The ACT government intends to make Canberra “a destination of choice for public healthcare workers”, Chief Minister Andrew Barr announced today – and this year’s Budget, released next week, will spend more than $200 million over four years to support health workers, provide more health services, and better resource the health system, he said.
“By investing in our workforce conditions and our hospital and healthcare facilities, we are supporting working conditions and environments that will attract and retain high-quality doctors, nurses and other healthcare workers,” Mr Barr said.
“Our healthcare workers are the heart and soul of the health system,” health minister Rachel Stephen-Smith said. “We are committed to their wellbeing, and we know that a better supported workforce can deliver even better health services for Canberrans.”
The funding includes more than $122 million in staffing and resourcing to operate the new Critical Services Building at Canberra Hospital. The building, expected to open next year, is the centrepiece of the Canberra Hospital expansion, designed to increase emergency department, surgical, and critical care capacity, with a bigger emergency department, more operating theatres, more treatment spaces, and more intensive care beds.
The government will use the $122 million to employ at least 80 more doctors, nurses, allied health and support workers. The government committed to engage 400 full-time equivalent health professionals over this four-year term; they state that this will exceed that figure, creating 570 positions.
But to attract the best people, Professor Walter Abhayaratna, president of the Australian Medical Association (AMA) ACT branch, believes that Canberra Health Services and Canberra Hospital must develop an identity as a “triple shield” – clinical services, training and education, and research.
“Excellent service [is] vitally important; we should be reaching that as our core business. But [Canberra Hospital and CHS] should now aspire to be an excellent place to train the future health professional workforce – doctors, nurses, allied health – and to do research, which also inherently provides access to people, to innovative treatments, devices, and drugs, that you would not normally have access to, unless you’re in a clinical trial.
“To get the people who have the mindset that usual business is excellence in service, plus a need to educate and research in regular hours, that type of person needs to be attracted from the outset in the recruitment. You’ve got to have all the spaces, the processes, and the mindset such that when they come here on the promise that this is a triple shield … they then don’t find that they are going to be smashed with clinical services, and have no opportunity to do the others easily.
“Historically, unfortunately, we’ve had great people come here and find that it doesn’t quite suit them, and they go elsewhere. My concern is as they are recruiting people, we really have to have that health services identity – it’s not just a promise, it’s there in action.”
The Budget includes more than $28 million over the next four years to increase services and improve working conditions for the public health workforce. These measures include:
- $2.2 million for health workforce planning initiatives to attract and retain skilled workers.
- $8.6 million to improve the working environment for Junior Medical Officers, including longer contracts to provide job security for graduating doctors, additional learning positions, increased pastoral care, and improved training and development coordination.
The AMA welcomed both longer contracts and increased funding, for which they had advocated for some time now, Professor Abhayaratna said.
“Multi-year contracts seem simple, but will make a huge difference to junior doctors whilst they’re training. You can imagine when someone commits to a one-year contract, they have to get a rental, and then they have to go to the next place to get a rental. Nowadays, it’s quite hard to even do those things. Giving some certainty to junior doctors to have a multi-year contract gives them a place to live and an opportunity to really get to know the hospital well.”
Professor Abhayaratna hoped clinicians and senior doctors would be able to spend more time teaching (a core function) as part of their routine work.
“There is a feeling that the government recognises that whilst a hospital’s primary purpose is to look after patients, its next purpose is very much to look after those who are training the future workforce…
“Well, yes, you [students] can have a multi-year contract – but are you getting enough exposure to the type of clinical services that will allow you to grow as a clinician, and is there enough supervision? …
“People need time to be able to train the junior workforce. Often, we’re doing it after hours, including weekends. Normal practice in other places around the country that are respected for their training programs is that you do it during the regular week.”
Canberra Liberals MLA Leanne Castley, shadow minister for health, said: “Initiatives such as improving the working conditions for Junior Medical Officers have been needed in the health system for years. This year we know that only 59 out of 94 medical graduates from ANU accepted a position at CHS.”
- $3 million to provide study support payments for health professional students at ACT universities.
- $1.25 million to continue the Indigenous Allied Health Australia Health Academy program in the ACT to increase the Aboriginal and Torres Strait Islander health workforce, improve cultural safety in services, and deliver better educational outcomes for Aboriginal and Torres Strait Islander high school students.
- $3.5 million to replace and upgrade nurse-call systems and duress alarms.
- $9.9 million to boost Canberra Hospital cleaners’ pay and establish a project team to insource services across CHS.
The Canberra Liberals cautiously welcomed the announcement.
“Many of the initiatives announced by the health minister have been needed in the health system for years, so it is welcome that the government is finally getting around to addressing these issues,” Ms Castley said.
“This ACT Labor-Greens government are well known for over-promising and not delivering. We can only hope that this time they’ll come through for our hard-working doctors and nurses.”
The ACT government is negotiating the next phase of mandated minimum nurse/midwife to patient ratios. It states this will boost the government’s investments in safety and workforce, with a significant focus on ratios in maternity services.
Ms Castley, however, was concerned. “It is surprising to see that CHS is planning to introduce phase two of Nurse-to-Patient ratios when we know both hospitals are still not compliant with phase one.
“I am concerned that this crucial announcement for health workers from the minister will be bungled similarly to Operation Reboot [the ACT government’s $3.5 million plan to provide an additional 14,000 specialist outpatient appointments, which only achieved 43.8 per cent of its target], and result in more dollars budgeted and not effectively delivered by this government.”
