Two major Labor policies will require a substantial increase in the nurse and doctor workforce — but many are asking where the extra doctors and nurses will come from.
The first policy relates to aged care. Labor proposes that every aged care centre be staffed by at least one registered nurse, 24/7.
The second is the establishment of 50 new urgent care bulk billing clinics.
These policies will require a substantial increase in the nurse and doctor workforce. In the short-to- medium term, much of this increase will need to be imported.
Over the past 30 years, Australia has become increasingly reliant on both overseas-trained nurses and doctors as well as overseas students trained in Australian medical training facilities who go on to join the medical workforce.
Chart one shows the mix of visa categories under which registered nurses have been granted primary visas in the skill stream and the skilled temporary entry category — these would not include registered nurses on working holidaymaker visas, temporary graduate visas or nurses migrating on partner visas or working on student visas.
Chart one shows that in 2011-12 and 2012-13, the vast bulk of registered nurses migrating to Australia were either on employer-sponsored skilled temporary entry visas or employer-sponsored permanent visas.
This changed significantly from 2013-14 to 2016-17 when registered nurses made much greater use of skilled independent visas and the use of employer-sponsored visas started to decline.
From 2018-19, the composition shifted again to rely mainly on state and territory government nominated visas as the number of places in the skilled independent category were reduced and the changes that former Immigration Minister Peter Dutton made to employer-sponsored migration in 2017-18 contributed to a further reduction in employer-sponsored migration.
Australia’s registered nurse workforce has been growing much faster than the rate of general population growth, partly reflecting the ageing population and the difficulties in retaining nurses given low wage levels and difficult working conditions.
While the overall registered nurse and midwife workforce grew at an average of around 7,000 per annum from 2012 to 2017, this accelerated significantly from 2018 to 2021 when the registered nurse and midwife workforce grew at an average of 18,000 per annum as the health system sought to attract back registered nurses who had left the profession, particularly during the pandemic.
Over the last decade, the registered nurse workforce has grown by over 107,000. At the same time, over 50,000 registered nurses have migrated to Australia.
It is inevitable that growing the nurse workforce further will continue to require a significant contribution from migrant nurses.
Chart three shows the number of doctors, specialists and dentists granted skilled temporary entry visas.
This too declined markedly from 2013-14 and was likely replaced initially by greater use of skilled independent visas and then state/territory nominated visas.
The key takeaway from this should be that to attract the nurses and doctors we will need, Australia must fix the design of employer-sponsored visas to make them easier, faster and cheaper to use. Australia must also increase penalties for employers who misuse these visas and increase the minimum salary paid to migrants who are sponsored by employers.
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