THE PRODUCTIVITY COMMISSION 

THE ECONOMIC IMPACTS OF MIGRATION AND POPULATION GROWTH 

The Australian Nursing and Midwifery Council is pleased to submit the following response to the Economic Impact of Migration and Population Growth Study.

The Australian Nursing and Midwifery Council (ANMC) is a peak national organisation established in 1992 to facilitate a national approach to nursing and midwifery regulation. The ANMC works in close partnership with the state and territory nursing and midwifery regulatory authorities in evolving nursing and midwifery standards that are flexible, effective and responsive to the health care requirements of the Australian community.

The ANMC is the authority delegated by the Minister for Immigration, Multicultural and Indigenous Affairs to assess the qualifications of nurses and midwives who are educated overseas for migration purposes.  This is carried out within a framework of policies consistent with registration of the nursing and midwifery regulatory authorities.

Our core activities are:

•	Identifying matters which impact on, or are relevant to statutory nursing and midwifery regulation

•	Establishing, reviewing and promoting national standards frameworks for nursing and midwifery practice in Australia

•	Undertaking assessments of overseas qualified nurses and midwives consistent with the registration and/or enrolment requirements of the Australian nursing and midwifery regulatory authorities

•	Initiating and participating in relevant projects on regulation that aid the future growth and development of the nursing and midwifery professions

•	Ensuring nursing and midwifery standards reflect the contemporary needs of the Australian community

•	Fostering consultative mechanisms with key stakeholders to assist in the statutory regulation of the nursing and midwifery professions

All nurses who wish to migrate to Australia under the skilled migration program must provide a letter from the ANMC indicating they are “suitable for migration”.  The letter of determination is “evidence of skills assessment “.

In the year ending June 2005 the ANMC had 1984 applicants for assessment as suitable for migration as nurses from over 56 countries.  Applications are increasing each year.

Do the skills of migrants differ from those of other Australian workers?  If so how?

Nursing education within Australia is an undergraduate degree that includes clinical rotations within the hospital and community settings.  The Australian state and territory nursing and midwifery regulatory authorities require nurses and midwives to be regulated and accountable to the community.  Nurses are required to meet the competency standards set by the authorities.  Qualities of leadership, communication, management and life long learning skills are essential for the contemporary nurse in Australia.

All nurses registered in Australia are required to meet the National Competency Standards.  English proficiency and nursing skills are the two areas identified by the ANMC that may differ between Australian and overseas trained nurses.

Applicants to the ANMC where English is not their first language, or have not completed their degree in and English speaking institution must complete an English proficiency test.  Nursing and midwifery skills also differ from county to country.  Competency based assessment programs, or bridging programs, both theory based and clinical are provided in each state and territory, for applicants who are required to undertake some form of competency based assessment program before coming eligible for registration as a nurse and or a midwife in Australia.

Is there evidence that immigrants exhibit more or less technical knowledge and entrepreneurial behaviour than people born in Australia.

The ANMC regularly reviews the level of education in countries for the purpose of measuring the level of competencies against Australian standards.  Recent studies of China and the Republics of the former Yugoslavia have been undertaken.  Results have shown the need for more orientation to learning in fields such as medical terminology, pharmacology and basic grammar.

Is there evidence of regulatory barriers arising from, for example, the failure to recognize international qualifications or skills, or lack of appropriate professional or occupational bridging programs?

The purpose of regulation throughout Australia is protection of the public.  Nurses and midwives that have not been educated in Australia must be assessed against the same standards required for nurses and midwives through out Australia.  The ANMC Nurse Competencies Standards state that Nurses in Australia are regulated and accountable to the community for providing high quality care through sate and effective work practice.  To assist in achieving this, the state and territory nursing and midwifery regulatory authorities set standards of competence that describe the behaviour of nurses.  

For registration requirements the practice of registered nurses is governed by the relevant legislation of each state and territory.  

The ANMC believes that by: 

•	Conducting research to ascertain the level of educational preparation of nurses in other countries.
•	Developing and implementing standards which articulate the competencies required of nurses and midwives in Australia.
•	Assessing all nurses, whether educated in Australia or elsewhere against those standards.
•	Implementing bridging programs for those nurses and midwives whose educational preparation and/or demonstration of competence indicates an inability to meet Australian standards.
•	Ensuring that all applicants for registration have sufficient English language skills for safe practice.

they are fulfilling their obligation to the Australian public to ensure that all registered nurses and midwives have the necessary skills to deliver safe and competent nursing and midwifery care.

It is essential that regulatory authorities are able to maintain their mandate to regulate appropriately in the interests of the public.

Karen Cook
Chief Executive Officer
Australian Nursing & Midwifery Council
23 September 2005