Submission to Senate Employment, Workplace Relations, Small Business
and Education References Committee inquiry into "The capacity of
public universities to meet Australia’s higher education needs"
from
The Council of Deans of Health Sciences
14 February 2001
Introduction
1. The Council of Deans of Health Sciences consists of Deans from those
Faculties which have programs in a range of health science disciplines.
Specifically, the Faculties must have at least three programs from the
list of professions at Attachment A. The Council of Deans of Health
Sciences thus complements similar Councils which specifically represent
the interests of Faculties of Nursing and of Medicine. It is important
to note that most of the Faculties covered within the Faculty of Health
Sciences also incorporate nursing programs within their Faculties and
some also incorporate Schools of Medicine. There are only nine Faculties
which meet the criteria for membership and these are listed at Attachment
B.
2. The Council of Deans of Health Sciences welcomes this opportunity
to make a submission to the Senate Inquiry into the Capacity of Public
Universities to meet Australia’s Higher Education Needs.
Term of Reference (a) i: The adequacy of current funding arrangements
with respect to the capacity of universities to manage and serve increasing
demand
3. The Council of Deans of Health Sciences believe that current
arrangements for organisation and funding of universities constrains
significantly the ability of universities to meet the burgeoning demand
for health science education in Australia and thus impacts adversely
on the ability of the health sector to respond to changing needs.
4. Health sciences courses, across a range of disciplines, are extremely
popular and this applies not only to medicine but also to many health
sciences professions such as physiotherapy and occupational therapy.
If additional places were made available in these courses they would
easily be able to be filled by students of a very high quality.
5. There is an emerging workforce shortage in many of these professions
in rural, regional and metropilitan centres. These shortages arise because
of the aging of the Australia population, the changes occurring in the
health sector, and the changing nature of treatment which is increasing
the need for a workforce with more advanced skills.
6. Current university funding arrangements are generally not able to
respond to these changing patterns of demand. This is partly because
of overall caps in funded places within a state and in part because
of the difficulty in moving places from low demand areas which have
a lower course completion cost to the somewhat more expensive health
sciences programs. Moreover, making additional places available in the
health sciences for full-fee paying domestic undergraduate students
has not proven to be a successful strategy to meet the changes in demand.
7. The changing nature of the health sector has placed additional pressures
on health science education for a number of reasons. First, funding
constraints within the health sector have limited the ability of health
agencies to provide the same level of clinical education placements
compared with previous years. As hospitals and other agencies have been
downsized, there are fewer suitably qualified staff available to supervise
students which reduces the availability of places in clinical education.
Secondly, a shift in treatment location from institutional settings
to community and home based settings is occurring in the health sector.
This is supported by the Council of Deans of Health Sciences as providing
better treatment options but this shift further reduces the availability
of clinical placements. In the past, large outpatient clinics in hospitals
could absorb a number of students on placement. Placing students as
part of domiciliary programs can be more disruptive for clients and
so limits the number of students that can accompany a visiting professional
generally to one student per home. It is also more difficult for university
academic staff to observe student performance in these settings.
8. These changes in the health sector have significantly increased
the costs of clinical education to universities because:
- the supervision provided by university staff has increased to replace
that previously provided by health sector staff;
- universities are invariably being asked to pay health sector agencies
for clinical supervision;
- the average number of students in each clinical placement is falling.
9. These changes in the costs of clinical education have not been reflected
in changes in resourcing from the Commonwealth government to universities
for these increased costs.
Term of Reference (a) i and (f):
10. One particular aspect of the inadequacy of funding arrangements
relates to the requirement on universities to absorb the full costs
of salary increases through improved productivity. Health sciences courses
have been traditionally underfunded in universities (essentially because
the relative funded model was based on a pre-university pattern of staffing
and teaching) and thus health science faculties are particularly adversely
affected by this decision.
11. Health Sciences faculties are constrained in their ability to achieve
productivity improvements. Typical strategies may not work:
- increasing class sizes is often precluded (e.g. because registration
bodies specify clinical supervision ratios), unwise (because of student
safety considerations), or counter-productive (because of high capital
costs of specialist teaching facilities such as wet anatomy);
- reduction in subject content may impact adversely on students’
ability to meet registration requirements and to perform adequately
as skilled employees in the health sector on graduation.
- increased contact hours for staff may not be feasible because they
already have relatively high workloads compared to colleagues in science
disciplines.
- on-line delivery systems in the health sciences are now being used
but they are not leading to the productivity gains and efficiencies
that were initially predicted (e.g., because of initial financial
outlays; the need for a significantly enhanced IT infrastructure).
12. Salaries of staff in Health Sciences faculties need to be related
not only to their university peers but also to those paid in the health
sector. Failure to pay adequate salaries will reduce the ability of
universities to attract experienced professionals to pursue academic
careers (teaching or research or both).
13. It is the view of the Council of Deans of Health Sciences that
the ability of the university sector to achieve further productivity
gains as a way of funding salary increases is now very limited, especially
in health sciences.
Term of Reference (b)
14. The Council of Deans of Health Sciences believes that the existing
funding arrangements for universities are not sufficiently flexible
to respond to changing needs and recommends a review of the funding
arrangements for undergraduate teaching and clinical education
15.The increased reliance on private funding and market behaviour in
the university sector, in particular the shift of postgraduate education
to full fee has significantly affected the ability of the university
sector to respond to the needs of the health sector.
16. Many health professionals need to update their qualifications regularly
as a result of the rapidly changing requirements of the health sector.
Often health professionals are not undertaking additional qualifications
because of their desire to obtain additional income but rather because
of the changed needs in the workplace and their desire to increase their
ability to respond to existing needs. Accordingly, the private returns
to postgraduate education are very low and hence health personnel are
very unwilling to pay for full fee courses.
17. Because of the funding restraint within the health sector itself,
employers are generally not prepared to pay the fees for a full fee
postgraduate program.
18. As a result of these factors, the reduction in funded postgraduate
places and increased reliance on full-fee payment for postgraduate coursework
has lead to a reduction in demand for postgraduate coursework in universities.
In the medium term this is likely to have an adverse impact on the performance
of the health sector itself.
19. The Council of Deans of Health Sciences would be happy to speak
directly to the Committee about the issues raised in this submission.
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