National Reporting Instrument 2018
Background
[iBG]
Adopted in 2010 at the 63rd World Health Assembly (WHA Res 63.16), the WHO Global Code of Practice on the International Recruitment of Health Personnel (“the Code”) seeks to strengthen the understanding and ethical management of international health personnel recruitment through improved data, information, and international cooperation.
Article 7 of the Code encourages WHO Member States to exchange information on the international recruitment and migration of health personnel. The WHO Director General is additionally mandated to report to the World Health Assembly every 3 years. WHO Member States completed the 2nd Round of National Reporting on Code implementation in March 2016. The WHO Director General reported progress on implementation to the 69th World Health Assembly in May 2016 (A 69/37 and A 69/37 Add.1). During the 2nd Round of National Reporting, seventy-four countries submitted complete national reports: an increase in over 30% from the first round, with improvement in the quality and the geographic diversity of reporting.
The National Reporting Instrument (NRI) is a country-based, self-assessment tool for information exchange and Code monitoring. The NRI enables WHO to collect and share current evidence and information on the international recruitment and migration of health personnel. The NRI (2018) has been considerably shortened, while retaining key elements. It now comprises 18 questions. The common use of the instrument will promote improved comparability of data and regularity of information flows. The findings from the 3rd Round of National Reporting are to be presented at the 72nd World Health Assembly, in May 2019.
The deadline for submitting reports is 15 August 2018.
Should technical difficulties prevent national authorities from filling in the online questionnaire, it is also possible to download the NRI via the link: http://www.who.int/hrh/migration/code/code_nri/en/. Please complete the NRI and submit it, electronically or in hard copy, to the following address:
Health Workforce Department
Universal Health Coverage and Health Systems
World Health Organization
20 Avenue Appia, 1211 Geneva 27
Switzerland
hrhinfo@who.int
The data and information collected through the National Reporting Instrument will be made publicly available via the WHO web-site following the proceedings of the 72nd World Health Assembly. The quantitative data collected will be updated on and available through the National Health Workforce Accounts online platform (http://www.who.int/hrh/statistics/nhwa/en/).
Article 7 of the Code encourages WHO Member States to exchange information on the international recruitment and migration of health personnel. The WHO Director General is additionally mandated to report to the World Health Assembly every 3 years. WHO Member States completed the 2nd Round of National Reporting on Code implementation in March 2016. The WHO Director General reported progress on implementation to the 69th World Health Assembly in May 2016 (A 69/37 and A 69/37 Add.1). During the 2nd Round of National Reporting, seventy-four countries submitted complete national reports: an increase in over 30% from the first round, with improvement in the quality and the geographic diversity of reporting.
The National Reporting Instrument (NRI) is a country-based, self-assessment tool for information exchange and Code monitoring. The NRI enables WHO to collect and share current evidence and information on the international recruitment and migration of health personnel. The NRI (2018) has been considerably shortened, while retaining key elements. It now comprises 18 questions. The common use of the instrument will promote improved comparability of data and regularity of information flows. The findings from the 3rd Round of National Reporting are to be presented at the 72nd World Health Assembly, in May 2019.
The deadline for submitting reports is 15 August 2018.
Should technical difficulties prevent national authorities from filling in the online questionnaire, it is also possible to download the NRI via the link: http://www.who.int/hrh/migration/code/code_nri/en/. Please complete the NRI and submit it, electronically or in hard copy, to the following address:
Health Workforce Department
Universal Health Coverage and Health Systems
World Health Organization
20 Avenue Appia, 1211 Geneva 27
Switzerland
hrhinfo@who.int
The data and information collected through the National Reporting Instrument will be made publicly available via the WHO web-site following the proceedings of the 72nd World Health Assembly. The quantitative data collected will be updated on and available through the National Health Workforce Accounts online platform (http://www.who.int/hrh/statistics/nhwa/en/).
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Please describe
Disclaimer
[disclaim]
For more information on WHO Data Policy kindly refer to http://www.who.int/publishing/datapolicy/en/
For more information on WHO Data Policy kindly refer to http://www.who.int/publishing/datapolicy/en/
I have read and understood the WHO policy on the use and sharing of data collected by WHO in Member States outside the context of public health emergencies
Designated National Authority Contact Details
[q01a]
Name of Member State:
Australia
[q01b]
Contact information:
Full name of institution:
Commonwealth Department of Health
Name of designated national authority:
Leila Jordan
Title of designated national authority:
Director UN Health
Telephone number:
(02) 6289 8680
Email:
WHO@health.gov.au
Implementation of the Code
[q1]
1. Has your country taken steps to implement the Code?
Yes
[q2]
2. To describe the steps taken to implement the Code, please tick all items that may apply from the list below
2.a Actions have been taken to communicate and share information across sectors on the international recruitment and migration of health personnel, as well as to publicize the Code, among relevant ministries, departments and agencies, nationally and/or sub-nationally.
2.b Measures have been taken or are being considered to introduce changes to laws or policies consistent with the recommendations of the Code.
The introduction of measures to address the maldistribution of the health workforce including the District of Workforce Shortage and funding Rural Workforce Agencies to deliver the Rural Health Workforce Support Activity.
2.c Records are maintained on all recruiters authorized by competent authorities to operate within their jurisdiction.
2.d Good practices, as called for by the Code, are encouraged and promoted among recruitment agencies.
The Government has established a Distribution Working Group to consider the implementation of programs and policies that use remoteness classifications. A core responsibility of the Group is to consider mechanisms to encourage equitable health workforce distribution. The Group is comprised of a broad range of stakeholders and includes representation from the Royal Australian College of General Practitioners, the Australian Medical Association, Rural Doctors Association of Australia and the Rural Health Commissioner to ensure GPs views are considered.
2.e Measures have been taken to consult stakeholders in decision-making processes and/or involve them in activities related to the international recruitment of health personnel.
2.f Other steps:
[q3]
3. Is there specific support you require to strengthen implementation of the Code?
3.a Support to strengthen data and information
3.b Support for policy dialogue and development
3.c Support for the development of bilateral agreements
3.d Other areas of support:
None
Data on International Health Personnel Recruitment & Migration
[iq4]
Improving the availability and international comparability of data is essential to understanding and addressing the global dynamic of health worker migration.
[q4]
4. Does your country have any mechanism(s) or entity(ies) to maintain statistical records of foreign-born and foreign-trained health personnel?
Yes
[q4x1]
Please describe:
The Australian Health Practitioner Regulation Agency keeps these records.
[iQ5]
For the latest year available, consistent with the National Health Workforce Accounts (NHWA) Indicators 1-07 and 1-08, please provide information on the total stock of health personnel in your country (preferably the active workforce), disaggregated by the country of training (foreign-trained) and the country of birth (foreign-born). Please consult with your NHWA focal point, if available, to ensure that data reported below is consistent with NHWA reporting.
[q5x1]
5. Data on the stock of health personnel, disaggregated by country of training and birth
5.1 Consolidated stock of health personnel
5.1 Consolidated stock of health personnel
| Total | Domestically Trained | Foreign Trained | Unknown Place of Training | National Born | Foreign Born | Source* | Additional Comments# | |
|---|---|---|---|---|---|---|---|---|
| Medical Doctors | 91341 | 59237 | 29447 | 2657 | 40412 | 50906 | National Health Workforce Datasets: Medical, Dental, Nursing & Midwifery, and Pharmacy 2016. | None |
| Nurses | 315164 | 254870 | 55780 | 4514 | 203190 | 111688 | National Health Workforce Datasets: Medical, Dental, Nursing & Midwifery, and Pharmacy 2016. | Data for Nurses and Midwives has been consolidated as many have dual qualifications. |
| Midwives | 0 | 0 | 0 | 0 | 0 | 0 | National Health Workforce Datasets: Medical, Dental, Nursing & Midwifery, and Pharmacy 2016. | Data for Nurses and Midwives has been consolidated as many have dual qualifications |
| Dentists | 19490 | 14209 | 4472 | 809 | 9439 | 10037 | National Health Workforce Datasets: Medical, Dental, Nursing & Midwifery, and Pharmacy 2016. | None |
| Pharmacists | 23842 | 20230 | 2862 | 750 | 13479 | 10351 | National Health Workforce Datasets: Medical, Dental, Nursing & Midwifery, and Pharmacy 2016. | None |
[iq5x2]
5.2 Country of training for foreign-trained health personnel
Please provide detailed data on foreign-trained health personnel by their country of training, as consistent with NHWA Indicator 1-08. This information can be provided by one of the following two options:
Please provide detailed data on foreign-trained health personnel by their country of training, as consistent with NHWA Indicator 1-08. This information can be provided by one of the following two options:
[q5x2x2]
Option B: Uploading any format of documentation providing such information (e.g. pdf, excel, word).
Please upload file
[Q5fn]
*e.g. professional register, census data, national survey, other
#e.g. active stock, cumulative stock, public employees only etc.
#e.g. active stock, cumulative stock, public employees only etc.
Partnerships, Technical Collaboration and Financial Support 1/2
[q6]
6. Has your country provided technical or financial assistance to one or more WHO Member States, particularly developing countries, or other stakeholders to support the implementation of the Code?
6.a Specific support for implementation of the Code
6.b Support for health system strengthening
6.c Support for health personnel development
6.d Other areas of support:
[q7]
7. Has your country received technical or financial assistance from one or more WHO Member States, the WHO secretariat, or other stakeholders to support the implementation of the Code?
7.a Specific support for implementation of the Code
7.b Support for health system strengthening
7.c Support for health personnel development
7.d Other areas of support:
Partnerships, Technical Collaboration and Financial Support 2/2
[q8]
8. Has your country or its sub-national governments entered into bilateral, multilateral, or regional agreements and/or arrangements to promote international cooperation and coordination in relation to the international recruitment and migration of health personnel?
No
Health Workforce Development and Health System Sustainability
[q9]
9. Does your country strive to meet its health personnel needs with its domestically trained health personnel, including through measures to educate, retain and sustain a health workforce that is appropriate for the specific conditions of your country, including areas of greatest need?
Yes
[q9x1]
9.1 Measures taken to educate the health workforce
The Australian Government aims to ensure that Australia has the workforce necessary to improve the health and wellbeing of all Australians. The Government is implementing policies and delivering programs that improve the capacity, quality, distribution and mix of the health workforce to better meet the needs of the Australian community and deliver a sustainable and well distributed health workforce.
The Government invests over $623.7 million per annum to deliver four major education and training programs that contribute to the recruitment, retention and distribution of doctors as well as building training capacity across the system. The Rural Health Multidisciplinary Training (RHMT) program supports rural training opportunities for health students during their university studies. Training opportunities for interns and junior medical officers are funded through the Junior Doctor Training Program. Vocational training opportunities are supported through the Australian General Practice Training (AGPT) program and the Specialist Training Program (STP). While these initiatives dont have a specific focus on international graduates they contribute to the development of a high quality national medical training system.
The Australian General Practice Training (AGPT) program is a Commonwealth funded postgraduate vocational training program for medical graduates wishing to pursue a career in general practice.
The AGPT program provides training towards three endpoints:
• Fellowship of the Royal Australian College of General Practitioners (RACGP);
• Fellowship of the Australian College of Rural and Remote Medicine (FACRRM); and
• Fellowship in Advanced Rural General Practice (FARGP).
Registrars who are offered a place through a competitive selection process accept a training position in one of 11 training regions across Australia. There are nine Regional Training Organisations (RTOs) responsible for training registrars (and meeting regional distribution targets) in the regions. The Streamlining GP Training initiative in the Stronger Rural Health Strategy will transition the AGPT program from the Commonwealth to the GP Colleges (the RACGP and the ACRRM). Further information on the AGPT program can be found at http://www.agpt.com.au/ and at the College websites at https://www.racgp.org.au (RACGP) and https://www.acrrm.org.au (ACRRM).
The Non-Vocationally Registered (Non-VR) Fellowship Support Program (FSP) was announced as part of the 2018-19 Stronger Rural Health Strategy: Streamlining GP Training Budget Measure with participants commencing in 2019. The program is to be administered by the GP Colleges, the Royal Australian College of General Practitioners (RACGP) and the Australian College of Rural and Remote Medicine (ACRRM), and will provide support to assist non-VR medical practitioners to gain vocational registration as a specialist general practitioner. The Non-VR FSP program is to be administered by the GP Colleges and will provide support to assist non-VR medical practitioners to gain vocational registration as a specialist general practitioner. Further information on the Non-VR FSP can be found at the College websites at https://www.racgp.org.au (RACGP) and https://www.acrrm.org.au (ACRRM).
The Remote Vocational Training Scheme (RVTS) is a three- or four-year program that delivers structured distance education and supervision to doctors while they continue to provide general medical services in Aboriginal and Torres Strait Islander communities and rural and remote locations throughout Australia. The aim of the RVTS is to support medical practitioners to gain Fellowship of the Royal Australian College of General Practitioners (RACGP) and/or the Australian College of Rural and Remote Medicine (ACRRM).
The Australian Government (through the Department of Health) funds four Aboriginal and Torres Strait Islander health professional organisations (ATSIHPOs) to help grow the Aboriginal and Torres Strait Islander health workforce. One key objective for the ATSIHPOs is to assist with increasing the number of Aboriginal and Torres Strait Islander students studying for qualifications in health and developing strategies that assist them with completion/graduation rates. Strategies may include, but are not limited to, the coordination of financial support and scholarship opportunities, provision of networking opportunities, working with education providers on developing and delivering appropriate health criteria and the coordination of student representative committees.
9.2 Measures taken to retain the health workforce
Rural Workforce Agencies are funded to deliver the Rural Health Workforce Support Activity and Health Workforce Scholarship program. These activities aim to improve the access, quality and sustainability of the rural health workforce, and support existing rural health professionals to upskill to meet community need.
ATSIHPOs also develop and implement strategies that assist Aboriginal and Torres Strait Islander health workforce retention rates. Strategies delivered by ATSIHPOs may include, but are not limited to, the provision of mentoring programs, provision of leadership opportunities, support with career pathway planning and development, and professional development opportunities, advocating for and supporting workplaces to be culturally safe for Aboriginal and Torres Strait Islander workers.
9.3 Measures taken to ensure the sustainability* of the health workforce
The Commonwealth funds 1500 training places under the AGPT program and 32 places per year through the RVTS program. It will fund an additional 100 Rural Generalist places from 2021.
A Fellowship Support program will be available between 2019 and 2023 for non-vocationally registered (non-VR) medical practitioners who are providing GP services to attain Fellowship. I’m not sure this goes to sustainability of the workforce.
9.4 Measures taken to address the geographical mal-distribution of health workers
Under the Stronger Rural Health Strategy, the new Health Demand and Supply Utilisation Patterns Planning (HeaDS UPP) Tool will, for the first time, bring together data on how the community uses health services and the health workforce.
The HeaDS UPP Tool will provide a single, integrated quality source of health workforce and services data to inform workforce planning and analysis for Government and stakeholders.
The Bonded Programs (Bonded Medical Places (BMP) Scheme and the Medical Rural Bonded Scholarship (MRBS) Scheme) are critical components of the Government’s health workforce strategy to ensure the Australian trained medical workforce is well-distributed, flexible and targeted to areas of most need.
Under the Bonded Programs, recipients receive a medical place at university in return for agreement to work (return of service obligation or RoSO) in an eligible rural or remote location, or district of workforce shortage for a period of between 12 months and 6 years
The 2018-19 Federal Budget provided a total of $20.2 million over four years to reform the Bonded Programs. These reforms are a critical component of the Federal Budget’s $500 million Stronger Rural Health Strategy and are required to be in place on 1 January 2020.
Reforms will streamline administrative arrangements, provide more support for recipients to undertake their return of service in rural and remote areas and better target the bonded medical workforce to areas of workforce shortage.
As the Bonded Programs mature, increasing numbers of doctors are due to commence their return of service. Up to 700 doctors (maximum) are expected to commence their return of service each year over the next 5-7 years.
There are currently 9,552 Bonded Program recipients studying at medical school or in pre-vocational training with a further 550 recipients undertaking their return of service obligations.
Targets for the distribution of AGPT program training places across regional and remote areas ensure a continued focus on rural and remote GP workforce distribution. Entry to the AGPT program is competitive, and at least 50% of training under the AGPT Program is undertaken in rural, regional and remote locations.
The Non-VR FSP program encourages non-vocationally recognised doctors to undertake training towards a recognised College Fellowship pathway while continuing to provide services to their communities.
[q10]
10. Are there specific policies and/or laws, across governmental ministries, for internationally recruited and/or foreign-trained health personnel in your country?
Yes
[q10x1]
10.1 Please provide further information in the box below:
Section 19AB of the Health Insurance Act 1973 requires overseas trained doctors and foreign graduates of accredited medical schools (FGAMS) to practise in a district of workforce shortage for their medical specialty for a period of 10 years from the date of their first medical registration in Australia.
The 10-year period is commonly referred to as ‘the 10-year moratorium’, and commences from the date of a doctor’s first registration as a medical practitioner in Australia. Doctors who have not obtained Australian permanent residency or citizenship by the end of the 10 year moratorium, are required to continue to practise in a district of workforce shortage.
Doctors on the 10-year moratorium (i.e. overseas trained doctors and foreign graduates of accredited Australian medical schools) can only apply for the Rural Pathway within the AGPT program and are required to complete training in rural or remote settings (ASGC-RA2-5 or MMM2-7).
[q11]
11. Recognizing the role of other parts of government, does the Ministry of Health have processes (e.g. policies, mechanisms, unit) to monitor and coordinate across sectors on issues related to the international recruitment and migration of health personnel?
Yes
[q11x1]
11.1 Please provide further information in the box below:
Health Workforce Division has policy and program responsibility for these functions.
[q12]
12. Has your country established a database or compilation of laws and regulations related to international health personnel recruitment and migration and, as appropriate, information related to their implementation?
Yes
[q12x1]
12.1 Please provide further information in the box below:
The Department of Home Affairs collects and reports the number of temporary and permanent visa applications granted to health personnel.
Temporary migration (457) visa data is publicly available on the Department of Home Affairs website, as is information about Australian laws and rules relating to migration.
[q9x3fn]
*Health workforce sustainability reflects a dynamic national health labour market where health workforce supply best meets current demands and health needs, and where future health needs are anticipated, adaptively met and viably resourced without threatening the performance of health systems in other countries (ref: Working for Health and Growth, Report of the High-Level Commission on Health Employment and Economic Growth, WHO, 2016, available from http://apps.who.int/iris/bitstream/10665/250047/1/9789241511308-eng.pdf?ua=1
).
Responsibilities, Rights and Recruitment Practices
[q13]
13. Which legal safeguards and/or other mechanisms are in place to ensure that migrant health personnel enjoy the same legal rights and responsibilities as the domestically trained health workforce? Please tick all options that apply from the list below:
13.a Migrant health personnel are recruited internationally using mechanisms that allow them to assess the benefits and risk associated with employment positions and to make timely and informed decisions regarding them
13.b Migrant health personnel are hired, promoted and remunerated based on objective criteria such as levels of qualification, years of experience and degrees of professional responsibility on the same basis as the domestically trained health workforce
13.c Migrant health personnel enjoy the same opportunities as the domestically trained health workforce to strengthen their professional education, qualifications and career progression
13.d Other mechanisms, please provide details below if possible:
[q14]
14. Please submit any other comments or information you wish to provide regarding legal, administrative and other measures that have been taken or are planned in your country to ensure fair recruitment and employment practices of foreign-trained and/or immigrant health personnel.
[q15]
15. Please submit any comments or information on policies and practices to support the integration of foreign-trained or immigrant health personnel, as well as difficulties encountered.
NIL
[q16]
16. Regarding domestically trained/ emigrant health personnel working outside your country, please submit any comments or information on measures that have been taken or are planned in your country to ensure their fair recruitment and employment practices, as well as difficulties encountered
NIL
Constraints, Solutions, and Complementary Comments
[q17]
17. Please list in priority order, the three main constraints to the implementation of the Code in your country and propose possible solutions:
| Main constraints | Possible solution | |
|---|---|---|
| NIL | NIL | |
| NIL | NIL | |
| NIL | NIL |
[q18]
18. Please submit any other complementary comments or material you may wish to provide regarding the international recruitment and migration of health personnel, as related to implementation of the Code.
[q18x1]
Please upload any supporting files
No comment