The implications for rural and remote health of the abolition of 457 visas are sure to be a hot topic of conversation at the National Rural Health Conference which begins in Cairns next week.
The Rural Doctors Association of Australia (RDAA) has issued a statement raising questions and concerns about the move, noting that international medical graduates comprise about 40 percent of the medical workforce in rural and remote areas.
The RDAA says that “we will continue to need international medical graduates in country Australia in the short and medium-term at least, and probably well into the long-term for some locations”.
Concerns are also being raised about the impact upon research and the ability of universities to recruit academics and students internationally.
Now the Australian Healthcare and Hospitals Association (AHHA) and the National Rural Health Alliance (NRHA) have issued a joint statement sounding the alarm about the implications for rural health services (see an earlier statement from the Australian Medical Association).
Beneath the joint statement is a response from Assistant Health Minister David Gillespie to the AMA and RDAA. It will be interesting to hear if conference participants next week find it as reassuring as he intends.
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Abolition of 457 visas could lead to rural health service shortages: AHHA and NRHA
The Australian Government’s abolition of 457 visas could have adverse effects on the supply of health services in rural areas, the AHHA and National Rural Health Alliance said today.
‘While we fully support education and training strategies to build a strong health workforce within Australia, it’s a fact that it is still a challenge to fill some roles, particularly in regional and rural areas’, said AHHA Chief Executive Alison Verhoeven.
NRHA Chief Executive David Butt said there were nearly 4,000 medical practitioners in Australia on 457 visas, as well as 1,800 nurses, 500 allied health workers, nearly 400 specialists, around 200 dental professionals, and nearly 650 other health professionals, including aged care, disability, health administration and medical science workers.
‘Many of these people are working in rural and regional areas’, Mr Butt said.
‘These skilled clinicians and other health professionals who have come to Australia on 457 visas have made a substantial contribution to our capacity to provide to provide health services, particularly to people in the bush.
‘Many have stayed on to become permanent residents, and are highly valued members of our community.’
Ms Verhoeven said feedback from AHHA members ‘on the ground’ in rural areas is that the opportunity to transition from a 457 visa to permanent residency was a significant incentive for much-needed overseas-trained doctors to take up positions in Australia, and especially in rural areas. This ability to transition is not part of the replacement 2- and 4-year visas now being offered.
‘We think that there could well be a negative impact, not only on availability of clinicians, but on continuity of care if visas are only issued for 2 or 4 years’, Ms Verhoeven said.
‘We also think that this impact will stretch beyond medical practitioners to a range of health and disability and aged care workers, including administrative staff who code and collect the health data that are so important to health services planning and funding.’
Mr Butt said people in rural and regional areas, including Aboriginal and Torres Strait Islander Australians, already experience reduced access to health services, and more illness and injury compared with other Australians.
‘We must ensure that market testing is not the cause of further delay to these communities. I also strongly urge the Government to look at these issues as part of a more comprehensive plan to address workforce distribution.
‘Changes to the visa program must therefore take into account our need to ensure good health services are available for all community members—skill shortages cannot be fixed overnight and require long term planning and investment’, Mr Butt said.
Rural doctors not affected by 457 visa changes: Gillespie
Assistant Health Minister, Dr David Gillespie, has reassured doctors and rural communities on the impacts of the Coalition Government’s changes to the temporary and permanent employer-sponsored skilled migration schemes.
“The changes announced this week will not have any significant impact on the ability of rural and regional areas to recruit temporary skilled overseas trained health professionals,” Minister Gillespie said.
“While I note the concerns of the Australian Medical Association and the Rural Doctors’ Association of Australia about the future of international medical graduates in rural communities, appropriately qualified health professionals will continue to have access to Australia’s Temporary Migration scheme.”
Minister Gillespie said the changes are intended to prioritise opportunities for Australian workers and professionals, and will be introduced in stages through to March 2018.
“Initially, the skilled occupation lists have been tightened to remove some occupations, including some health occupations where very few people had accessed the visa over the last four years. This will have minimal impact, with less than a handful of overseas professionals currently working in Australia,” Minister Gillespie said.
Minister Gillespie said the visa assessment process for overseas trained doctors is already quite stringent.
“All overseas trained doctors, regardless of their visa category, are assessed against their prior work experience and their English language skills before they can enter Australia. This testing is conducted as part of the medical registration and credentialing processes that inform visa application assessments,” Minister Gillespie said.
“Many temporary resident overseas trained doctors who have entered Australia under the current 457 visa arrangements are being employed to work in state-approved supervised Area of Need positions.
“These positions are approved only after the prospective employer has completed labour market testing and can demonstrate a need for an overseas-trained doctor to fill a position.
“In addition, the Medicare legislation places a requirement on overseas trained doctors to work in areas recognised as districts of workforce shortage.”
Minister Gillespie said there will be consultation process ahead of the more significant changes in March next year.
The Department of Health will continue to ensure that any future changes to the skilled occupation lists support health workforce requirements.
He said the Coalition Government remains heavily invested in boosting the Australian-trained regional and rural workforce through initiatives such as the Rural Health Multidisciplinary Training program.
“As part of this initiative, we’ve recently announced an additional $54.4 million over two years to 2018-19 for 26 regional training hubs and three additional University Departments of Rural Health,” Minister Gillespie said.
“This will provide additional opportunities for health and medical students to live, study and work in rural and regional Australia and improve access to health services for the people that live in those communities.”
