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Program Review & Evaluation

Comprehensive review and evaluation of the 19AB and District Workforce Shortage distribution levers

A person in a health consultant job at HealthConsult

Purpose

The Australian Government’s Department of Health and Aged Care commissioned HealthConsult to evaluate Section 19AB of the Health Insurance Act 1973 and the District Workforce Shortage (DWS) classification as part of the "Working Better for Medicare Review." The evaluation aimed to determine the effectiveness of these mechanisms in equitably distributing medical professionals across Australia, with a particular emphasis on improving healthcare access in regional, rural, and remote communities.

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Approach

HealthConsult used a structured, mixed-methods evaluation approach:

  • Stakeholder engagement: Conducted extensive consultations with over 40 organisations, including RACGP, ACCRM, Rural Workforce Agencies, Health Workforce Regulators, PHNs, LHNs, and State and Territory Health Departments. Additionally, gathered feedback through an online survey receiving over 260 responses and reviewed 33 detailed written submissions.
  • Documentation review: Analysed historical documentation and current policy frameworks to establish a clear and effective review framework.
  • Option validation: Developed and tested proposed policy options iteratively with stakeholders, ensuring alignment with strategic objectives and stakeholder consensus.
  • Collaborative development: Maintained close collaboration with the Department and stakeholders, using regular feedback loops to refine recommendations and ensure they were evidence-based and actionable.

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Outcome

HealthConsult delivered key outcomes to guide future policy directions:

  • Final Report: Provided detailed analysis, offering 19 evidence-based recommendations to enhance and refine Section 19AB and DWS. Recommendations focused on clearly defining objectives, tightening exemption criteria, introducing a graded classification system to better identify genuine workforce shortages, and strengthening incentives to attract medical professionals to underserved regions.
  • Actionable recommendations: Developed practical recommendations that informed strategic decisions by the Department, ensuring alignment with current workforce policies and priorities.
  • Implementation Plan: Outlined a clear transition plan for recommended policy changes, supported by targeted stakeholder engagement and change management strategies to effectively manage implementation risks.

All deliverables, including the final report provided in May 2024, were well received by the Department and lead reviewers, Michael (Mick) Reid AM and Professor Sabina Knight. HealthConsult’s recommendations have informed strategic decisions for the future role of Section 19AB and DWS levers.