of which 14,687 are registered dentists in Australia. This shows an increase from 55.4 to 56.9 between the years 2011-2012 (Pugh et al., 2013). The allied health workforce comprises of 126,788 allied health practitioners with 27,025 pharmacists that is 21.3 % of the total allied health workforce population. As the above mentioned statistics depicts, there is an overall increase in the clinical health workforce in Australia. Each category shows an increase in the clinical healthcare workforce in Australia.
According the AIHW report (2014) there is a spatial distribution in the clinical workforce of Australia. The Australian Institute of Health and Welfare- Geographically-adjusted Index of Relative Supply (GIRS) were used to examine the supply in clinical health workforce in Australia in the key professional areas. These GIRS score was used to compare it with the indigenous population to study the extent of workforce supply in the areas of indigenous living. The findings of the report suggested that GIRS scores of 0 or 1 signify challenges in terms of challenges. The Aboriginal and Torres Strait Islander people lives in areas with low supply of midwives, psychologists and optometrists and a relatively low score in GIRS than the non-indigenous people. The supply of healthcare services is less for the Aboriginal and Torres Strait Islander people and not sufficient to meet the needs of the population (Brunetto et al., 2013).
The nursing and midwifery workforce has increased since 208. There is an increase of 334,078 that is 6.8% increase in 2012. It increased to 7.5% that is from 269,909 to 290,144 (Crettenden et al., 2014). The overall workforce increased by 0.5% from 1,117.8 to 1,123.6 full term registered nurses and midwives per 100,000 populations. The supply of medical healthcare practitioners’ workforce also increased from 323.2 to 355.6 per 100,000 populations between the years 2008 to 2012 (Negin et al., 2013). This reflects that there is a rise in the employment of healthcare professionals since 2012 with 34.9 % since 2008. The dental workforce in Australia also showed an increase since 2008. Out of 19,462 dental practitioners, 14,687 that is 75.5% were dentists. The supply of dentists increased from 55.4 to 56.9 from practitioners to full time dentists per 100,000 populations. The balance workforce shifted with an increase in 5.3% number of dentists in 2012. The allied health workforce comprises of psychologists, pharmacists, physiotherapists and other health practitioners. There is an overall increase in the number of psychologists from 76.2 % to 92.3% between the years 2011-2012. The Aboriginal and Torres Strait Islander health practitioners comprises of only 265 that is 0.2% of the total allied health workforce (Hawthorne, 2014).
Reasons For Migration To Australia
In Australia, the clinical health workforce depends on the international and overseas students and health professionals. The scale of migration has caused a dramatic health workforce diversification in Australia. The domestic shortages in Australia are also another reason for the migration of skilled people to Australia. The need for skilled workers and thriving economy in Australia are the main reasons underlying the Australian migration policy (Connell & McManus, 2016). Moreover, there would be less investment on education and training of the skilled migrants as they are selected on the basis of their qualifications. The Australian government through many policies target healthcare practitioners overseas that acts as a push factor for the skilled migrants to Australia. The migration policies welcome the migrants majorly from countries like India, New Zealand, Singapore, Middle East, Philippines, United Kingdom, Italy, Netherland and Ireland. The better employment opportunities, plenty of visa facilities for the skilled migrants under the General Skilled Migrant Program and better education facilities provide great opportunities for the migrants to come and settle in Australia (Bahn, Barratt-Pugh & Yap, 2012). There are long-term visa options for the skilled migrants with permanent sponsored visa options helps the migrants to come and settle in Australia. The globalization in the healthcare system in terms of labor has made major implications on the healthcare system facing shortages of registered nurses and other healthcare professionals has led to the increase in the migration of healthcare professionals to Australia.
The Australian Migration Program and General Skilled Migrant Program were initially aimed at increasing the chances of employment and better job opportunities for the migrants. However, the reform in the migration policy shifted from unemployment to arranged employment before arrival t Australia. The skilled migrants are selected on a basis of occupation, skills, age, qualifications, employability and English language ability (Hollifield, Martin & Orrenius, 2014).
The migration policies in Australia are not sustainable enough and immigration practices maintaining social cohesion and public support that are long term. The immigration intake needs to be managed and screened at an intensive level, however, it is not religiously or community biased. The policy helps to maintain a sustainable Australia. However, there is no such information available about the implications of the migration policies on the sustainability of the Australian population. The current immigration policy is encouraging a large number of migrants to become permanent citizens of Australia. It is greatly hampering the indigenous population in Australia as the migrants are taking control over the local people (Collins, 2013). There are serious implications of the migration policies as there is diverse culture existing within the Australian society. Therefore, there is a requirement to reform the existing migration policies to make a sustainable Australian country.
The shortage of healthcare professionals in Australia is the main reason for skilled migration to Australia. Although, it has positive implications in terms of reduction of shortages in healthcare professionals and diverse health workforce, it has serious implications on the indigenous population. To maintain sustainability in Australia, the existing migration policies need to be reformed. The Australian government should respond urgently to the shortage of healthcare professionals and ways to improve retention. The government should avoid excess dependency on foreign healthcare professionals to fulfill the domestic needs. They should formulate the policy that is aimed at making the best use of the present workforce. Moreover, they should expand the education, training and job opportunities to improve retention through better workforce organization and integration in the health workforce. The linking of payment to performance along with mixing of policies that depends on flexibility in institutional constrains, health labor markets and costs are also required to reduce the impact of migration. Policies are required that focus on rural areas linking the internal and international migration is also a significant change (Scarino, 2014).
Conclusion
Australia is building its health workforce through migration. Since 2008, there occurs a migration in the health workforce where skilled migrants in major categories like medical practitioners, nurses, midwives, pharmacists, dentists and allied healthcare professionals. They have migrated majorly from New Zealand, Middle East, South East Asia, Philippines, Ireland and Singapore. The migration has increased in the country due to flexibility in migration policies that drive majority of skilled migrants to the country. It helps to bridge the shortage of the healthcare professionals; however, they have negative impact on the indigenous population. The Australian Government should formulate the existing policies to improve retention through betterment of workforce organization and culture. They should focus on the rural areas and decrease their dependency on foreign skilled migrants. There is also a requirement to change the existing immigration policy to increase the strictness of screening and recruiting of skilled migrants under the Migration Program.
References
Bahn, S., Barratt-Pugh, L., & Yap, G. (2012). The employment of skilled migrants on temporary 457 visas in Australia: Emerging issues. Labour & Industry: a journal of the social and economic relations of work, 22(4), 379-398.
Brunetto, Y., Xerri, M., Shriberg, A., Farr?Wharton, R., Shacklock, K., Newman, S., & Dienger, J. (2013). The impact of workplace relationships on engagement, well?being, commitment and turnover for nurses in Australia and the USA. Journal of Advanced Nursing, 69(12), 2786-2799.
Buchan, J., O’may, F., & Dussault, G. (2013). Nursing workforce policy and the economic crisis: a global overview. Journal of Nursing Scholarship, 45(3), 298-307.
Collins, J. (2013). Rethinking Australian immigration and immigrant settlement policy. Journal of Intercultural Studies, 34(2), 160-177.
Connell, J., & McManus, P. (2016). Rural revival?: place marketing, tree change and regional migration in Australia. Routledge.
Crettenden, I. F., McCarty, M. V., Fenech, B. J., Heywood, T., Taitz, M. C., & Tudman, S. (2014). How evidence-based workforce planning in Australia is informing policy development in the retention and distribution of the health workforce. Human resources for health, 12(1), 7.
Hawthorne, L. (2012). International medical migration: what is the future for Australia. MJA Open, 1(Suppl 3), 18-21.
Hawthorne, L. (2014). Indian students and the evolution of the study?migration pathway in Australia. International Migration, 52(2), 3-19.
Hollifield, J., Martin, P., & Orrenius, P. (2014). Controlling immigration: A global perspective. Stanford University Press.
Negin, J., Rozea, A., Cloyd, B., & Martiniuk, A. L. (2013). Foreign-born health workers in Australia: an analysis of census data. Human resources for health, 11(1), 69.
Pugh, J. D., Twigg, D. E., Martin, T. L., & Rai, T. (2013). Western Australia facing critical losses in its midwifery workforce: A survey of midwives’ intentions. Midwifery, 29(5), 497-505.
Scarino, A. (2014). Situating the challenges in current languages education policy in Australia–unlearning monolingualism. International Journal of Multilingualism, 11(3), 289-306.
Weller, J. M., Nestel, D., Marshall, S. D., Brooks, P. M., & Conn, J. J. (2012). Simulation in clinical teaching and learning. Med J Aust, 196(9), 594.
Willis, E., Reynolds, L., & Keleher, H. (Eds.). (2016). Understanding the Australian health care system. Elsevier Health Sciences.
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