A health workforce plan is an important aspect to meeting a country’s current and future health care needs. Human resource is an integral part of any health system and requires appropriate planning from several stakeholders to optimally deliver quality and accessible health care (Crettenden et al., 2014). World Health Organization (WHO) defines health workforce as all individual whose work is for protecting and improving health of the communities. They include practitioners in clinical and non clinical field who administer public and individual health interventions. An effective national health workforce plan aim to ensuring all citizens in all locations have access of skilled health practitioner, who is well equipped, supported and motivated (Craveiro et al., 2018). A national health plan targets to achieve national health goals, obligations, and commitment of its citizens. According to WHO, a health workforce plan has to be comprehensive and address health workforce finances, policies of practice, partnership for optimal health care, leadership in health sector, and health resource management systems. Lack of an explicit health human resource planning threatens a country’s healthcare systems capacity to attain its objectives. A national health workforce plan should therefore focus on developing a healthcare system that is responsive to a population needs and expectations. The following report compares Australian and Japan national health workforce plan. Japan healthcare is good a comparison to Australian healthcare because of a developed country similar to Australia and has the highest outcome in terms of life expectancy in the whole world. This will show the difference in health workforce planning or planning process that causes the difference. This will involve environmental scanning, preparation of workforce profiles and discussion of critical issues to addressed in the countries health workforce plan. The report will also evaluate each country’s national workforce plans to find out if they are addressing WHO priorities in health workforce.
This section analyses the Australian and Singaporean health workforce using national and international health workforce plans and included polices and plans for health workforce. This will enable understanding of the factors shaping each country’s health workforce plan and planning processes.
Australia has a population of 24.13 million people. The country has a GDP of more than USD 1.205 trillion and USD 49927.82 per capita income. The Australian government bears health care cost through Medicare Scheme. The Medicare Scheme help low and poor incomer citizens pay medical bills (McGrail, & Humphreys, 2015). The country has 102802 medical practitioners distributed in different capacities in the country’s health system. The Australian health workforce recorded a growth rate of 1.6% from year 2012 to 2015. Medical practitioners work an average of 42 hours per week with a female to male ratio of 2:5. The country old workforce above 55 years is 1 in every 4 practitioners. Australia also recorded 3210 student commencement of medical undergraduate studies in 2015.
The Australian health workforce is planned and managed by the government through The Department of Health. The Department of Health has Health Workforce Australia that is directly involved in promotion and management of adequate health workforce in Australia. The HWA uses policies and programme mission is to address challenges in the health workforce of providing innovative, skilled, and flexible workforce for the Australian health system (Buchan, Twigg, Dussault, Duffield, & Stone, 2015). The HWA has developed a long term national workforce projection. This projection is for planning doctors, midwives and nurses workforce to 2015 called HW 2025. This framework is the bases of developing policies that ensure the countries health workforce continually meet the people’s need.
The Australian health workforce is faced by several challenges that require appropriate planning to build capacity for the future. The first challenge in the health is inadequate domestic practitioners. The country relies on internationally recruited practitioners. Secondly, there is an increasing aging population in the country who consume more health care as compared to a young population. Another challenge for the Australian health system relating to workforce is cost. It estimated that health workforce cost account for 70% of the total healthcare cost in the country. Lastly, the Australian health system has distribution challenge with much rural parts lacking access to qualified practitioners. Therefore, the Australian health workforce require appropriate planning to meet it people’s health care need by addressing the current issues and preparing for the future challenges.
Japan has a population of 127.3 million people with 61.9 million being males an 65.4 million being females. The country has a negative population growth of -0.71%. The Japanese population has experienced a decline since the year 2005. The country also has the highest proportion of order people than young people. The Japan economy has a GDP of more than USD 4.072 trillion and more than USD 31935 GDP per Capita. The Japanese healthcare system is administered using an integrated structure that comprise of national bureaucracy that is the ministry of Health, Labour and Welfare (MHLW), prefectural public health department and municipal public health department. The MHLW is the overall body that has responsibility for the health care and occupations in health. The Japan health workforce recorded 3362855 workers in 2013 which was an increase by 4.3%. There health workforce has 2.38 doctors per 1000 people which is below the OECD average which requires 3.1. The nurse per 1000 citizens is 11.39 above the average 8.8 recommendation of the OECD. The Japan health workforce is women dominated making up 75% of the total medical practitioners in the country.
The MHLW is responsible for health workforce planning and policies development. The MHLW Health Policy Bureau ensures policies are developed and monitored through regular surveys and advisory. The health workforce training programmes are managed by the Japanese Medical Administration Division and Reg8inal Health Care Planning Division. The country workforce demand is expected to increase by 50-100% by the year 2025. The country therefore faces a challenge of increasing the number of practitioners by more than half of the current number of practitioners. The challenges in the Japanese health workforce are caused by increasing aged population that will demand more health care services and increasing lifestyle diseases in the country (Beck et al., 2018).
Japan and Australia health workforce can be compared by use of graphs and tables to show similarities and difference. This will compare and contrast the two health workforce performance and plans.
|
Categories |
Japan |
Australia |
|
Population |
127.3 million |
24.13 Million |
|
Doctors |
319,480 |
102,805 |
|
Nurses |
1,535,161 |
307,104 |
|
Midwives |
38,486 |
28,211 |
|
Total Medical Practitioners |
1893127 |
438120 |
Medical Practitioners bar graph
The Japanese health workforce increased to attain 26.37 medical practitioners per 1000 people in 2012. Doctors, nurses, and midwives ratio per 1000 people increased that show an improvement of health workforce supply in the Japan health system.
Australia health workforce improved from 2012 to attain 375 medical practitioners per 1000 people in 2015. This represented a 1.8% annual growth of health workforce.
The supply by principle area of practice and sex show that the largest portion of Australian clinicians were specialists by 35% and then followed by general practitioners with 33.1%. Therefore, the supply of clinical workforce increased to 134 practitioners per 1000 population.
Health workforce age is an important aspect in planning health workforce of a country. It shows the further capacity of a health system enhancing the ability of the government and other policy markets to make future informed decisions (Hewko et al., 2015). Japan health workforce majority age group in 50-59 following by 40-49 age brackets. The age group below 29 years has the least practitioners in Japanese health system.
In Australia health system, the average age of medical practitioners is 40-50 years. Women form 41.1% of the total health workforce.
Several issues are evident in data profile of both Australia and Japan. These issues are likely to undermine the capacity of the country’s ability to be responsive and flexible to meet populations in the future. These issues are discussed separately in this section as follows;
According to data profile in this report, Australia faces two major problems in it health workforce. There is an imbalance that can comprise the ability of the Australian health care system to deliver quality health care. The first critical issue is gender. There is 41% female compared to 59% males in the Australian health workforce. This entails that there are more men in the composition of the country’s health workforce. This causes imbalance in distribution by gender leading to inequalities. According to Hu, Lavieri, Toriello & Liu, (2016), sex inequalities is a political and social that can have impact on how human resource in health care is distributed and managed. In case of inequalities, policy makers have an obligation of formulating and implementing strategies that encourage a certain gender to pursue professional practice in health care. The second critical issue in Australian health workforce is the ageing practitioners. The average age of medical practitioners is 45 years old. This entails that by the year 2025 most of the practitioners in the practice be retiring or preparing to retire from the health system. Lafortune, (2014) stated that age is an important factor to planning future availability and capacity of a health system. A young aged health workforce indicate a growing capacity that will meet the population health care need in the future while an old aged medical practitioners in an indication of a health system that will not be responsive to future needs of a population. Therefore, an aging health workforce is threat to a health system ability to deliver accessible health care to citizens of a country. Australia therefore has to handle aging and gender issues in the health workforce to avoid the issues undermining the capacity of projected increased demand for health services in the future.
The Japanese health workforce is faced with several issues that if not addressed in the health workforce plan can undermine the ability of the country health system to deliver quality and accessible health care to its citizens. The first critical issue in the Japan health workforce is the aging human resource. The majority of medicine practitioners are between 50 to 59 years of age. This age group of highly qualified workforce will not be available in the future and therefore the MHLW require appropriate planning to successful develop by training new practitioners. The Japanese health workforce has a very low health workforce of 29 years and below. This is an indicator that there are many practitioners who are likely to vacant the health system while at the same time there is low recruitment level of new practitioners. According to Balasubramanian et al., (2015) health workforce planners should periodically monitor the age of practitioners to plan for succession of employees in the health system without leaving a gap at any particular time. The second critical issue in Japan health workforce is motivation to work in the health care sector. The Japan has a high level of people who does not contribute to the country’s workforce. Some practitioners were leaving the health system with an objective to returning in the future. Lopes, Almeida, & Almada-Lobo, (2015) states that motivation is an important part of a health workforce plan that enable professional practitioners to have willingness to participate in a health system. A health workforce plan has to attract, recruit, and retain medical practitioners to enhance efficiency of human resource performance in the health care (Naccarella, Wraight, & Gorman, 2016). Therefore, the Japan health workforce plan needs to consider aging practitioners and motivation of staff when planning to enhance appropriateness of the plan to meet the population health needs.
The following section evaluates the countries health workforce against the set recommendations of the WHO on transforming the health workforce for SDGs. The WHO recommendations are aimed at changing the health employment, service delivery, and health education in order to maximize future returns on health investments.
Firstly, the WHO recommends of job creation when a country invests in creating jobs in the health sector majorly for youth and women with right skills, right places, and right number (World Health Organization, 2016). In Australia, the AHW has put efforts to planning health workforce by outlining a framework to be used to expand the health human resource to meet 2025 health care demands in Australia. On the other side, Japanese MHLW has no framework for future strategies on expanding the health labour market. Therefore, Australia is in adherence to the first recommendation of WHO on transforming health workforce as opposed to Japan.
The second recommendation of WHO are Women’s and, gender rights. The WHO seek to maximize women participation in economic growth and foster empowerment through addressing inequities in education and gender biases in the health labour market. Both Australia and Japan health workforce are dominated by men. Therefore, neither Australia nor Japan is successfully implementing the second recommendation of WHO on health workforce.
The third WHO recommendation is education, training, and skills aimed at scaling up transformative, lifelong learning and high quality education to health workers. The Japanese health training and development is focused on high quality education and lifelong professional development that continuously meet its citizens health needs. The AHW sets a framework that enables professional development of medical practitioners in Australia. In this case, both Australia and Japan are committed to quality health education and lifelong professional development.
The fourth recommendation of WHO is health services delivery and organization. This recommendation aim to reform the service models in the hospital care to focus on prevention and efficient provision of affordable, community based, high quality, people centered primary and affordable health care. Both Australia and Japan haven’t made any proposal to adopt this recommendation in enhancing health workforce in their countries.
Fifth, the WHO recommends the use of technology to harness the power that comes from cost effective information technology. The digital technologies allow access to health care services and improved responsiveness in the health system. This recommendation has not been implemented by any of the two countries under discussion.
The sixth WHO recommendation is ensuring investment in international health regulations core capacities. This enables a country to build capacity of its workforce to detect and be responsive to public health needs. AHW aims to increase capacity of health workforce by 2025 while Japan has health workforce capacity that meet the country’s health needs.
The seventh WHO recommendation is raising adequate funds to enable a health system invest in right skills, number of workers, and decent working conditions. Japan MHLW funds health care related studies to build required skills. AHW also uses scholarships programs to fund health students.
The eighth WHO recommendation is promoting intersectoral collaboration. This establishes support that enhances achievement of fit for purpose health workforce. Japan health system is a collaboration of several stakeholders in different capacity in the government committed to adequate and highly skilled workforce. Australia health system has conflicts between the federal government and local authorities.
The ninth recommendation is recognition of international health workers in order to optimize skills. Both Australia and Japan recognize international health workers and are part of the country health workforce.
The last WHO recommendation is undertaking of robust research and all analysis of the labour market. This enhances the ability of a country to plan it health workforce and make informed decisions when formulating and implementing strategies. Both Australia and Japan have a data and information that follow OECD and WHO metric for accountability and comparison.
Conclusion
Health workforce is an integral part of a health system and combine knowledge and skills with equipments to deliver desired health care. Health workforce planning help organize resources towards a predetermined goal of improved, accessible and quality health care from skilled practitioner. Australia health workforce is planned by AHW with operates under The Department of Health. In Japan, health human resource is planned by MHLW that overseen all the operations of health in the country. The critical issues in Australian health human resource planning is aging practitioners and gender inequality while Japan health workforce plan is faced by aging medical practitioner and motivation of the health care providers. Australia follows WHO recommendations on job creation and education and training and skills. Therefore, it can be concluded that Japan had a better health workforce in terms of plans and process of planning as compared to Australia that is striving to implement all the WHO recommendations on health workforce.
References
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Beck, A. J., Singer, P. M., Buche, J., Manderscheid, R. W., & Buerhaus, P. (2018). Improving data for behavioral health workforce planning: development of a minimum data set. American journal of preventive medicine, 54(6), S192-S198.
Buchan, J., Twigg, D., Dussault, G., Duffield, C., & Stone, P. W. (2015). Policies to sustain the nursing workforce: an international perspective. International nursing review, 62(2), 162-170.
Craveiro, I., Hortale, V., Oliveira, A. P. C. D., Dal Poz, M., Portela, G., & Dussault, G. (2018). The utilization of research evidence in Health Workforce Policies: the perspectives of Portuguese and Brazilian National Policy-Makers. Journal of Public Health, 40(suppl_1), i50-i56.
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.
Hewko, S. J., Cooper, S. L., Huynh, H., Spiwek, T. L., Carleton, H. L., Reid, S., & Cummings, G. G. (2015). Invisible no more: a scoping review of the health care aide workforce literature. BMC nursing, 14(1), 38.
Hu, W., Lavieri, M. S., Toriello, A., & Liu, X. (2016). Strategic health workforce planning. IIE Transactions, 48(12), 1127-1138.
Lafortune, G. (2014). Health workforce planning and mobility in OECD countries.
Lopes, M. A., Almeida, Á. S., & Almada-Lobo, B. (2015). Handling healthcare workforce planning with care: where do we stand?. Human resources for health, 13(1), 38.
McGrail, M. R., & Humphreys, J. S. (2015). Spatial access disparities to primary health care in rural and remote Australia. Geospatial health, 10(2).
Naccarella, L., Wraight, B., & Gorman, D. (2016). Is health workforce planning recognising the dynamic interplay between health literacy at an individual, organisation and system level?. Australian Health Review, 40(1), 33-35.
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