121 Policies, still no plan: Australia’s health workforce paradox

Australia’s health workforce is at breaking point. Wait times are growing, burnout is rising, and yet policy continues to proliferate, without addressing the root causes. New research has exposed a deeper structural problem in how the nation plans and governs its health workforce.

Despite decades of concern over shortages, Australia still lacks an overarching national strategy to ensure enough trained workers are in the right places to meet demand, both now and in the future. Instead, policy remains fragmented.

When Topp et al reviewed all 121 federal health workforce policy documents, they uncovered a patchwork of short-term, profession-specific policies. Most relied on grants and standalone programs rather than long-term direction, and often ran in parallel rather than in concert. Alarmingly, critical professions such as pharmacy, public health and emergency care were routinely overlooked.

The numbers tell the story. Even with more than 852,000 registered health professionals, demand continues to outstrip supply, particularly in regional and remote communities.

More than a decade of reports have called for improvements to national health workforce governance or strategy. This study shows why those recommendations remain urgent.

In 2025, the challenge is no longer just about recruiting more staff. It is about system-level coordination, coherent policy, and long-term planning to ensure Australia’s healthcare remains sustainable, equitable and fit for purpose.

Australia once had a national body – Health Workforce Australia – established in 2009. It was disbanded in 2014 during a government efficiency drive. Since then, workforce planning responsibilities have splintered across multiple federal departments, statutory bodies and jurisdictions. Five states now have their own separate 10-year strategic plans.

Some professions benefit from national strategies – a national medical workforce strategy, a nurse practitioner plan and a mental health workforce strategy are already in place, with an allied health workforce strategy still in development. But no mechanism exists to ensure these strategies align or interact, or to prevent critical professions and service areas from falling through the cracks.

Of the 121 federal policies analysed, 81% were time-limited grants or programs. These are typically quick responses to immediate gaps, such as scholarships, relocation incentives or targeted professional development – but hardly designed for lasting reform.

Only 23 policies offered the potential for longer-term direction and it was unclear how they related to each other. Few cross-referenced one another, or acknowledged how a change in one area might affect another.

Most federal policy documents focus heavily on workforce supply – training and recruitment. Far fewer engage with the equally critical issues of workforce performance, skills utilisation, or geographic distribution.

The mismatch is clear: funding flows one way, employment responsibility lies elsewhere. The federal government funds most of primary care, aged care, and Indigenous health, while states and territories employ most of the workforce. Governance is highly decentralised. Private providers, Primary Health Networks and Aboriginal and Torres Strait Islander Community Controlled services add further complexity.

Without national coordination, workforce policy risks remaining reactive, inconsistent and beholden to political cycles – focusing on what’s most visible today, rather than what’s structurally necessary for tomorrow.

The authors argue Australia must re-establish a national body for health workforce planning, akin to the former Health Workforce Australia. A recent independent review concurs that the current meeting of health ministers is not an effective way to govern health workers. Without a national hub, the current patchwork approach will continue.

Policymakers must shift from profession-specific, short-term fixes to a system-wide approach. This means recognising how healthcare professionals operate as part of a broader labour market and how policies must work together, particularly across rural and remote settings.

The country needs fewer ad hoc grants that ebb and flow with each new federal government – and more durable strategies and agreements that guide action over time. These must be backed by clear data, and be evaluated and accountable.

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