如果我们不解决卫生工作人员中迫在眉睫的关键技能短缺问题，澳大利亚人将遭受损失。 为了满足未来的医疗需求，我们应该将“安置贫困”作为一项公平措施来解决。 我们需要对日益严重的卫生劳动力短缺发出警报，否则澳大利亚人将因许多疾病（包括癌症、精神健康问题和心脏病）而遭受可避免的死亡人数增加。 那些生活在农村和偏远地区的人已经是1。 死于多种疾病的可能性是大城市的5倍，这是由于几个因素造成的，包括看医生、护士和专家的等待时间更长。 我们的人口不断增长和老龄化，大学协议估计，到2033年，也就是9年后，将需要50多万个新的医疗和社会援助工作岗位来满足我们的需求。 那么，我们如何确保培训这条劳动力管道呢？该协议提出，解决技能短缺的部分办法可以通过解决学生面临的经济负担或“安置贫困”来找到。 “安置贫困”应作为一项公平措施加以解决，为在接受强制性培训安置时面临严重经济压力的学生提供经过经济状况调查的财政支持。 财政支持可能包括助学金制度以及为相关健康、牙科、口腔健康、护理和药学专业的学生提供的担保奖学金计划，这将有助于解决农村和偏远地区的关键卫生劳动力需求。 但我们不应该把这些实习误认为是“无报酬的工作”，并要求所有实习都有报酬。 它们不是就业，而是健康学生教育和培训的强制性部分。 它们是在有监督的环境中完成的基于实践的培训。 他们被称为“工作综合学习”，确保学生发展其卫生专业注册所需的技术技能和知识，并有义务确保卫生专业人员毕业时他们是安全的从业者，能够按照澳大利亚公众要求的标准提供护理。 全面引入“带薪实习”威胁到培训的完整性——在评估医疗保健学生时，会引发潜在的利益冲突，以及“雇主”的优先事项与学生的学习需求之间的冲突。 更好的财政支持模式是由英联邦和各州共同资助的助学金制度，类似于英国的国家医疗服务学习支持基金。 该基金适用于特定的医疗保健课程，包括培训补助金、差旅和临时住宿资金，以及为遇到经济困难的学生提供的基金。 雇主还应该为支持安置的成本做出合理的贡献，因为他们从合格毕业生的管道中受益。 大学可以发挥自己的作用，例如通过增加大学助学金，首先帮助更多低收入学生上大学。 政府政策鼓励慈善事业和企业提供财政支持，以解决卫生专业学生安置贫困问题。 在一项长达十年的新的国家卫生劳动力战略下，这种协调行动可以确保我们的大学继续培养一支优秀的卫生专业劳动力，并在数量和领域上保持多样性，以满足所有澳大利亚人的需求，无论他们住在哪里。 但我们应该小心，不要误诊，制定错误的解决方案和治疗计划。 这篇文章于2024年4月3日首次作为评论文章发表在《澳大利亚人报》上。 该报告由悉尼大学医学与健康执行院长兼副校长robyn ward教授撰写。
australians will suffer if we dont address a looming critical skills shortage in the health workforce. to meet future healthcare needs, we should address “placement poverty“ as an equity measure writes professor robyn ward in the australian.we need to sound the alarm on a looming critical shortage in the health workforce or australians will suffer an increase in avoidable deaths from many illnesses including cancer, mental health problems and heart disease.already those living in rural and remote areas are 1.5 times more likely to die of many conditions than those in major cities, due to several factors including longer wait times to see doctors, nurses and specialists.we have a growing and ageing population, and the universities accord estimates more than 500,000 new healthcare and social assistance jobs will be needed by 2033, only nine years away, to meet our needs.so how do we ensure we are training this workforce pipeline?the accord proposes that part of the solution to the skills shortage can be found by addressing the financial burden, or “placement poverty”, faced by students.“placement poverty” should be addressed as an equity measure, providing means-tested financial support for students who face severe financial pressures when undertaking compulsory training placements.the financial support could include a bursary system as well as a bonded scholarship scheme for allied health, dental, oral health, nursing and pharmacy students which could help address the critical health workforce needs in rural and remote areas.but we should not mistake these placements as “unpaid work” and require that all placements be paid.they are not employment, but a mandatory part of a health student’s education and training. they are practice-based training completed in a supervised setting.known as “work-integrated learning”, they ensure students develop the technical skills and knowledge required for registration in their health profession and are compulsory to ensure that when health professionals graduate they are safe practitioners – able to deliver care at the standard required by the australian public.introducing across-the-board “paid placement” threatens the integrity of the training – raising potential conflicts of interest when it comes to assessment of healthcare students and conflict between the priorities of the “employer” and the learning needs of the students.a better financial support model would be a bursary system – jointly funded by the commonwealth and the states – similar to the uk’s national health service-learning support fund. that fund applies to specified healthcare courses and includes training grants, funding for travel and temporary accommodation, and a fund for students experiencing financial difficulties.employers should also make reasonable contributions to the costs of supporting placements as they benefit from the pipeline of qualified graduates. and universities can play their part, such as through top-up university bursaries to help get more low ses students to university in the first place.there is a place for government policies to encourage financial support from philanthropy, as well as from business, to address student placement poverty across the health professions.such co-ordinated action under a new decade-long national health workforce strategy can ensure our universities continue to train a health profession workforce of excellence, as well as diversity in the numbers and in the areas necessary to meet the needs of all australians, wherever they live.but we should be careful not to misdiagnose the problem and develop the wrong solution and treatment plan.this article was first published as an opinion piece in the australian on 3 april 2024. it is authored by professor robyn ward, executive dean and pro vice-chancellor of medicine and health at the university of sydney.
