National Reporting Instrument 2021
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 3rd round of national reporting in March 2019. The WHO Director General reported progress on implementation to the 72nd World Health Assembly in May 2019 (A 72/23). The 3rd Round of National Reporting additionally informed the Member-State led Review of the Code’s relevance and effectiveness, as presented to the 73rd WHA in 2020 (A 73/9).
The Review highlights that Code implementation, through targeted support and safeguards, is necessary to ensure that Health Emergency and Universal Health Coverage-related progress in Member States serves to reinforce rather than compromise similar achievement in others. In light of the considerations in the Report and decision WHA 73(30), the WHO Secretariat has additionally prepared the Health Workforce Support and Safeguards List, 2020.
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 findings from the 4th Round of National Reporting are to be presented at the 75th World Health Assembly in May 2022. Given the ongoing COVID-19 pandemic, the NRI (2021) has been adapted to additionally capture information related to health personnel recruitment and migration in the context of the pandemic.
The deadline for submitting reports is 31 January 2022.
Should technical difficulties prevent national authorities from filling in the online questionnaire, it is also possible to download the NRI via the link: https://www.who.int/teams/health-workforce/migration/code-nri. 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
Disclaimer: 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 75th WHA in 2022. 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 3rd round of national reporting in March 2019. The WHO Director General reported progress on implementation to the 72nd World Health Assembly in May 2019 (A 72/23). The 3rd Round of National Reporting additionally informed the Member-State led Review of the Code’s relevance and effectiveness, as presented to the 73rd WHA in 2020 (A 73/9).
The Review highlights that Code implementation, through targeted support and safeguards, is necessary to ensure that Health Emergency and Universal Health Coverage-related progress in Member States serves to reinforce rather than compromise similar achievement in others. In light of the considerations in the Report and decision WHA 73(30), the WHO Secretariat has additionally prepared the Health Workforce Support and Safeguards List, 2020.
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 findings from the 4th Round of National Reporting are to be presented at the 75th World Health Assembly in May 2022. Given the ongoing COVID-19 pandemic, the NRI (2021) has been adapted to additionally capture information related to health personnel recruitment and migration in the context of the pandemic.
The deadline for submitting reports is 31 January 2022.
Should technical difficulties prevent national authorities from filling in the online questionnaire, it is also possible to download the NRI via the link: https://www.who.int/teams/health-workforce/migration/code-nri. 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
Disclaimer: 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 75th WHA in 2022. 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
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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
[q01b]
Contact information:
Country
Australia
Full name of institution:
James
Name of designated national authority:
James Gosper
Title of designated national authority:
Acting Director
Telephone number: (E.g. +41227911530 .)
+61262891576
Email: (Please enter one email address only.)
WHO@health.gov.au,James.Gosper@health.gov.au,hrhinfo@who.int
Implementation of the Code
[q1]
1. Has your country taken steps to implement the Code?
Yes
[q1x1x]
1.1 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.
Yes
[q1x1]
Action 1
Please note: Workforce recruitment is the responsibility of state and territory [sub-national] governments. Responses to this are examples of jurisdictional responses, but not an exhaustive list.
The Queensland Department of Health monitors the recruitment of international medical graduates across Queensland hospital and health services, including their registration type, position, country where they attained their primary qualification and progression to general or specialist registration with the Australian Health Practitioner Regulation Agency (AHPRA).
Action 2
Action 3
[q1x2x]
1.2 Measures have been taken or are being considered to introduce changes to laws or policies consistent with the recommendations of the Code.
Yes
[q1x2]
Measure 1
There are not currently any known considerations for amendments to recruitment policies within jurisdictions that relate to the recommendations of the Code. Private recruitment agencies may be engaged by State and Territory hospital and health services for the provision of medical practitioners and these entities are required to meet legislative responsibilities.
Measure 2
Measure 3
[q1x3x]
1.3 Records are maintained on all recruiters authorized by competent authorities to operate within their jurisdiction.
Yes
[q1x3]
Please describe:
Please note: Workforce recruitment is the responsibility of state and territory [sub-national] governments. Responses to this are examples of jurisdictional responses, but not an exhaustive list. The Queensland Government Office of Industrial Relations (OIR) is responsible for licensing and compliance services to promote the integrity of the labour hire industry in Queensland. The OIR requires all labour hire providers to have a licence to provide labour and a register of licensed providers is available on their website: https://www.labourhire.qld.gov.au/i-use-labour-hire-providers
[q1x4x]
1.4 Good practices, as called for by the Code, are encouraged and promoted among recruitment agencies.
Yes
[q1x4]
Please describe:
1.4.1 Promotion of the Code among private recruitment agencies.
Please note: Workforce recruitment is the responsibility of state and territory [sub-national] governments. Responses to this are examples of jurisdictional responses, but not an exhaustive list. Queensland Health has a standing offer arrangement (SOA) for locum medical officers and recruiting medical officers through recruitment agencies. The SOA provides a panel of 14 preferred suppliers meeting Queensland Health specifications, including ensuring compliance with all relevant legislation, directives and policies. The SOA documentation includes information for hospital and health services relating to obligations under the Labour Hire Licensing Act 2017 (information relating to the SOA is accessible only by Queensland Health staff.) New South Wales (NSW) Health provides standards and requirements for the professional conduct of Medical Locum Agencies in providing Locum Medical Officers to NSW Public Health Organisations, the standards and conditions against which Medical Locum Agencies must demonstrate compliance for certification and the process for an application to the NSW Health Register of Medical Locum Agencies. Information for Medical Locum Agencies - Recruitment of Locum Medical Officers (nsw.gov.au)
1.4.2 Domestic legislation or policy requiring ethical practice of private recruitment agencies, as consistent with the principles and articles of the Code.
Please note: Workforce recruitment is the responsibility of state and territory [sub-national] governments. Responses to this are examples of jurisdictional responses, but not an exhaustive list. Some examples of labour hire legislation and policies from jurisdictions: In 2021, the Australian Capital Territory (ACT) introduced a new licensing scheme for labour hire providers that will better protect workers and promote responsible practices in the labour hire services industry. All labour hire providers are required to hold a licence by 27 November 2021, under the Labour Hire Licencing Act 2020. Labour Hire Licensing Act 2020 | Acts Queensland legislation (Labour Hire Licensing Act 2017 and the Labour Hire Licensing Regulation 2018) is in place to protect workers from exploitation by providers of labour hire services and to promote the integrity of the labour hire industry (https://www.legislation.qld.gov.au/view/html/inforce/current/act-2017-033) (https://www.legislation.qld.gov.au/view/html/inforce/current/sl-2018-0035)
1.4.3 Public or private certification of ethical practice for private recruitment agencies.
Please note: Workforce recruitment is the responsibility of state and territory [sub-national] governments. Responses to this are examples of jurisdictional responses, but not an exhaustive list. Along with their legislative obligations, the 14 recruitment agencies listed in the Queensland Health SOA are member organisations of the Recruitment, Consulting and Staffing Association (RCSA) of Australia and New Zealand, the industry’s peak body. Members of the RCSA are bound by their code of professional conduct, which is authorised by the Australian Competition and Consumer Commission and includes clauses relating to social sustainability. https://www.rcsa.com.au/Web/Membership/RCSA_Code___Compliance/Web/RCSA_Code/RCSA_Code_and_Compliance.aspx
1.4.4 Others
[q1x5x]
1.5 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.
No
[q1x6x]
1.6 Other steps:
No
Partnerships, Technical Collaboration and Financial Support 1/2
[q2x1]
2.1. 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?
2.1.1 Specific support for implementation of the Code
As part of Australia’s commitment to working with Indonesia and international health partners to respond to the COVID-19 pandemic, Australia provided financial assistance to the WHO to support Indonesia’s response and recovery efforts. With this funding, WHO and Indonesia will work together to strengthen Indonesia’s laboratories, improve the way that Indonesia collects and uses health information, and also help to protect patients and health workers at health facilities.
2.1.2 Support for health system strengthening
2.1.3 Support for health personnel development
2.1.4 No support provided
2.1.5 Other areas of support:
[q2x1oth]
2.1.5 Other areas of support:
Support Area 1
Australia has committed through the UNFPA for a four-year partnership to improve access to quality sexual and reproductive health and rights in six priority countries in the Pacific: Fiji, Kiribati, Samoa, Solomon Islands, Tonga and Vanuatu. The Transformative Agenda is expanding and improving sexual and reproductive health services, particularly for family planning, including information and education, building capacity of health workers, improving health information management, and strengthening youth-friendly and disability-inclusive services.
Support Area 2
Support Area 3
[q2x2]
2.2. 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?
2.2.1 Specific support for implementation of the Code
2.2.2 Support for health system strengthening
2.2.3 Support for health personnel development
2.2.4 No support received
2.2.5 Other areas of support:
Partnerships, Technical Collaboration and Financial Support 2/2
[q3]
3. Has your country or its sub-national governments entered into bilateral, multilateral, or regional agreements and/or arrangements with respect to the international recruitment and migration of health personnel?
No
[q3xUploadx1]
[q3xUploadx2]
[q3xUploadx3]
Health Workforce Development and Health System Sustainability
[q4]
4. Does your country strive to meet its health personnel needs with its domestically trained health personnel, including 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
[q4x1x]
4.1 Measures taken to educate the health workforce
Yes
[q4x1]
4.1.1 Manage production
4.1.2 Improve quality of education
4.1.3 Strengthen regulation
4.4 Others
[q4x2x]
4.2 Measures taken to ensure the sustainability* of the health workforce
Yes
[q4x2]
4.2.1 Workforce planning/forecasting
4.2.2 Increasing domestic production and education opportunities
4.2.3 Increasing employment opportunities
4.2.4 Manage recruitment of international health personnel
Other
[q4x3x]
4.3 Measures taken to address the geographical mal-distribution and retention of health workers*
Yes
[q4x3]
4.3.1 Education (Education institutions in underserved areas; students from under-served areas; relevant topics in education/professional development programmes; others)
The objective of the Australian Governments Visas for GPs Program is to manage the growth of Australia’s medical workforce by regulating the number of overseas doctors working in the primary health care sector in major cities and redirecting them to areas where there is genuine need for additional primary health care services, which are generally in regional, rural and remote areas. To achieve this, the Visas for GPs Program requires employers of overseas doctors seeking employer sponsored visas to work in Australia to obtain a Health Workforce Certificate (HWC) from a Rural Workforce Agency (RWA). RWAs will only issue a HWC for positions located in areas where there is genuine need for additional primary health care services.
4.3.2 Regulation (Mandatory service agreements; scholarships and education subsidies with return of service agreements; enhanced scope of practice; task shifting; skill-mix; others)
Section 19AB of the Health Insurance Act 1973, requires certain doctors to work for 10 years in under-serviced locations.
4.3.3 Incentives (Financial and non-financial)
Programs such as the More Doctors for Rural Australia Program provide funding to practices for supervision of new doctors, as well as funding for approved training.
4.3.4 Support (Decent and safe living and working conditions; career advancement opportunities; social recognition measures; others)
[q4x4x]
4.4 Other relevant measures
No
[q5]
5. Are there specific policies and/or laws that guides international recruitment, migration and integration of foreign-trained health personnel in your country?
Yes
[q5x1]
5.1 Please provide further information in the box below:
Law/policy 1
Australian Citizenship Act 2007 ; Australian Human Rights Commission Act 1986; Migration Act 1958 (Cth); Migration Regulations 1994 (Cth)
Law/policy 2
Responses to this are examples of jurisdictional responses, but not an exhaustive list. Public Service Act 2008 (PDF) ; Recruitment and selection (Directive 12/20) ; Attraction and retention incentives directive ;Supporting employees affected by workplace change directive; Fixed term temporary employment directive
Law/policy 3
Responses to this are examples of jurisdictional responses, but not an exhaustive list. Medical Officers (Queensland Health) Award – State 2015 ; Medical Officers’ (Queensland Health) Certified Agreement (No.5) 2018; Health Practitioner Regulation National Law (Queensland)
[q6x]
6. Recognizing the role of other government entities, 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?
No
[q7x]
7. 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
[q7x1x]
7.1.a Please provide further information in the box below.
Medical Board of Australia - International medical graduates (IMGs)
Nursing and Midwifery Board of Australia - Internationally qualified nurses and midwives (nursingmidwiferyboard.gov.au)
Australian Health Practitioner Regulation Agency - Overseas qualified practitioners (ahpra.gov.au)
[q7x2x]
7.1.b Please upload any format of documentation that provides such information (e.g. pdf, excel, word)
Upload document:
Responsibilities, Rights and Recruitment Practices
[q8x]
8. 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:
8.1 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
8.2 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
8.3 Migrant health personnel enjoy the same opportunities as the domestically trained health workforce to strengthen their professional education, qualifications and career progression
8.4 Other mechanisms, please provide details below if possible:
[q9x]
9. 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.
[q10x]
10. Regarding domestically trained/ emigrant health personnel (diaspora) 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
Measure 1
-
Measure 2
Measure 3
Data on International Health Personnel Recruitment & Migration
[iq11]
Improving the availability and international comparability of data is essential to understanding and addressing the global dynamic of health worker migration.
[q11]
11. Does your country have any mechanism(s) or entity(ies) to maintain statistical records of foreign-born and foreign-trained health personnel?
Yes
[q11x1]
Please describe
Records of all registered health professionals are kept by the Australian Health Practitioner Regulation Agency. This includes country of primary qualification and residency status.
[iQ12]
12. Data on the active stock of health personnel, disaggregated by country of training and birth
Previous data shared with WHO is available here. Please liaise with your NHWA focal point and update as relevant.
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 workforce1), 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.
Previous data shared with WHO is available here. Please liaise with your NHWA focal point and update as relevant.
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 workforce1), 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.
[q12x0]
12.1 Consolidated stock of active health personnel
This information can be provided by one of the following three options. Please choose your preferred mode of data entry:
This information can be provided by one of the following three options. Please choose your preferred mode of data entry:
Option B: Download the Excel template with existing data and Upload with the updated data
Australia 12.1 and 12.2
No comment
[q12x1x3]
Upload any format of documentation that provides such information (e.g. pdf, excel, word).
[q13x2]
12.2 Top 10 countries of training for foreign-trained health personnel
Please provide data on the top 10 countries of training for foreign-trained health personnel in your country. This information can be provided by one of the following two options:
Please provide data on the top 10 countries of training for foreign-trained health personnel in your country. This information can be provided by one of the following two options:
Option B: Download the Excel template with existing data and Upload with the updated data
[q13x2x2]
Option B: Completion of the template in Excel
Download and Upload
Download and Upload
Please upload file (Maximum file size: 5MB)
Australia 12.1 and 12.2
No comment
[q13x2x3]
Upload any format of documentation that provides such information (e.g. pdf, excel, word).
Please upload file
COVID-19 and Health personnel mobility
[q13]
13. Were measures undertaken at national or sub-national level in response to the COVID-19 pandemic with respect to the temporary or permanent mobility of international health personnel?
13.1 No change in national or sub-national regulation, policy or processes related to the entry or exit of foreign-trained or foreign-born health personnel
13.2 National and/or sub-national regulation, policy or processes enacted to ease entry and integration of foreign-trained or foreign-born health personnel
Please note: Workforce recruitment is the responsibility of state and territory [sub-national] governments. Responses to this include examples of jurisdictional responses, but not an exhaustive list. Australian health regulations in place for the entry of health professionals with overseas qualifications are in place for quality and safety purposes and therefore were not amended. No formal measures were implemented relating to the temporary or permanent mobility of international health personnel. Queensland Hospital and Health Services continued to conduct meritorious selection processes for the recruitment of medical practitioners. In creating applicant pool, preference is given to individuals with current registration or have completed the requisites for registration with the Australian Health Practitioner Regulation Agency (AHPRA). International medical graduates residing overseas are engaged only when a suitably qualified Australian medical practitioner is not available to fill a position. Due to lockdowns and travel bans, recruitment from COVID-19 impacted countries was avoided where possible. International Medical Graduates seeking to travel to Australia are required to meet the exemption requirements as outlined by the Australian Border Force Commissioner.
13.3 National and/or sub-national regulation, policy or processes enacted to limit the exit of health personnel from country
National policy changes were made by the Australian Government Department of Home Affairs with relation to priority skilled migration occupation lists.
13.4 Others
[q14]
14. Did you have a mechanism to monitor the inflow and outflow of health personnel to/from your country during the COVID-19 pandemic?
Inflow
Outflow
No
[q15]
15. Please list any challenges related to ethical international recruitment of health personnel during the COVID-19 pandemic
Please describe (e.g. active recruitment of ICU personnel)
Please describe (e.g. active recruitment of ICU personnel)
1st Challenge
2nd Challenge
3rd Challenge
Constraints, Solutions, and Complementary Comments
[q16]
16. Please list in priority order, the three main constraints to the ethical management of international migration in your country and propose possible solutions
| Main constraints | Possible solution /Recommendation | |
|---|---|---|
| - | ||
[q17]
17. Is there any specific support your country requires to strengthen implementation of the Code?
17.1 Support to strengthen data and information
17.2 Support for policy dialogue and development
17.3 Support for the development of bilateral/multi-lateral agreements
17.4 Other areas of support:
[q18]
18. 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.
The recruitment of health personnel, including international personnel, is managed through Australian State and Territory governments (sub-national).
Note we have provided a “no” response to question 14. Data from the Australian Health Practitioner Regulation Agency and the Department of Health indicates that the number of overseas trained health professionals decreased during the pandemic, and the amount of domestically-trained health professionals increased overall. Therefore Australia did not experience an inflow or outflow.
Australia’s workforce strategy is aimed at increasing the availability of domestically trained health workforce. We therefore believe other Member States may be better placed to answer question 16 on ethical management of international migration.
The data table provided for question 12.1 does not appear to be consistent with the data in the NHWA platform, we are working with the focal point to update the data to provide to the WHO as soon as practicable. We apologise for the delay and any inconvenience.
[q18x1]
Please upload any supporting files
Thank You
[iThank]
You have reached the end of the National Reporting Instrument - 2021. You may go back to any question to update your answers or confirm your entry by clicking ‘Submit’.