The Andrews State Government is currently crafting a reform package for the Victorian healthcare system. The project has been dubbed Health 2040.
On Friday 18 September the Andrews government launched the Victorian Health Reform Summit. Ten key principles that are set to guide the reform were identified at the summit. The government has subsequently issued a discussion paper expounding upon these principles. The point of the discussion paper is of course to initiate discussion, and on the questions of workforce and workforce planning we are well positioned to play a role.
We know that Victoria’s healthcare system is the most efficient in the country. This is not a coincidence; Victorian healthcare workers have been pushed to the limit in a long-standing and very successful effort to increase productivity.
It is our strong view that both Labor and Liberal governments have given Victoria’s Allied Health Professional workforce short shrift over the past ten or so years. Our career path is seriously deficient and our wages are relatively poor and have stagnated during this period of rapidly increasing productivity. In fact, our colleagues in all other states are on higher rates of pay than we are in Victoria.
We are not alone in this view; our recent, ‘What’s Important To You At Work’ survey demonstrates that this view is felt by AHPs right across the state. 88% of those surveyed are very concerned or extremely concerned at increasing workloads with no corresponding growth in staffing levels.
Predictably, the discussion paper has very little to say on the question of workforce. The summary note for Principle 5 simply notes: “We need to make better use of the skills of our health care workforce if we are to provide better services.”
More worrying perhaps is the fact that the Travis review (a recent review looking into efficiencies in Victorian hospitals) indicates that there are further productivity gains of up to 20% to be found in health budgets across the board. Despite economic-rationalist protestations to the contrary, we know that productivity increases mainly flow from labour reform and not from structural reform.
A closer examination of the discussion paper shows that the state is looking at three key areas of relevance to workforce reform: shortages, skills and safety. Each area brings significant risks and dangers in terms of ensuring that the delivery of healthcare is as good as it can be while ensuring that your jobs are good jobs—jobs that are rewarding, well paid and socially productive.
While it is tempting to embark upon a detailed critique of each of these areas, we will content ourselves with taking a brief look at the issue of workplace safety.
VAHPA recognises that occupational violence is a serious issue in Victoria’s public hospitals & health services, an issue that needs to be addressed. However, this should not come at the cost of addressing a more significant, if less media-friendly occupation hazard; excessive workloads and the stress associated with such.
With almost 93% of survey respondents feeling that their workload has increased in the past two years, and 92.4% of respondents feeling that increasing workloads are leading to rising stress levels of individual health professionals, VAHPA believes that addressing these issues is crucial to ensuring the success of any future health workforce.
Finally, VAHPA believes that health and sickness are never purely individual matters and hence the tasks of identifying and resolving the origins of ill health and caring for those who become sick are social issues rather than individual issues. The delivery of healthcare is not the delivery of a commodity to an individual. It is part of a broad social system; it must reflect the values and mores of that society and not simply the predominant economic structures of that society.
Sadly, the language used in the Health 2040 discussion paper shows a clear bias towards the individual (‘person-centred care’ etc.) and away from the needs of society and the collective. We cannot allow healthcare to be drawn into a Thatcher-esque world where, “there is no such thing as society. There are individual men and women, and there are families.”
We have made submissions to Health 2040 and will continue to advocate on behalf of Victorian Allied Health Professionals.