Health Workforce Australia (Abolition) Bill 2014
Health Workforce Australia
Health Workforce Australia (HWA) was established by the Health
Workforce Australia Act 2009 as part of the National Partnership Agreement
on Hospital and Health Workforce Reform. This agreement expired in June 2013.
In late 2005, a Productivity Commission report on Australia's health
noted the complexity of arrangements under which numerous bodies were involved
at all levels in health workforce education and training.
HWA was established to create more effective, streamlined and integrated
clinical training arrangements to:
support workforce reform initiatives;
support health workforce research and planning; and
further new workforce models and reforms.
Purpose and key provisions of the
The Bill seeks to abolish Health Workforce Australia and transfer its
functions and programmes to the Department of Health.
The key provisions of the Bill are as follows:
- part 1 contains amendments to the Health Workforce Australia Act 2009
(HWA Act) that will introduce interim arrangements that facilitate the ‘winding
up’ of HWA. The provisions include: removal of the requirement for HWA to act
in accordance with the directions of the Australian Health Ministers’
Conference; termination of current HWA Board appointments; and allocation of
the Board's current functions to the Minister. The amendments in Part 1 would
commence the day after Royal Assent;
the Health Workforce Australia Act 2009 is repealed (item 19 of
the vesting of assets, liabilities and interests in land from Health
Workforce Australia (HWA) to the Commonwealth without any conveyance, transfer
or assignment (items 21 and 22 of Schedule 1);
the transfer of pending proceedings, investigations, records and
instruments (including contracts, undertakings, deeds or agreements) from HWA
to the Commonwealth (items 25, 26, 27, 28 and 29 of Schedule 1); and
no transfer of appointment, engagement or employment of an HWA officer
to the Commonwealth (item 33 of Schedule 1).
Submitters to the inquiry generally recognised the comprehensive data
collection efforts and reporting activities of HWA. The primary concerns of
submitters focused upon the need to ensure that any proposed transfer of its
functions and programmes to the Department did not undermine the continuation
of this work.
Many submitters were keen to understand the precise nature of the
functions and programmes to be transferred to the Department:
If the purpose of the Abolition Bill is to prevent duplicity
in administrative functions, and not the abolishment of the functions and
programmes of HWA, then it is vital that the breadth of work of HWA is fully
understood and considered under any new arrangements.
Several submitters emphasised that the Department should maintain HWA's
cross-jurisdictional perspective and stakeholder engagement:
When amalgamating HWA's core functions into the Commonwealth
Department of Health, an appropriate governance structure will be vital to
ensure the new model does not lose the strengths of HWA's organisational
structure as an independent, stand-alone body with a separate Board and public
Submissions identified a number of HWA's key projects that should
continue in order to optimise the effectiveness of the Australian health system.
For example, the proposed National Medical Training Advisory Network
and Health Workforce 2025—Oral Health.
Upon introduction of the Bill into Parliament, the Hon. Peter Dutton MP,
Minister for Health (the Minister) stated that the proposed abolition of HWA
and transfer of its functions and programmes to the Department will:
...streamline the delivery of programs to build our health
workforce and remove an unnecessary layer of administration and bureaucracy ...
The programs currently managed by HWA will continue, but aligning these with
those already delivered through the [Department] will allow us to save valuable
resources by reducing duplication in both service delivery and in the
significant overheads required to run an agency.
The Commonwealth Government is committed to providing national
leadership while continuing to work with states and territories towards
national workforce planning and reform.
The Government is proposing to
achieve $142.0 million in savings from the abolition of HWA
and changes to health workforce planning. Efficiencies will be achieved by
the abolition of the agency and transfer of its functions to the Department. 
In its submission, the Department has noted that, contrary to the
National Partnership Agreement on Hospital and Health Workforce Reform, the
states and territories have never contributed their expected share of funding
to the operations of HWA (approximately $539.2
million from 2008–2013).  In contrast, the
Commonwealth has remained the sole funder of HWA contributing $1.05 billion.
In evidence, the Department explained:
This has presented
challenges with HWA's governance arrangements, with HWA reporting to all Health Ministers and having a Board
comprising of representatives of each jurisdiction,
giving the Commonwealth government
limited influence over the ·use of Commonwealth resources.
The Review of Australian Government Health Workforce Programs (Mason
stated that it is reasonable that the Australian Government would want more
direct involvement in HWA, as the states have not contributed their share of
operating funds, yet still retain a stake in governance. This governance arrangement
has also led to 'uncertainty from the perspective of stakeholders' about the
roles and responsibilities of HWA and the Department which need to be resolved.
The Mason review also stated that stakeholders perceived that HWA had 'an
extremely onerous compliance based contracting model'.
Importance of health workforce planning
Workforce capacity building and data collection
A number of submitters noted that HWA's data analysis and policy
development work were the areas most valued by stakeholders.
HWA's work on 'comprehensive and sophisticated health workforce data
capture and analysis...to enable health workforce modelling and support planning'
was acknowledged. Submitters
noted that, prior to the establishment of HWA, there was a 'paucity of data' on
Australia's health workforce. Through monitoring workforce trends, collating
data and building the evidence base on Australia's health workforce, HWA has
contributed significantly to national planning for a sustainable workforce. In
turn, this information has 'instigated and informed clinical redesign and
innovation improving efficiencies within the health system'.
Several submitters raised the reticence of various jurisdictions and
professions to share workforce data prior to the establishment of HWA.
Submissions identified the importance of continuing the work started by
HWA to identify and implement reforms to improve the distribution of the health
workforce in rural and remote communities.
The National Rural Health Alliance commented:
The Bill’s Explanatory Memorandum states that Australia has a
'...well distributed health workforce, delivering frontline health
services for all Australians'. Many people in rural and remote Australia would
be surprised at this description, having poor access to many types of health
professional and the services they provide.
The National Rural and Remote Health Workforce Innovation and Reform Strategy,
the project on Rural and Remote Generalist Allied Health Professions,
the feasibility study of a National Framework for Rural Medical
and the General Practice Rural Incentives Program
were all identified as important initiatives.
Submissions identified clinical training funding for the non-government
and private sectors as a valuable area of activity that should continue under
the Department of Health's administration of health workforce planning.
Flinders University noted that accommodation of students in rural and
remote locations has always been an impediment to delivery of clinical
training. HWA funding has allowed Flinders University to provide eight new
residences and upgrade three existing residences to provide student
accommodation in the Northern Territory.
Flinders University also noted that HWA's support for clinical training
initiatives has allowed the university to expand and expedite its training of
students in a range of health related fields, particularly in rural and remote
Medical Training Advisory Network
A number of submissions identified the recent establishment of the National
Medical Training Advisory Network (NMTAN) as a highly valued component of HWA's
current work program.
The NMTAN identified and sought to resolve looming bottlenecks in the training
pipeline and its work is considered increasingly necessary: 
Even though this is in the early stages of its work, this
cross-professional expert group is fundamental to developing an effective
strategy to meet the demands for and from our medical workforce into the medium
and long-term future. It is also able to provide expert and detailed input to
assist in the future refinement of the HW2030 modelling process.
allied health, and other health professional groups
HWA's approach in adopting a 'whole-of-workforce perspective' in
reforming the sector was described as 'seminal' and the Department of Health
was urged to maintain this momentum:
...while much of their work has focused on the medical and
nursing workforce, action has occurred across the spectrum of health
professions. This has included a broad range of allied health professions and
Aboriginal and Torres Strait Islander health workers. This whole-of-workforce
approach is vital to build the capacity of the health workforce to meet the
emerging health needs of the population, particularly in relation to the
management of chronic illness. This broad focus on reform must continue.
Osteopathy Australia encouraged the Department to continue investing in
efficient workforce planning for allied health professionals because it accords
with the Government's stated desire to 'reduce demand for unnecessary or
For example, osteopaths see patients who are taking responsibility for their
health by self-referring and paying fees out of their pocket without taxpayer
The committee noted HWA's role in facilitating novel workforce policy
initiatives as a means of addressing skills shortages. Professor Wronski
The notion of generalism came out of medicine originally as a
way of developing skill sets amongst rural medical practitioners so that they
were comfortable working in areas of workforce shortage, and it spread into the
allied health areas. For instance, you can look at the situation of a smaller
town. Let's say you are only ever going to be able to afford one or two allied
health personnel. Obviously you would want them to be card‑carrying
physios, [occupational therapists] or whatever else. What are the expanded
skill sets that would enable that facility to provide a fair range of services,
mobilising the most out of those personnel?
The development and implementation of a primary health care nursing
workforce plan should be prioritised in the work undertaken by the Department following
the transfer of functions and programmes from HWA.
Staffing issues and capacity
The issue of the relocation of HWA's functions from Adelaide and
Melbourne to Canberra was raised.
The Department stated that 'ultimately, the Department is a policy department
largely located in Canberra'.
The Department confirmed the transitional arrangements for HWA staff:
A number of staff [30–40] have taken redundancy payments and
left the organisation. We have commenced an expression-of-interest process for
staff who are interested in transferring to the department, which is largely
complete. We are now waiting for the Australian Public Service Commission to
confirm arrangements for the transfer of staff from HWA to the department. So
there has been progress, but there have been no actual transfers from HWA to
the department at this stage.
The Australian Medical Association identified the types of skills
the Department should look to retain or recruit including those with:
an understanding of the health policy landscape and an
understanding of the modelling techniques and assumptions that have been used
by HWA in the past
Communication and independence
Stakeholders expressed appreciation of HWA's strong focus on
collaboration and engagement, and expressed the hope that this approach will
continue with any transfer of responsibilities to the Department:
HWA has adopted a comprehensive consultative approach to all
their activities and this intensive engagement with stakeholders will need to
be continued by the Department in order to achieve effective and sustainable
outcomes. This consultative approach must continue to be applied to the legacy
projects that will be inherited by the Department as well as to
newly commissioned projects.
This broad consultative approach has been regarded as a
key reason for the 'high uptake of implementation of HWA policy proposals'
through findings and outcomes that are practical and relevant. 
The Australian Dental Association stated that an independent body such
as HWA is not critical if the Department continues to consult with stakeholders:
I am not sure independence is really that important an issue.
As I said, the work they have done has been transparent and open and they have
consulted well. As long as that process continues and is not lost, I think we
would be pretty happy.
Catholic Health Australia (CHA) claimed that the lack of 'specific
requirements for HWA to consult and cooperate with both education and health
providers on the provision of financial support for clinical training' has been
a shortcoming. CHA advocated a new national agreement for action on health workforce
as a replacement to HWA, with the role of the Department of Health clearly
Transfer of HWA functions and responsibilities to
Several submitters highlighted the HWA's capacity to communicate and
collaborate with industry, different departments and jurisdictions. Submitters
noted it is critical that the Department communicate and collaborate with
industry, different department and jurisdictions to ensure that there is a
unified and coherent approach to workforce planning.
Submitters said that prior to the establishment of HWA, there was a less‑focused
approach to workforce planning and emphasised the importance of the
Commonwealth continuing to co-ordinate for training and health workforce
The Department noted the potential for 'duplication and confusion for
stakeholders' in both agencies managing health workforce programs:
These issues will be addressed by transferring HWA's
programmes to the Department. There will be more clarity for stakeholders, consistent
funding arrangements and the opportunity to align overlapping programmes.
In response to concerns that innovation may be stifled and that the
transition may hurt the progress made by HWA in strengthening the sector, the
There will continue to be work undertaken in the Department, and in state governments, to develop innovations and reforms
to address health workforce challenges, and to support the
implementation of these policies.
The Government remains committed to effective health
workforce training, productivity and innovation and will ensure that this work
is delivered more efficiently through reducing corporate overheads, and
eliminating duplication between HWA and the Department.
The Department committed to 'continue
to work with stakeholders, including the states and territories and the private sector'.
The Department will continue to use established fora, such as the Australian Health Ministers' Advisory Council
and the Health Workforce Principal
The committee notes that as part of this commitment, the Department is
conducting a review of all advisory committees to identify duplicate committees.
The Department stated that those committees that represent stakeholders the Department
does not already directly engage with will be retained.
The Department confirmed that all Clinical Training Funding Agreements
will be continued for the 2015 academic year.
The Department acknowledged that staff of HWA have 'well developed
skills in data analysis and modelling, programme delivery and evidence-based strategic policy advice'. The Department advised the committee that 'many HWA staff will have the opportunity to join the Department'
and that the Department was supporting the work HWA was doing to manage the transition
process with its staff.
The committee acknowledges the positive submissions reflecting on HWA's
role in leading and co-ordinating health workforce planning. The committee
considers that it is important for the Department to maintain this lead role
within health workforce planning and training. In addition, the amalgamation of
this work with the Department will remove duplication and increase the ability
of the Government to provide a more streamlined approach to the health workforce.
Consultation and collaboration with all stakeholders must continue in order to
sustain the unified and coherent framework established by HWA.
The committee is satisfied that the transfer of HWA's roles and
responsibilities to the Department of Health should not interfere with on-going
health workforce planning and programs.
3.42 The committee recommends that the Health Workforce Australia (Abolition) Bill 2014 is passed.
Senator Zed Seselja
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