Jeremy Lasek – PHAA
In one of the biggest demonstrations of support for significant new investment in Australia’s over-stretched public health workforce, well over 500 people registered for an online symposium on 7 December 2021. The symposium brought together many of Australia’s leading public health experts in the field.
Victoria’s Chief Health Officer, Professor Brett Sutton, best summed up the consensus of the forum when he said, “there’s no such thing as overinvesting in public health.”
Jointly presented by the Public Health Association of Australia (PHAA), the Australasian Faculty of Public Health Medicine (AFPHM) and the National Aboriginal Community Controlled Health Organisation (NACCHO), the two-hour symposium discussed the new and existing public health workforce gaps, and the actions and support required to create increased efficiency and efficacy of public health services.
PHAA CEO, Adjunct Professor Terry Slevin, said greater investment in the National Public Health Workforce had been highlighted in the national response to COVID-19, and it was one of seven key priorities for action put forward by his organisation ahead of the 2022 federal election.
Setting the scene for the discussion, Prof Slevin reminded participants that twice last year, National Cabinet made a firm commitment to enhance public health workforce initiatives.
“That was in 2020, and we’re now near the end of 2021 and yet to see a budget commitment.”
The need for greater investment was supported by the Commonwealth’s Deputy Chief Medical Officer, Dr Steph Davis, who noted that even before the pandemic, there was clear evidence of a shortage of both public health physicians and the non-medical public health workforce.
COVID-19, she said, “has brought those cracks to the forefront.”
Dr Davis said the COVID-19 pandemic had made the discussions about the future public health workforce even more urgent, including the National Cabinet commitment for developing a formal public health workforce training program.
Prof Slevin suggested it was time to end the niceties, stating: “This now has to be a demand for a bigger slice of the pie of funding…we will knock on every door of every politician to make sure they don’t forget those commitments they’ve made.”
Prof Sutton added: “We need to remind National Cabinet of the commitments they’ve made and ask ‘What are the timelines [for greater funding]?’”
The symposium picked up a number of strong themes which should help shape the future needs and skills of Australia’s public health workforce.
“The thing the pandemic has taught us is the great diversity of skills needed,” NSW Chief Health Officer, Dr Kerry Chant PSM said.
Dr Chant said future public health workforce training “needs to broaden our cross-disciplinary approach.
“We need to solidify our workforce with a broader range of skills. The COVID learnings tell us we need broad-based training and skills, and unique partnerships with universities to have a more diverse workforce that we can pull in and out as required across government and across agencies.”
Having learnt many lessons through the pandemic, Dr Chant emphasised the need to better train future public health professionals in complex decision-making.
“We need mentors to tell us how we’ve navigated the difficult conversations,” and, “how we can galvanise the strength of experiential learning.”
The Influence of COVID-19
The broad effect of the COVID-19 response on the workforce was at the fore in several presentations.
“COVID has defined everything we’ve done in the past 20 months,” said Queensland’s Deputy Chief Health Officer, Dr James Smith, “including bringing people together.”
But he said the “rising issue” which needs to be front of mind is the “traumatised workforce” and bringing those people “back into the fold and into the mainstream again.”
His observations were supported by the Northern Territory’s Public Health Physician, Dr Danielle Esler, who said the Top End’s workforce had been “incredibly stretched” throughout the pandemic response.
“We need to address the fact that what has been asked and demanded is much more than what we’ve signed up for. Trainees have stepped up to work at much higher levels – beyond what should be expected. We need to explicitly address the tensions.”
According to the ACT’s Deputy Chief Health Officer, Dr Vanessa Johnston, the pandemic “exposed and worsened” underlying problems within the public health workforce.
“It has revealed chronic underinvestment in public health over decades,” Dr Johnston said.
Dr Johnston said the pandemic also brought attention to the additional skills required by public health professionals, including what several speakers described as “soft skills”. These included data analysis, risk communications, psychology, marketing, media and political engagement.
Dr Johnston and others asked how best, post-pandemic, “to transition this amazing surge workforce to other areas” while ensuring “we don’t lose their experience and passion.”
An even funding spread
PHAA President, Adjunct Professor Tarun Weeramanthri, supported the call for long-term investment, saying Australia can’t rely only on a surge workforce for future health crises.
“There is still some denial of the need for that long-term investment and a reliance on our surge ability,” he said.
Adjunct Prof Weeramanthri said it was important to capitalise on the opportunities presented by COVID and “the next six months will be vital as a window [for additional funding].”
The speakers agreed with his premise that funding needed to be uniformly channelled to all jurisdictions and particularly to areas of greatest need.
“We will only be as good as the weakest link across all jurisdictions,” Prof Weeramanthri added.
Dr Mark Veitch, Director of Public Health in Tasmania, said it was “important to exploit the moment of COVID”, and, “We should increase our investment in training, particularly for people of diverse backgrounds.”
The Role of Aboriginal Community Controlled Health Organisations (ACCHOs)
Dr Megan Campbell from the National Aboriginal Community Controlled Health Organisations (NACCHO) said there must be training and leadership opportunities for Aboriginal and Torres Strait Islander people, and recognition of the important role of ACCHOs in keeping communities safe and healthy.
Dr Campbell said it was essential that curriculum development was led by Aboriginal and Torres Strait Islander people, and that a future national training program is not city-based, emphasising the importance of local on-the-ground knowledge and experience.
Prof Slevin shared a potential funding model created by the PHAA to increase the capacity and capability of public health professionals across the nation.
“We have a genuine window of 12 months to get this funding, because if we don’t, we will have done the country a great disservice.”
The final word was from Prof Brett Sutton, who called on all participants to advocate strongly for significantly more investment.
“We need to make the case for public health across the spectrum. If you can’t do it in a crisis, there will never be a better time.”