{"id":1037,"date":"2025-07-16T13:08:18","date_gmt":"2025-07-16T03:08:18","guid":{"rendered":"http:\/\/54.206.0.193\/wordpress\/?p=1037"},"modified":"2025-12-03T14:21:42","modified_gmt":"2025-12-03T03:21:42","slug":"who-governs-australia-health-workforce","status":"publish","type":"post","link":"https:\/\/hwfpolicyhub.jcu.edu.au\/index.php\/2025\/07\/16\/who-governs-australia-health-workforce\/","title":{"rendered":"Who Governs Australia\u2019s Health Workforce?"},"content":{"rendered":"

HWF EXPLAINER SERIES \u2013 No. 2 How is the health workforce governed? \/ V.1 \/ 19.05.25<\/p>\n<\/div><\/div><\/div>

Governance sets the conditions within which planning, funding, regulation, and employment take place. It defines who is responsible for what, and how power and resources are distributed across the system.<\/p>\n<\/div>

Understanding the governance landscape<\/h4><\/div>

Australia\u2019s health workforce is governed through a complex mix of national, state, and local institutions. Unlike countries with a single national health system, responsibility in Australia is shared between the Commonwealth and eight states and territories. These responsibilities are further divided between agencies that oversee professional standards and training, those that manage workforce supply and distribution, and those that employ health workers directly.<\/p>\n

This multi-level governance structure creates both strengths and challenges. On the one hand, it allows for flexibility and responsiveness to local needs. On the other, it makes national coordination and long-term planning difficult. In many areas, responsibilities are not clearly divided but instead overlap. Understanding who governs what is essential to understanding how workforce issues\u2014like shortages, training gaps, or inequities\u2014can be addressed.<\/p>\n<\/div>

National responsibilities<\/h4><\/div>

The Commonwealth Government plays a leading role in setting workforce policy directions, funding university and vocational education training (VET) places, providing incentives for rural and remote workforce distribution, and funding general practice and other primary care through the Medicare system. Through the Department of Health and Aged Care, it funds and commissions national data collection, modelling, and workforce planning tools\u2014though it no longer houses a dedicated workforce agency since the closure of Health Workforce Australia in 2014.<\/p>\n

The Australian Health Practitioner Regulation Agency (AHPRA), co-funded by the Commonwealth and states and territories, administers the National Registration and Accreditation Scheme. This scheme governs registration for 16 health professions, including doctors, nurses, midwives, pharmacists, and various allied health professions. AHPRA ensures that only qualified professionals can practise, and that they meet continuing professional development requirements.<\/p>\n<\/div>

Other national actors<\/h4><\/div>

In addition to the Department of Health and Aged Care and AHPRA, a range of national-level institutions contribute to health workforce governance through data, funding, training, industrial relations, and policy coordination.<\/p>\n<\/div>

  • <\/i><\/span>
    National Skills Commission (NSC): <\/b>Formerly responsible for labour market forecasting across sectors, including health care, the NSC produced regular skills priority lists and demand projections. Its functions are now being restructured under a broader national skills reform agenda, but its historical datasets and reports continue to inform workforce thinking, especially in relation to VET-qualified health roles.<\/span><\/div><\/li>
  • <\/i><\/span>
    Australian Institute of Health and Welfare (AIHW):<\/b><\/span> The AIHW manages the National Health Workforce Dataset (NHWDS), a key resource for monitoring workforce composition, distribution, and trends. This data is drawn from AHPRA registration surveys and is critical for informing planning and funding decisions at both federal and state levels.<\/span><\/div><\/li>
  • <\/i><\/span>
    Medical and health professional colleges:<\/b> These organisations\u2014such as the Royal Australian College of General Practitioners or the Royal Australasian College of Physicians\u2014play a major role in setting postgraduate training standards, certifying professional development, and influencing workforce policy. While not government entities, they often have delegated responsibility for accreditation and training pipelines, particularly in medicine.<\/span><\/div><\/li>
  • <\/i><\/span>
    Fair Work Commission and industrial awards system:<\/b> National employment conditions for many health professionals are governed under the Fair Work Act through sector-specific industrial awards. These awards set minimum pay, conditions, and entitlements for categories of health workers across Australia, although actual enterprise agreements may vary by employer or jurisdiction.<\/span><\/div><\/li>
  • <\/i><\/span>
    Health Workforce Stakeholder Forums and Taskforces: <\/b>From time to time, the Commonwealth convenes cross-sectoral advisory groups to inform workforce strategies, such as the former Health Workforce Principal Committee under the Australian Health Ministers\u2019 Advisory Council (AHMAC), or more recently, advisory groups for aged care workforce reform and rural health.<\/span><\/div><\/li><\/ul>

    These national actors do not hold direct governance authority over all aspects of the workforce, but they provide critical data, policy framing, funding levers, or delegated training functions that shape system-wide outcomes.<\/p>\n<\/div>

    State and territory responsibilities<\/h4><\/div>

    State and territory governments are responsible for employing the vast majority of public health workers, including those in hospitals, public health units, and community health services. They also manage ambulance services, some aged care and mental health services, and local workforce support initiatives.<\/p>\n

    Each jurisdiction has its own health department and distinct sub-state governance arrangements that manage health services at a regional level. These units play a critical role in operational decisions around staffing, recruitment, service delivery models, and workforce innovation. A list of the sub-state units for each jurisdiction is below.<\/p>\n<\/div>\n

    \n

     <\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n
    Jurisdiction<\/strong><\/th>\nSub-state health service units<\/strong><\/th>\n<\/tr>\n<\/thead>\n
    Queensland<\/td>\nHospital and Health Services (HHS)<\/td>\n<\/tr>\n
    New South Wales<\/td>\nLocal Health Districts (LHD)<\/td>\n<\/tr>\n
    Victoria<\/td>\nHealth Services (e.g. hospital boards)<\/td>\n<\/tr>\n
    South Australia<\/td>\nLocal Health Networks (LHN)<\/td>\n<\/tr>\n
    Western Australia<\/td>\nHealth Service Providers (HSP)<\/td>\n<\/tr>\n
    Tasmania<\/td>\nHealth Service Streams (North, South, NW)<\/td>\n<\/tr>\n
    Northern Territory<\/td>\nTop End and Central Australia Health Services<\/td>\n<\/tr>\n
    ACT<\/td>\nACT Health Directorate (centralised)<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<\/div>\n

    Other governance actors<\/h4><\/div>

    Beyond formal government agencies, several other institutions and sectors play influential governance roles over the Australian health workforce\u2014by shaping its structure, conditions, values, and priorities.<\/p>\n<\/div>