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Numbers still don’t meet demand

New figures show there are more doctors and nurses, but supply varies across regional areas.

There has been an increase in nurses and doctors over the past year, new figures reveal, however, there is concern that the numbers aren’t enough to meet demand.

Overall, in the four years to 2008, the number of doctors working in medicine jumped 18 per cent, while the number of nurses increased by 12 per cent. This is according to the Australian Institute of Health and Welfare (AIHW), which released two reports last month examining the nation’s doctor and nurse labour forces.

But David Braddock, from the AIHW’s labour force unit said after taking population growth into account the increase per 100,000 people isn’t quite as large.

“It’s seven per cent for doctors and six per cent for nurses,” he said.

Debra Cerasa, RCNA CEO, said that was an important point to take into account, as the 12 per cent figure could fuel complacency, rather than add momentum to the call for a strategy to strengthen the development of a flexible, sustainable nursing and midwifery workforce.

“The figures show an increase in total employment, but we have no current empirical evidence of the true demand for nurses to provide services for Australia’s ageing population and growing number of people with chronic disease, now and into the future,” Cerasa said.

“Nor have we identified where the greatest demand will be or what education and experience our nurses will need to meet the challenges ahead. We need more nurse practitioners and specialist nurses, but should these be in acute, ageing, mental health or other specialist clinical areas?

“When will we begin the process of solving one of the biggest challenges facing the nursing and midwifery workforces today?”

The AIHW figures also showed that as regional areas continue to struggle attracting doctors, the shortage is being filled by nurses.

There were 187 doctors in the bush per 100,000 people in 2008, compared to 376 medical practitioners per 100,000 people in major cities.

The lack of doctors in the regions is even more pronounced when it comes to specialists. By contrast, there are more nurses in remote areas than in the cities.

Very remote areas have the highest supply with 1275 nurses per 100,000 people, while cities have the lowest, with 1035 per 100,000.

David Braddock, from the AIHW’s labour force unit, said new nurse practitioners tended to be working in the bush.

“They’re nurses who’ve been given additional roles over a normal nurse, up to prescribing drugs, and in some cases they’re filling the gap left by the lack of medical practitioners in some of those remote areas,” Braddock said.

Despite this, a gulf exists in the level of support nurses are given compared to doctors who take up employment in remote locations, said the ANF.

“Some incentives are paid to nurses and midwives on a state by state basis but these are grossly inadequate compared to doctors,” said Lee Thomas, ANF federal secretary.

While nurses supported incentives paid to doctors and the improved access it resulted in, Thomas said the inequality was stark.

“While doctors receive up to $120,000 to move and as much as $47,000 each year to remain, nurses and midwives are yet to be provided with federal incentive packages in recognition of their willingness to work in regional and remote communities.”

Rural Australians deserve the same healthcare options as everyone else and an incentives program would boost numbers of nurses in those communities, she said.

“Why should someone in a regional or remote setting be forced to drive long distances or wait for weeks to see a GP when they could potentially have access to a highly experienced nurse or midwife?”

The AIHW report highlighted other areas for concern, particularly the ageing workforce.

The average age of doctors in 2008 was 45.6 years, virtually unchanged from 45.5 in 2004.

But the average age of nurses escalated from 43.3 to 44.1 in the same period. The proportion of nurses aged over 50 increased from 29 per cent to 35 per cent.

“The medical profession were worried about their ageing a few years ago but that seems to have plateaued a bit I suspect due to the inflow of new doctors,” Braddock said.

“But the nursing workforce continues to age and some of those increases are fairly strong.”

The average weekly hours worked by doctors has decreased from 44 in 2004 to 42.7 in 2008.

However, nurses are working longer days.

Over the four years their average weekly hours jumped from 32.8 to 33.4.

“It’s been a long-term trend that doctors have been reducing their hours from the quite high levels that they used to work and are heading towards a more community standard,” Braddock said.

“Whereas nurses have been trending up for quite a while.”

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