Career Pathways for the Aboriginal and Torres Strait Islander Health Workforce: Secondary Data Workforce Report: Career Pathways Project

Data sets and data collection: The method for this component of the broader mixed methods study of Aboriginal and Torres Strait Islander Career Pathways consists exclusively of undertaking descriptive statistical analysis of existing data. The limitations of using secondary data sources, particularly when unit record data is not available for re-analysis, are acknowledged. Accordingly, specific inferences from the findings are limited, and the findings ultimately need to be considered in conjunction with the findings from other study components. Five main sources of data were explored as follows: ”¢ ABS Population Census data interrogated by Aboriginality, age, gender, occupational classification, industry classification and educational level ”¢ Department of Employment, Education and Workplace Relations (DEEWR) data was used to provide an insight into the age and gender composition of the current Aboriginal and Torres Strait Islander student population and future entrants to health professions ”¢ Data from the National Centre for Vocational Education Research (NCVER) includes relevant course enrolments and course outcomes (graduations) from VET level courses ”¢ The Commonwealth Department of Health (Workforce Branch) holds data on of all the processed annual workforce surveys of registered professions ”¢ Australian Institute of Health and Welfare (AIHW) holds data from an annual survey of Aboriginal community-controlled services receiving Commonwealth funding to deliver primary health care and other services. They are required to contribute to the Online Services Report (OSR) annually. Current situation: In the last twenty years there has been impressive growth in the absolute number of Aboriginal and Torres Strait Islander people in the health workforce. The growth rates average 4.7% per annum. These are much higher workforce growth rates than the total general workforce population. Whilst only accounting for approximately 20% of the total Aboriginal and Torres Strait Islander health workforce, employment growth in ACCHSs for the last 10 years (AIHW, 2017a) has contributed significantly to total growth. Despite the significant growth in the Aboriginal and Torres Strait Islander workforce, this analysis has revealed that there has been no real improvement in the Aboriginal and Torres Strait Islander proportion of the total health workforce (and especially as yet the health professional workforce). Of thirty five health occupations reviewed, only six occupations had an Aboriginal and Torres Strait Islander workforce proportion of the total workforce that was equal to or greater than 3% (equivalent with the total population proportion). Equally discouraging has been a lack of change in the proportion of Aboriginal and Torres Strait Islander workforce to the Aboriginal and Torres Strait Islander population. lack of change in the proportional representation of Aboriginal and Torres Strait Islanders in the total health workforce appears to be primarily due to an equally rapid growth in the non-Indigenous health workforce. The lack of change in the proportion of Aboriginal and Torres Strait Islander workforce per the Aboriginal and Torres Strait Islander population is attributed to a significant increase in the number of persons identifying as Aboriginal and Torres Strait Islander, against which Aboriginal and Torres Strait Islander health worker participation has only just kept pace. Factors facilitating career development and advancement: There has been significant growth in enrolments in, and graduations from, health-related higher education and tertiary education courses. This growth in education activity has clearly helped fuel workforce growth in general, but particularly in certain health professions where the initial base number was very low (e.g. pharmacists, physiotherapists and medical imaging professionals). The overall increases in the participation of Aboriginal and Torres Strait Islander workers in the health sector is helping potentially to create a “critical mass effect”. This effect will assist in reducing the influence of culturally unsafe workplaces acting as a barrier to future aspirants wanting to enter health professions. The presence of greater numbers of Aboriginal and Torres Strait Islander workers in particular professions also provides a larger pool of appropriate mentors and career coaches to help newer entrants survive and prosper. Policies and practices to nurture and optimise the value from these professional critical mass populations (through structured mentor programs, appropriate training and remuneration) will be important. Factors impeding career development and advancement? A disproportionate amount of recent Aboriginal and Torres Strait Islander workforce growth has been in low status and lower paying jobs (such as personal care workers). These jobs tend to have ‘shorter’ salary scale structures that terminate at comparatively low-end points with poor articulation to other roles particularly roles in professional careers. The preponderance of Aboriginal and Torres Strait Islander workforce growth in occupations with poorer career progress prospects is strongly influenced by what sectors of the health industry in which employment is occurring. More employment growth has happened in residential care, personal care and some primary health care industry sectors where there are limited career progression opportunities, as opposed to employment in the hospital sector where career pathways, because of greater workforce sizes and more hierarchical organization structures, tend to be longer and provide greater career progression opportunities. The workforce in these jobs nevertheless represents a potential population to be rapidly developed to assume health professional careers. They have existing health work competencies and health industry understanding and can have significant motivation to progress. Policies and practices to realise the potential of this population require going beyond local initiatives and require structures that cross individual organization boundaries to provide quality practice supervision, career coaching and access to education that is more than study leave. Other influences Opportunities for employment of Aboriginal and Torres Strait Islanders in the health workforce seems to vary by jurisdiction (some States have better employment outcomes), by the profession / occupation (several health professions seem to be doing better than most others), by sector in which employed (the Aboriginal Community Controlled sector is a greater employer of Aboriginal and Torres Strait Islanders compared with the Government or private sectors) and by location of employment (which compared to the non-Indigenous workforce favours rural and remote settings). These influences can be both positive or negative to career progress of Aboriginal and Torres Strait Islanders in the health workforce.