The Deeble Institute for Health Policy Research, the research arm of the Australian Healthcare and Hospitals Association (AHHA), has released its Perspectives Brief for July 2024 titled, South Australia Oral Health Workforce Projections Barriers: The Importance of Data. This brief explores the current characteristics of the oral health workforce and sector in South Australia, highlighting workforce planning and recruitment challenges and the importance of accurate, complete, and timely data.
Background: In 2022, SA Dental obtained workforce data from the Australian Health Practitioner Regulation Agency (AHPRA) and publicly available data from the Department of Education to build various projections and scenarios for the oral health workforce in South Australia. This data was vital for their research but had several limitations, including:
- Robust AHPRA data relies on registrants voluntarily providing non-essential/optional information. As only basic/required information is needed for AHPRA registration, this affected the quality of AHPRA data.
- Data published was often lagging by a couple of years.
- Certain roles in the workforce are excluded from the data. For example, dental assistants and dental technicians play important roles in the dental team, but as they are not registered professions, workforce planning is more difficult for these two professions.
The Oral Health Landscape in Australia: The oral health workforce in Australia involves various professions, including:
- Dental Specialists
- Dentists
- Dental Prosthetists
- Dental Therapists/Oral Health Therapists
- Dental Hygienists
- Dental Assistants
- Dental Technicians
Oral Health Providers in Australia: Across Australia, dental practices can be owner-run small businesses or part of franchises owned by corporate groups or major insurance providers such as Bupa and Health Partners. Over the years, there has been a continuing trend of smaller private practices being bought out by larger franchises and private health insurance and equity firms. This trend is also affecting Australian medical practices and other health providers. Reasons for this trend include:
- Rising costs of compliance
- Rising cost of technology
- Costs associated with delivering rural and remote healthcare and maintaining equipment
- Increased competition (including the increased bargaining power of larger companies and the competition for skilled workers across the globe)
- Challenges in attracting, recruiting, and retaining talented and skilled workers, especially those committed to building long-term careers in rural Australia
Dental Services in Australia: According to the Australian Institute of Health and Welfare 2023, the private sector accounts for approximately 83% of the dental services provided nationally.
Private Dental Services in Australia:
- Charge fees for their services, paid for by patients out-of-pocket or by the patient’s private insurance fund.
- May provide private dental services to a limited number of adult patients funded by the public sector’s schemes program.
- May provide basic general dental services to eligible children aged 0-17 as part of the Child Dental Benefits Schedule.
Public Dental Services in Australia:
- The public sector, including SA Dental, delivers statewide dental services to eligible healthcare card and pensioner concession card holders at a subsidized cost.
- Provides dental services for children and remote areas.
- Often has arrangements with teaching hospitals and universities, which facilitate clinical placements, professional training, workforce initiatives, and opportunities for dentistry students to provide dental services to patients.
Workforce Shifts in the Australian Dental and Healthcare Sectors: The healthcare and dental sectors in Australia face significant challenges with workforce distribution and recruitment. Suggested reasons for this include:
- Australia’s need for regional, rural, and remote clinics and workforces, where workforce and training challenges are more extreme.
- New and prospective employees favouring part-time work over full-time work, affecting workforce availability and capacity.
- Frequent changes to health policies over the last 20 years, with multiple federal funding sources introduced and ceased, along with the current economic climate, have resulted in increasing uncertainty of long-term service provision, investment, and workforce requirements.
- In the dental sector, the public sector is a small employer of the overall oral health workforce in Australia.
- The pandemic may have impacted young people’s motivation to work, resulting in fewer full-time equivalent (FTE) workers.
- The pandemic may have prompted some individuals to retire earlier than anticipated.
- While the number of international students has increased, these students tend to return to their home countries after graduation, leaving Australia with fewer workforce numbers despite universities training more oral health practitioners each year.
Recommendations of the Perspectives Brief July 2024:
- Importance of Data: More accurate, complete, and timely data collection and analysis are needed for better workforce planning and to inform policymaking.
- Targeting Workforce Development in Regional, Rural, and Remote Areas: Workforce development efforts need to be distributed in these areas. Workforce development efforts for the oral health sector need to match those of the medical and nursing sectors.
- Access to Training and Education in Regional, Rural, and Remote Areas: Develop relevant courses and apprenticeship programs for regional, rural, and remote students and a return-of-service initiative, including strategies that reduce social barriers and professional isolation.
- Collaboration Between Stakeholders: The Department for Education, universities, and the VET sector need to develop and expand tailored training programs that foster local health practitioners.
- Targeted Initiatives to Attract and Retain Talent in Regional Areas: This could include offering financial incentives, visa benefits, and providing affordable housing options.
- Investment in Digital Infrastructure and Technology: To bridge the geographical gap and facilitate remote work and access to healthcare. Transport payments can assist patients in accessing services in metropolitan areas where possible.
While Australia’s dental and health workforce challenges are not going away any time soon, the Deeble Institute’s Perspectives Brief highlights the importance of quality data collection and the creation of clear pathways for students from rural backgrounds to enter the health workforce. Increased collaboration among government, the private sector, and educational institutions is necessary to enhance policymaking and workforce development programs that have the potential to bring about long-term benefits for the nation.
