ANZCA Bulletin - June 2009 - Australian and New Zealand College ...

Governmentand workforceEmeritus Professor Garry Phillips AMThe Government of Australia has beentracking the Colleges for many years,and first began publishing data providedby them, and obtained from othersources in 1996, when the first MedicalTraining Review Panel (MTRP) reportwas published 1 , along with the firstpublication by the Australian MedicalWorkforce Advisory Committee (AMWAC)on supply, requirements and projectionsof the Anaesthetic Workforce in Australiacogently revised in 2001 2 .Since 2005, when the ProductivityCommission’s Research Report onAustralia’s Health Workforce hit thestreets 3 , the Council of AustralianGovernments (COAG) agreed to eight of itsrecommendations, modified eleven, anddid not support two. As a result, AMWACwas abolished, and there has been a hiatusin reliable medical workforce data untilsome was included in the National HealthWorkforce Taskforce (NHWT) report byKPMG in April, 2009 4 .In a section entitled “EmergingStrategies”, a brief and variable qualitysummary is made of trends in the UK,Canada and the USA with regard to“physician assistants”, but it ignoresthe extent to which anaesthetists andintensivists have worked for decadeswith nursing teams in Australia in areaslike pre-anaesthesia clinics, duringanaesthesia, in the recovery roomand in intensive care units.A research paper published in March2008 from the Social Policy section of theAustralian Department of ParliamentaryServices 5 repeats much of the informationconsidered by, but interpreted quitedifferently, in a well-researched paperpublished by Thompson, Phillips andCousins in 2007 6 . It is of more thanpassing interest that while the role of“nurse anaesthetists” in several countrieswas explored by the Royal College ofAnaesthetists and the NHS in 2002, witha view to adoption in the UK of “nurseassistants”, this had not progressed farby 2008 7-8 .One reason given for recommendingcontinuation of training of nurse assistantsin the UK is said to be “in the context ofdecreasing trainee numbers, hours ofwork and a higher expectation oftraining quality”.While nurses are in short supply inAustralia, and likely to remain so fora long time, an ambitious program forexpansion of medical student numbers inAustralian medical schools is already inplace. Commencing medical students areprojected to reach 3074 by 2010 (from 1470in 2002). This is a much higher percentagethan the increase in commencing nursingstudents in the same period (from 8042 to13,895). The flow-on effect of increasedmedical graduates to vocational trainingwill result in a large increase in medicalspecialist anaesthetists.In addition, anaesthesia in Australiais attracting increasing numbers ofInternational Medical Graduate Specialists(IMGS). A paper published by the NHWTin September, 2008 sees no definite end tothe need for IMGS 9 . Since 2002, the numberof IMGS who have been accepted into theprocess agreed by the Australian MedicalCouncil (AMC)/medical boards/councilsand the medical colleges and have eitherachieved Fellowship of the Australianand New Zealand College of Anaesthetists24The ANZCA Bulletin June 2009