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Unlocking skills in hospitals: better jobs, more care

by Stephen Duckett and Peter Breadon


Enabling less highly-trained hospital workers to play a bigger role could improve jobs for doctors and nurses, save public hospitals nearly $430 million a year and fund treatment for more than 85,000 extra people.

Doctors, nurses and allied health professionals such as physiotherapists and occupational therapists are all squandering their valuable skills on work that other people could do.

It doesn’t take 15 years of training to provide light sedation for a stable patient having a simple procedure, or a three-year degree to help someone bathe or eat – but that is the situation in Australian hospitals today. This mismatch of skills and jobs is putting heavy pressure on hospitals when there are already long waiting lists for many treatments and demand is growing fast.

The report suggests three ways – among many – that hospitals can get a better match between workers and their work. Nursing assistants could free up nurses’ time by providing basic care to patients. Specialist nurses could free up doctors’ time by doing common, low-risk procedures now done by doctors. More assistants could be employed to support physiotherapists and occupational therapists.

The first two of these alone would save public hospitals $390 million a year and fund treatment for almost 80,000 more people.

While these ideas are supported by successful trials and evidence, formidable barriers of culture, tradition, industrial relations and vested interest stand in the way of change. However, government budgets are under pressure. Hospitals have to get more efficient, or much tougher decisions about who should miss out on care will become inevitable.

Current workforce roles were designed in the days of the horse and buggy. The choice to update them should be easy, because it means more and better care, more rewarding jobs for health professionals and a more sustainable system.

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