Meeting future health workforce needs is a challenge for all health professionals
There now seems little debate that the medical profession needs to accept task substitution as one solution to the health workforce crisis. The contributions in this issue of the Journal from the Royal Australian College of General Practitioners,1 Royal Australasian College of Physicians (RACP),2 the Royal Australasian College of Surgeons3 and Australian Medical Association (AMA)4 all acknowledge that reality and express a guarded acceptance of moving in this direction. They correctly emphasise that the overriding issue is the detail of how these strategies should be implemented, always bearing in mind the essential principle that patient care must not be compromised. Collectively, these organisations acknowledge that health care is delivered by a team. Who directs that team is perhaps debatable, although it will in most situations be a medical practitioner. We should, however, acknowledge the recent observations of Sir Graeme Catto, President of the UK General Medical Council:
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- University of Queensland, Brisbane, QLD.
- 1. Kidd MR, Watts IT, Mitchell CD, et al. Principles for supporting task substitution in Australian general practice. Med J Aust 2006; 185: 20-22. <eMJA full text>
- 2. Sewell JR. Task transfer: the view of the Royal Australasian College of Physicians. Med J Aust 2006; 185: 23-24. <eMJA full text>
- 3. Collins JP, Hillis DJ, Stitz RW. Task transfer: the view of the Royal Australasian College of Surgeons. Med J Aust 2006; 185: 25-26. <eMJA full text>
- 4. Yong C-S. Task substitution: the view of the Australian Medical Association. Med J Aust 2006; 185: 27-28. <eMJA full text>
- 5. Royal College of Physicians. Doctors in society: medical professionalism in a changing world. London: RCP, 2005: 39-44. Available at: http://www.rcplondon.ac.uk/pubs/books/docinsoc (accessed Jun 2006).
- 6. Laurant M, Reeves D, Hermens R, et al. Substitution of doctors by nurses in primary care. Cochrane Database Syst Rev 2005; (2): CD001271.
- 7. Australian Government Productivity Commission. Australia’s health workforce. Research report. Canberra: Productivity Commission, 2005.
- 8. Brooks PM, Ellis N. Health Workforce Innovation Conference. Med J Aust 2006; 184: 105-106. <MJA full text>
- 9. UK Department of Health. HR in the NHS Plan: more staff working differently. London: Dept of Health, 2002. Available at: http://www.dh.gov.uk/assetRoot/04/05/58/66/04055866.pdf (accessed Jun 2006).
- 10. Hooker RS, Cawley JF. Physician assistants in American medicine. 2nd ed. St Louis, Mo: Churchill Livingstone, 2003.
- 11. Kenny A, Duckett S. A question of place: medical power in rural Australia. Soc Sci Med 2004; 58: 1059-1073.
- 12. Smith A. The wealth of nations. Edinburgh: Mundell, Dorg and Stevenson, 1804.
- 13. Brooks PM. Organisation of healthcare: challenging the “ego systems”. Med J Aust 2000; 172: 445-447.