Dr Paul Bauert, President AMA (NT), with Mandy Taylor, ABC Central Australia, 'Morning show'

The report into workforce needs was prepared for the Office of Aboriginal and Torres Strait Islander Health and the Federal Health Department is now questioning its analysis, but it is the first time anyone's come up with hard and fast figures on how many health professionals are needed.

Dr Paul Bauert is president of the NT branch of the Australian Medical Association and he's also on the AMA's Indigenous Health Task Force.

Good morning.

BAUERT: Hi, Mandy.

TAYLOR: Well, Dr Bauert, what do you think of the numbers that have been come up with? Are they pretty spot on as far as you're concerned?

BAUERT: Yes, I think that entire report was spot on. It was prepared for the Office of Aboriginal and Torres Strait Islander Health* as you've mentioned. You know, it hasn't been funded by anybody else. It's the Department of Health and Aged Care consultancy and the figures have come in and from what you're saying the Government's now refusing to accept them, but the numbers you've listed are actually minimum - the minimal requirements.

You mentioned a number of 500 doctors. Their needs estimate was somewhere between 486 to 1469, so that really we are desperately short of doctors working in the area of indigenous health.

TAYLOR: It's a huge number. Would the numbers that they have come up with, is that just to bring it level with the number of doctors that are available in the cities or how have they worked out the actual numbers that are needed, do you know?

BAUERT: The minimum requirements are those that would be equal to what's happening in the cities. The higher estimates put a loading on the number of doctors for such things as remoteness and burden of disease so that as you would be well aware the burden of disease, particularly in remote Aboriginal communities, is much, much higher, so that there is a loading often up to four and a half times what would be needed in a capital city.

TAYLOR: Given the huge numbers that have been talked about is it achievable to have this as a target?

BAUERT: Well, it's not new. I mean we've known about these problems since at least 1989 and the longer governments refuse to acknowledge that there is a problem the worse the problem's going to get.

It is achievable and what's needed is a national training plan and that needs to have clear targets in defined time frames so that we can train health personnel to deliver health services to Aboriginal and Torres Strait Islander people.

I mean, the other big issue is the actual number of Aboriginal people in the workforce and that is minimal. We require, according to this same report, 3,200 additional Aboriginal people as doctors, nurses and Aboriginal health workers.

TAYLOR: There are, of course, quite a few schemes on a Federal and also on a Territory level intertwined to encourage doctors to train in remote health to go and work out bush. Are they not making much of an impact?

BAUERT: They don't seem to be. There do need to be further incentives. We do need to be working with the Aboriginal Medical Services Alliance of the Northern Territory (AMSANT) and the National Aboriginal Community Controlled Health Organisation (NACCHO) trying to get incentives for people first of all to train to become health workers - nurses and doctors - and, secondly, incentives to have them work in remote communities.

What the AMA wants to do is work with NACCHO and AMSANT in trying to develop some of these incentives and we intend doing that.

TAYLOR: Given the numbers that are being talked about, we must be talking about quite a wide time frame - years and years and years?

BAUERT: Well, as long as we set ourselves targets and as long as we have those time frames laid down and as long as the Government is serious about achieving these targets within the particular time frames, then at least that's a start. I think this report is good and that it tells us how huge the problem is and it also lays out a very clear plan of what needs to be done about it.

TAYLOR: It's not just about getting more people into training, is it? It's about encouraging them to actually go and take up positions out bush in remote areas, about addressing things as basic as living conditions?

BAUERT: Correct. You're quite right. There are problems both in training people for this work, and there are problems in ensuring that all colleges have a core component of Aboriginal health in them so that people get a feel or flavour for what is required, and, secondly, as you suggest, incentives for keeping people, getting people out in remote communities and keeping them there.

Other countries can do it, you see. They have all sorts of different incentives. They think outside the envelope. For instance, if you work in remote Canada, if you elected to work with Inuits in Canada you work completely tax free. Now that's one incentive and it seems to help in that particular country. It's something that hasn't been explored here.

TAYLOR: When we're talking about the vast amount of numbers that are needed, the other improvements that are needed, is there enough money? We're often talking about the amount of money that does go into indigenous health, but presumably this would need a huge injection of funds?

BAUERT: There are several myths around, Mandy, and one of the myths is that too much money is spent on Aboriginal health. In fact, when you look at the figures, the amount of money spent on Aboriginal health on a per capita basis is not as high as should be spent, and when you compare it to the rest of Australia most of this extra money they talk about goes into our hospitals in terms of having money spent on the ground in the remote communities just doesn't happen, and until the Federal Government makes a concerted commitment to actually spend that money on the ground in remote communities, things won't change.

TAYLOR: Thanks very much for joining us this morning.

BAUERT: You're welcome, Mandy.

TAYLOR: Dr Paul Bauert, who's the Northern Territory President of the AMA.

Ends

* Aboriginal and Torres Strait Islander Heath Workforce - Draft National Strategic Framework, November 2001