Independent regulatory agencies and Australia's health workforce crisis: Lessons from the gynaecological cancers workforce

Workforce shortages and maldistribution in the health care sector are the outcome of poor planning processes, entrenched power relations, jurisdictional boundaries and professional silos. In seeking to redress these problems, countries are moving toward establishing independent agencies to monitor, regulate and shape the health workforce. In Australia, for example, Health Workforce Australia (HWA) has been established to provide data on workforce numbers and fund clinical education. The purpose of this paper is to examine whether this strategy is likely to work. By locating HWA within the framework of an Independent Regulatory Agency, the implicit strengths and weaknesses of using HWA to manage workforce planning are highlighted. A theoretical discussion on regulatory capitalism and Independent Regulatory Authorities provides the context for the case study: the gynaecological cancer workforce – a niche health workforce that is complex and multidisciplinary. Data are from a mixed method study commissioned by Cancer Australia. The analysis of the gynaecological cancer workforce illustrates the difficulties that HWA will face in defining the health workforce, in measuring supply and demand and in setting targets for training and education. Findings are limited by the fact that HWA was only established in mid 2009. The establishment of independent agencies to oversee and implement government policy is a new form of control over universities and health professionals that challenges their professional autonomy. This paper points to the creation of new agencies of government control in the wake of an international health workforce crisis.