Boyce, Rosalie A. (2008) Health workforce: innovation, substitution and reform. In: Analysing health policy: a problem-oriented approach. Elsevier, Sydney, Australia, pp. 105-118. ISBN 978-0-7295-3843-5
In this chapter we examine the nature of the health workforce problem in Australia and the policy responses undertaken to redress what is now recognised as a largely unchallenged conclusion: without intervention and change, the health workforce will not be able to meet the future needs of the population. Further, the productive and economic capacity of the. nation will be directly and adversely affected by the inability to service the burden of disease, particularly chronic disease, in the community. Policy responses to be discussed include the Productivity Commission report and the subsequent Council of Australian Government (COAG) responses. Powerful health professional groups perceived several of the key recommendations in the policy responses as professional substitution strategies which would lead to a diminution of the relative position of their occupational group. In the latter part of the chapter the focus is on the role of professional substitution and delegation models to illustrate the volatile and contested nature of some reform strategies. 'II' with piecemeal by increasing either nursing or medical nUIl1bers after levels have reached so-called 'crisis' proportions, but for these professions it is now becoming an emerging problem as major structural reforms are suggested.
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