The University of Westrern Australia.
November 8, 2005
Productivity Commission.

	Re: Australia’s Health and Workforce: Productivity Commission Position Paper. 2005.

As Chair of the Postgraduate Medical Council of Western Australia, I note the creditable intention of the recommended reforms to promote more responsive education and training arrangements. There are some points that may be useful in further deliberations.

1.	The Workforce analyses fail to include numbers and costs of health administration which would be important to provide the total context.

2.	The listed systemic impediments and principles of the National Health Workforce Strategic Framework do identify the most critical issues.

3.	An Advisory Health Workforce Improvement Agency for coordination, standards and strategies would be useful, but implementation to achieve effectiveness will be important. Adequate representation from Health Service and Education sectors will be critical. It will need to receive regular reports from relevant discipline and State agencies and have lines of reporting to drive action.

4.	A National Accreditation Regime can only take on some of the responsibilities of the range of bodies currently involved. Some may then become unnecessary, but a number of management activities requiring regional knowledge and presence will still need to be devolved to regional bodies.

5.	The transfer of funding for health professional education and training from DEST to DoHA has been discussed and considered potentially worthwhile. The model may need to include identification of funding for prevocational and vocational training as vertical integration of training will be more cost effective with improved outcomes. The model may also include assessment and training of international medical graduates. The nexus of teaching and research is also a necessary component of an effective training paradigm and should be part of the funding model.

6.	The issues of Rural and Remote and Indigenous Health are critical and must be included in the Terms of Reference of all established Committees and Programs. Current models of setting up an extra layer of national management appear, in many cases, to divert funding from the primary activity without any added value. 

I trust that these comments may be helpful.

Sincerely, 
Professor Louis I. Landau.
Chair,
PostgraduateMedical Council of WA.
School of Paediatrics and Child Health.  M561.
The University of Western Australia..