The pandemic has brutally illustrated the gaps in systems that the global world took for granted. Stretched supply lines and logistical backlogs have dogged businesses as the flow of humans, through immigration and tourism has contributed to a growing skills shortage that has hit almost every sector in Australia, including the strained health system. Efforts to help address the issues have mostly failed as the problems become more entrenched. Federal attempts to drive solutions have strived to alleviate the root causes. A key election commitment by the Albanese Labor Government was a jobs and skills summit to help address the growing litany of issues in Australia. The summit’s key takeaways were:
- A permanent increase to the migration cap to 195,000 (from 160,000) with a focus on healthcare, infrastructure and the technology sector
- 180,000 new fee-free TAFE training places with a $1 billion one-year National Skills Agreement that will provide additional funding for fee-free TAFE in 2023
- Provisions to allow pensioners to work and earn more before their pension is reduced
- Updating the Fair Work Act to create a simple, flexible and fair new framework that ensures all workers and businesses can negotiate in good faith for agreements that benefit them
- $36 million to process the backlog of visas which stood at a backlog of 962,000 when Labor took office
Increasing the migration cap and helping to process the backlog of visas will do much to ease the skills shortage facing Australia. Yet, skills are in global demand and the bureaucratical, process-based issues stymie decisions by individuals looking to emigrate. Canada has announced its plans to attract 1.2 million migrants (equivalent to about 1 per cent of its population every year over the next 3 years), with NSW Premier Dominic Perrottet telling the jobs and skills summit “it shouldn’t be the case that in countries like Canada, that it’s taking two weeks, whereas in Australia it’s taking months.”
Victoria especially has struggled to meet their commitment to attract significant numbers of health care workers. In October 2021 the Victorian Government announced their plan to recruit 1,000 extra health care workers by paying for their relocation costs. A report in March 2022, speculated that only 100 workers had been enrolled in the program, with the Victorian Government confirming in June 2022 that 440 international health care workers had joined public hospitals. Similarly, the previous Federal Government were seeking to attract 2,000 extra healthcare workers, of which only around 600 had taken up employment by January 2022.
The global demand for skills, especially for the health sector, does create a significant barrier to the success of these policies, especially when paired with a significant backlog of visa approvals. Yet, the actual process for gaining Australian registration or accreditation is often overlooked as a vital part of the process.
The Australian Medical Council (AMC) is an independent national standards body that oversees accreditation standards for medical training in Australia and assesses international medical graduates for registration in Australia. The AMC is the Australian body that manages a Multiple-Choice Question (MCQ) examination assessing the medical knowledge of international medical graduates who hold an eligible medical qualification recognised by the Medical Board of Australia as well as a clinical examination or a Workplace Based Assessment (WBA) program. The Medical Board of Australia and the Australian Health Practitioner Regulation Agency (AHPRA) are responsible for the registration of medical practitioners in Australia.
There are some interesting statistics in the AMC’s Annual Report that highlight a growing issue around the failure rates of the assessments offered by the AMC.
The failure rates for these exams are high and the cost for these exams (from Jan 2023 the MCQ examination cost $2,920 and the clinical examination cost $4,130) presents a serious barrier to attracting trained doctors into Australia.
There are good reasons to have stringent controls over medical accreditation and training. It is vital that those practising medicine in Australia have recognised training and are able to competently treat patients using Australian standards. Yet, the cost and failure rate may present itself as an artificial barrier to gaining a greater share of the global skill market. While it may be understandable that the AMC needs to produce high quality candidates to become registered in Australia it does present a conundrum that of the 1,945 candidates who sat the first MCQ exam only 126 candidates would go on to be eligible for registration. That is a remarkably low pass rate of 6.5%, at a cost of $7000.
There is a role for governments driving migration and targeting occupations. However, behind these targets there must be a comprehensive review of the system. Despite bold policy to attract health care workers into Australia, both at Commonwealth and state jurisdictions there are significant structural and financial barriers to obtain registration. While the term health care worker is inclusive of the entire health sector; including nurses, allied health, pharmacist, midwives, psychiatrist, social workers and doctors, the barriers to registration risk the success of government policy priorities. A holistic policy approach is required when looking at the substantial challenges to the skills shortage, of which the skills summit is one part.
Ross Dennis is a Policy Analyst at FPL Advisory.
FPL Advisory is a team of specialists resolving risks and creating opportunities with respect to government. We work with public sector and corporate clients to execute strategies for owning and managing change.