- Open Access
New investments in primary care in Australia
© Del Mar; licensee BioMed Central Ltd. 2011
- Received: 20 January 2011
- Accepted: 17 February 2011
- Published: 17 February 2011
There is a crisis in primary care health workforce shortages in Australia. Its government has attempted to fix this by role-substitution (replacing medical work with nursing instead). This was not completely successful. Obstacles included entrenched social roles (leading to doctors 'checking' their nurse role-substituted work) and structures (nurses subservient to doctors) - both exacerbated by primary care doctors' ageing demographic; doctors owning their own practices; doctors feeling themselves to have primary responsibility for the care delivered; and greater attraction towards independence that may have selected doctors into primary care in the first place.
Yet there is much to be optimistic about this social experiment. It was conducted, if not ideally, at least in an environment that the Australian government has enriched with capacity for research and evaluation.
- Primary Care
- Health Worker
- Practice Nurse
- Health Workforce
- Healthcare Team
The paper by Pearce et al, above, clearly outlines the health worker crisis that is affecting Australia. This is true for many parts of the world, not just the Third World but many countries with developed economies as well.
The obvious response is for governments to create new health workers at an accelerated rate, and indeed this is happening. In addition the private sector is responding to the market forces by creating new university schools of medicine, for example in Brazil and India (where there are now more private schools than public).
What is interesting for Australia is that the government has attempted new interventions to fix the problem. This is the basis of its role-substituting intervention - replacing some medical responsibilities by (cheaper, and more available) nursing health workers.
Australia should be applauded for the brave attempt to address the health workforce needs in primary care, albeit clumsily delivered and not completely successful, but also for establishing and funding the health-services research needed to fix the problem better.
- Pearce C, Phillips V, Hall S, Sibbald B, Porritt J, Yates R, et al: Following the funding trail: Financing, nurses and teamwork in Australian General Practice. BMC Hlth Ser Res. 2011, 11: 38-10.1186/1472-6963-11-38.View ArticleGoogle Scholar
- Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T, et al: Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet. 2010Google Scholar
- Royal Australian College of General Practitioners. Media release 24 June 2010. 2010, (accessed 15 Oct 2010), [http://www.racgp.org.au/media2010/38052]
- Primary Health Care Research & Information Service: The PHCRED Straety. 2010, (accessed 15 Oct 2010), [http://www.phcris.org.au/phcred/]Google Scholar
- Australian National University: Australian Primary Health Care Research Institute. 2010, (accessed 15 Oct 2010), [http://www.anu.edu.au/aphcri/]Google Scholar
- The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1472-6963/11/39/prepub
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.