The role of health care assistants was the subject of heated debate at a workshop in Adelaide yesterday, held ahead of the official opening today of the Health Workforce Australia 2013 conference.
Jennifer Doggett reports from Adelaide:
Health care assistants provide vital front-line services to some of the sickest and most vulnerable people in our community. Yet in Australia these care providers are less regulated than florists.
The need for national regulation of health care assistants, such as nursing aides and aged care support workers, was hotly debated at a pre-conference workshop of the Health Workforce Australia 2013 Conference. The Workshop involved presentations from an expert panel with group discussion among the approximately 120 attendees.
Panel members included Rod Cooke, from the Community Services and Health Skills Council, Lee Thomas from the Australian Nursing and Midwifery Federation, Ann Maree Keenan from Austin Health, Andrew Larpent, Southern Cross Care, Tanya Lehmann, Country Health SA and Saravana Kumar from the International Centre for Allied Health Evidence.
Overall the Panel argued that the regulation of health assistants was a crucial step in maximising their contribution to the health system.
Reasons provided for needing a national registration for health care assistants included the lack of consistency across states and sectors in the roles and functions of health care assistants. One example provided to highlight the disparate nature of this category of health care workers was a list of over 50 job titles currently given to health care assistants, such as ‘patient care assistant’, ‘technical support worker’ and ‘scrub and scout.’
Regulation was seen as one way of increasing the recognition and legitimacy for this important group of health care workers, often ignored in the development of health policies and programs. One of the tangible benefits to the regulation of health care assistants was identified as increased safety and quality of care due to the imposition of a uniform standard across the health sector.
Other benefits included increasing the status of health assistants and giving people working in this role greater security in their roles. National regulation was also seen as an important pre-cursor for establishing standards for the provision of education and training and establishing an appropriate scope of practice.
Overall, a uniform regulatory approach across the health sector was supported in order to increase the accountability of health care assistants and, possibly also attract increased funding to increase their numbers.
Despite the strong support for national regulation some risks of this approach were also identified.
Tanya Lehmann stressed the importance of health care assistants in rural and remote areas and argued that their connection and commitment to the community was the single most important factor influencing their ability to improve patient care. She was concerned that a national approach to regulation may place a higher value on formal qualifications or experience than on community connections and knowledge and that this would not be in the interests of rural Australia. In fact, she argued that national regulation could create a barrier to the recruitment of health care assistants in rural areas where they are most needed.
Dr Saravana Kumar from the University of South Australia acknowledged the need for a flexible approach to regulation in rural areas but argued that this should not stand in the way of a national regulatory system. He said that a ‘one size fits all’ approach to regulation would not work in a country as large and diverse as Australia and any regulatory system for health care assistants must recognise the needs of rural and remote communities. He said that it would be worth considering options within the framework of national regulation, such as exemptions for identified rural communities or a two-tier system, which reflected the need for greater flexibility in rural areas.
The costs of regulation were also discussed with a number of participants making the point that increased regulation will come with increased costs and that these need to be proportional to the benefits that result.
One risk identified of national regulation was that we could over-regulate without delivering any significant results, such as improvements in health care quality.
Other participants provided some broader context on the issue, such as one Tweeter who noted that health care assistants were not the only un-regulated health workers.
The Workshop concluded with some unresolved questions being posed:
- What level of regulation for health care assistants is optimum?
- How should the needs of rural and remote communities be addressed through a national approach to regulation?
- How can regulation increase the benefits to patients without resulting in increased costs to health services?
With sessions still to come on workforce reform – including international speakers from Canada, Sweden and China and experts from the aged and mental health sector – there will be plenty of opportunities for delegates to further debate these issues during the two days of the conference.
Meanwhile, some similar issues – around language and accreditation – were raised in another workshop, “Aboriginal health is everybody’s business: Consultation for the Aboriginal and Torres Strait Islander Health Curriculum Framework for health students at university” – according to the Twitter stream. (Thanks to Dr Tim Senior for tweet-reporting).
• You can track Croakey’s coverage of the conference here.