Queensland Nurses’ Union

Beth Mohle

15 April 2005

Health Workforce Study
Productivity Commission
PO Box 80
BELCONNEN  ACT 2616

Dear Commissioners Woods and Owens

RE: Health Workforce Study

Thank you for the opportunity to provide preliminary input into the Productivity Commission’s Health Workforce Study.

The Queensland Nurses’ Union (QNU) has made numerous submissions in recent years on topics that are of direct relevance to your inquiry.  One strong concern that we have about this study is that we have had many inquiries at both a state and federal level (especially into nursing) in recent years and very little significant action to address the issues highlighted in these studies. We have seen a lot of talk and very little action. It is our fear that this new inquiry provides yet another opportunity to delay action by government.  However we do acknowledge that this inquiry does provide us with the opportunity to examine the whole of the health workforce and therefore highlight many long standing and entrenched inequalities, differential treatments and power imbalances within our health system which must be addressed if we are to ensure a cohesive, equitable, efficient and effective health system going forward.

We thought that it would be useful to provide the Commission with copies of the most relevant of these documents prior to the release of your issues paper in May.  Hard copies of these documents are enclosed.  Most are available in electronic form so please feel free to contact us should you require copies in this format.

The documents enclosed are:

•	The QNU submission to the Senate Inquiry into Nursing (Feb 2002) – this is a detailed submission covering a wide range of concerns about the nursing workforce and although it is now a few years old many if not all of the issues raised still require attention.
•	The QNU Submission to the National Review of Nursing Education (Feb 2002) – this inquiry was held at the same time as the Senate Inquiry into Nursing so similar concerns were raised in this submission.

•	QNU submission to Queensland Health – Smart State 2020 (June 2002).

•	University of Southern Queensland (USQ) summary of findings of research conducted on behalf of QNU – Your Work, Your Time, Your Life survey (July 2002) – please note this research was repeated at the end of 2004 and USQ is in the process of analysing this data at present and undertaking comparative analysis between 2001 and 2004 research. We will be able to provide the Commission with findings of this new research on a confidential basis once a report is made available to the union. 

•	QNU submission to Senate Employment, Workplace Relations and Education References Committee Inquiry into Current and future skills needs (February 2003).

•	QNU submission to Australian Council on Safety and Quality in Health Care on Safe Staffing (October 2003) – no further progress apparent from the Council on this taskforce.
•	QNU Briefing Document prepared for incoming Queensland Minister for Health  -Nurses: Worth looking after (March 2004).

•	QNU/ Queensland Nursing Council – Social Charter for Nursing in Queensland (2nd edition May 2004) and background pamphlet on the charter.

•	QNU submission to Queensland government prior to 2005-2006 Queensland Budget (December 2004).

The QNU intends making a detailed submission to your inquiry following the release of your issues paper in July.  We do wish to flag at this point some particular issues of concern to the union that will be raised in this submission, including:

•	current inadequacies and inconsistencies with regard to the way in which work is valued in the health sector and the failings of our current systems (industrial and professional) to appropriately deal with this issue. This is linked with the manner in which productivity is assessed in the health sector and the undue emphasis placed on meeting efficiency indicators, and insufficient attention to issues of effectiveness and quality of care. The failures of enterprise bargaining in the health sector will also be addressed in our submission;

•	workload management in the health sector and the nexus between workloads and patient outcomes and how we can best ensure safe staffing levels;

•	current significant skills shortages in health (especially in nursing) and the failure of governments at the state and federal levels to adequately address these shortages; 

•	issues of skill mix and substitution in the health and aged care sectors and concerns with current inadequacies in quality assurance systems and processes;

•	inconsistencies in health worker education in Australia and who bears the cost of this at present, especially with regard to post graduate studies and how this contributes to skills shortages. (For example, the differences in costs and arrangements for nurses undertaking post graduate studies compared to doctors);

•	the need to significantly change the culture and power relationships in health in order to aid recruitment and retention of personnel and encourage genuine “consumer” involvement in health planning and decision making;

•	significant issues with respect to health and safety (and the impact on workers compensation) and other issues related to providing a safe and supportive workplace environment for health workers;

•	the potential impact of demographic challenges on the health workforce and demand for health services;

•	the need to review current remuneration arrangements for health practitioners (such as the fee for service funding arrangements for medical practitioners);

•	the differential treatment of health workers with respect to government assistance for professional indemnity insurance;

•	the need to promote innovation in models of health care such as multi-disciplinary primary health care teams and the role of nurse practitioners in these and other settings;

•	lack of a coordinated, adequately resourced and nationally consistent framework for health workforce planning – the lack of political will to address this issue is of grave concern.

I hope that the information that we have provided to you is of assistance. We do have other information that may be of interest, so please do not hesitate to contact QNU Project Officer Beth Mohle on 07 3840 1437 (bmohle@qnu.org.au) should you require any additional information or clarification on any matters.

Yours sincerely

GAY HAWKSWORTH
Secretary