There is strong evidence that the Australian labour market is the ‘tightest’ it has been for many years, with unemployment rates at levels not seen since the 1970s (https://www.theguardian.com/business/2022/dec/15/australias-unemployment-rate-remains-at-34-in-november-as-64000-new-jobs-added).
A good manifestation of the current labour market situation is in job vacancies. While the number of vacancies at any one time are not always a reliable indicator, a trend in the level of vacancies is a good indicator of the state of the labour market. Australian job vacancies since the beginning of the start of the COVID 19 pandemic have grown exponentially as reflected in the Internet Vacancy Index. The same type of indices have shown labour market tightness also in NZ, UK and the USA (see figure below). Growth in vacancy numbers effectively means there are more jobs available than people to fill them.
What this means practically in the workplace is that when someone leaves a job for any reason (to go to a new job, go on maternity or long service leave, retirement, long-term injury, etc.) the chances are the job will remain vacant for longer than usual. This puts stress on other members of the workforce who have to make up for the unfilled position. Ironically, tight labour markets tend to be associated with higher turnover, since workers are almost guaranteed to get back into a job, thus exacerbating the situation.
Health professions have not been immune from this trend as shown in the figure below. If you thought that it was getting harder to fill health profession vacancies, then you would be right for most professions. Since 2018 the Internet Vacancy Index has gone up by 45% for physiotherapists, 69% for dental practitioners, 77% for general medical practitioners, 81% for occupational therapists, 97% for registered nurses and 190% for speech pathologists.
During COVID times the labour market situation was exacerbated by a higher than average number of employed workers being on sick leave or mandatorily required to stay at home because of a positive COVID test.
At the height of a third wave of COVID infections in the middle of 2022, HCA’s Principal, Lee Ridoutt, was involved in a Pulse IT Webinar organised and facilitated by DXC titled ‘Resilience in the Health Sector: Workforce Management and Employee Wellbeing’. Along with HCA’s Principal in the webinar was Bernadette Eather, Chief Nurse at Ramsey Australia and Louise Schaper, the CEO at the Australasian Institute of Digital Health. You can listen to the webinar here.
Much of the conversation was around how to prevent or ameliorate the impact of staff shortages and how to respond to prolonged periods of staff stress … potentially leading to burnout. Some interesting solutions were canvassed by the panel.
Since that Webinar HCA, along with it’s HWI partner, has been involved in several allied health workforce projects, one in Tasmania looking at the workforce situation in support of occupational therapy services and another in the Illawarra area of NSW looking at the broader allied health workforce.
In both cases the broad labour market conditions across Australia have had, and are continuing to have, a strong influence, impacting significantly on the short-term capacity of services to satisfy health consumer demand and to provide high value care. This has manifested in different ways … increased hurdles to consumers to access services (higher priority threshold levels), greater rationing of services in acute care to only the sickest, more superficial service interventions, increased burnout of workers, longer waiting times.
Two less expected phenomenon though have been revealed from these studies that have indicated that the short-term nature of the problems might in fact be more long-term.
The first is the possible longer term ‘traumatic’ impact of working for almost two years (and in many regards still working) through the darkest days of COVID under great stress. Some workers viewing this from a mental health perspective have advocated that a trauma informed care approach practiced with service consumers should also be practiced with the workforce. Just how this would look is yet to evolve, but a focus on five core principles – safety, trustworthiness, choice, collaboration, empowerment as well as respect for diversity – would be a requisite starting point.
The second is an emerging understanding that especially for allied health services, funded staffing levels are inadequate to deliver all the services that are being planned and promised to consumers. This is despite strong growth in most allied health profession workforces that is greater than doctor and nurse workforces – growth in service demand across all sectors (acute, community, mental health, aged care) is growing faster than workforce supply.
Solutions here will not be easy to find, but will require a much greater focus on service planning and investment strategies that prioritise workforce effort into high value care along with much more efficient utilisation of health workforce so that operate more consistently at the top of their scope of practice.
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