CURRENT AND FUTURE INDIGENOUS HEALTH AND WELFARE/COMMUNITY SERVICES WORKFORCE

The availability of Aboriginal and Torres Strait Islander staff is an important factor in whether or not Indigenous people are able to effectively access health services (Kowanko et al 2003; Ivers et al 1997). One of the objectives of the Aboriginal and Torres Strait Islander Health Workforce National Strategic Framework (Australian Health Ministers' Advisory Council) is to increase the number of Aboriginal and Torres Strait Islander people working across all the health professions (SCATSIH 2002).

There are a number of sources of information about the participation of Indigenous Australians in the health workforce and in higher education courses in health and welfare-related fields. These include the ABS Census of Population and Housing, the Australian Government Department of Education, Employment and Workplace Relations (DEEWR) Higher Education Student Statistics Collection, the AIHW Medical and Nursing Labour Force Surveys, and DoHA's Service Activity Reporting (SAR). These data sources vary in coverage and not all of them have accurate and consistent recording of Indigenous status. For example, in the Medical Labour Force Survey, most jurisdictions use a simplified version of the standard ABS question on Indigenous status (yes/no response). Because of the issues around the quality of Indigenous identification, information from this survey has not been presented here. Data in this section therefore come from the 2006 Census of Population and Housing, the Nursing and Midwifery Labour Force Census, SAR and the Higher Education Student Statistics Collection.


The health workforce

Indigenous people represent 1.9% of the total population aged 15 years and over. In 2006, there were 4,891 Aboriginal and Torres Strait Islanders employed in selected health-related occupations, representing 1% of the health workforce (table 10.10). There were 100 Indigenous medical practitioners in Australia, including 40 who were medical specialists of some kind, representing only 0.2% of people employed in these occupations.

The health occupations with the largest number of Indigenous workers were registered nurse (1,107), Aboriginal and Torres Strait Islander health worker (965) and nursing support worker (442). The health occupations with the highest proportion of Indigenous workers were Aboriginal and Torres Strait Islander health worker (96%), health promotion officer (11%) and environmental health worker (3%). Aboriginal and Torres Strait Islander health workers may be employed as specialists in such areas as alcohol and drug treatment, mental health, diabetes, eye and ear health, and sexual health, or they may work as generalist members of primary care teams, or as hospital liaison officers.

10.10 EMPLOYMENT IN SELECTED HEALTH-RELATED OCCUPATIONS, Indigenous persons aged 15 years and over - 2006
		Indigenous		All persons
Occupation		%	no.	no.
Medical practitioners
	General medical practitioner	0.2	60	29 920
	Other -specialist, psychiatrist or surgeon	0.2	40	25 155
Midwifery and nursing professionals
	Midwife	0.4	53	13 164
	Nurse educator or researcher	0.5	17	3 762
	Nurse manager	0.4	46	10 899
	Registered nurse	0.6	1 107	172 575
Health therapy professionals
	Dental practitioner	0.2	16	9 065
	Dental hygienist, technician or therapist	0.4	22	5 169
	Dental assistant	1.1	171	15 378
	Physiotherapist	0.4	54	12 286
Psychologist		0.3	39	13 437
Health and welfare service managers		1.3	141	10 807
Health diagnostic and promotion professionals
	Medical imaging professional	0.2	18	10 147
	Environmental health officer	2.5	98	3 907
	Occupational health and safety adviser	0.7	50	6 840
	Health promotion officer	11.2	437	3 898
Health and welfare support workers
	Aboriginal and Torres Strait Islander health worker	95.5	965	1 010
	Ambulance officer or paramedic	1.7	153	9 098
	Diversional therapist	1.0	41	4 078
	Enrolled or mothercraft nurse	1.1	215	19 397
	Massage therapist	0.7	54	8 200
	Hospital orderly	1.7	165	9 939
	Nursing support worker	2.0	442	22 380
	Personal care assistant	1.5	339	21 956
	Other nursing support or personal care worker	1.0	39	3 899
Total		1.0	4 891	492 342
Source: ABS 2006 Census of Population and Housing

While the ABS Census provides self-reported information on the number of people employed in health-related occupations, the Nursing and Midwifery Labour Force Census provides information about nurses who have renewed their registration/enrolment with a state or territory nursing and midwifery registration board at the time the Nursing and Midwifery Labour Force Census is conducted. In 2005, the proportions of enrolled and registered nurses who identified as Indigenous were 0.9% and 0.3% respectively (table 10.11).

10.11 EMPLOYED REGISTERED AND ENROLLED NURSES, by Indigenous status - 2005
	Indigenous		All persons(a)
	%	no.	no.
Employed registered nurses	0.3	644	198 315
Employed enrolled nurses	0.9	419	46 044
Total	0.4	1 063	244 360
(a) Includes not stated responses.
Source: AIHW 2008b

The welfare and community services workforce

People employed in welfare and community service-related occupations such as counselling, disability and social work often support the work of other health professionals, and may also be working within the health industry (AIHW 2003b). In 2006, Indigenous people were more likely to report being employed in selected welfare and community service-related occupations than in health-related occupations.

There were 12,411 Indigenous people employed in selected welfare-related occupations in 2006, representing 3.6% of those employed in these occupations. The largest numbers of Indigenous people employed in this sector were teachers' aides (2,011), carers for the aged or people with disability (1,735), child care workers (1,424) and Aboriginal and Torres Strait Islander education workers (1,379) (table 10.12).

Aboriginal and Torres Strait Islander people were well represented among family support workers (16%), youth workers (9%), special care workers (8%) and community workers (7%). Indigenous people also made up 2% of child carers.

10.12 EMPLOYMENT IN SELECTED WELFARE AND COMMUNITY SERVICE-RELATED OCCUPATIONS, Indigenous persons aged 15 years and over - 2006
		Indigenous		All persons
Occupation		%	no.	no.
Welfare workers
	Community worker	7.1	1 270	17 874
	Family support worker	15.9	309	1 946
	Youth worker	8.6	687	8 024
	Other welfare support workers	1.8	228	12 450
Child carers
	Child care worker	2.4	1 424	59 473
	Other child carers	2.2	562	25 783
Child care centre and welfare centre managers		1.9	178	9 479
Education aides
	Aboriginal and Torres Strait Islander education worker	91.3	1 379	1 510
	Teachers' aide	5.9	2 011	34 316
	Other education aides	1.4	303	20 937
Aged or disabled carer		2.2	1 735	77 413
Special care workers		7.8	184	2 354
Other health and welfare support workers		4.4	324	7 432
Welfare, recreation and community arts workers
	Welfare worker	5.7	643	11 270
	Other welfare, recreational, community arts workers	5.5	147	2 664
Counsellors		2.6	386	14 646
Minister of religion		0.6	88	14 784
Social professionals		3.4	237	6 908
Social workers		2.2	269	12 441
Social and welfare professionals nfd		5.5	47	849
Total		3.6	12 411	342 553
Source: ABS 2006 Census of Population and Housing

Undergraduate studies in health, welfare and community service-related courses

The future involvement of Indigenous Australians in health and welfare services will be influenced by their current participation in health and welfare-related education. Overall in 2005, 166 Indigenous students completed health-related undergraduate courses, and 83 completed welfare-related courses, representing 1% of all students completing undergraduate courses in these two fields (table 10.13). In the health-related field, the largest proportions of course completions by Indigenous students were in public health (e.g. Environmental Health and Indigenous Health) (47%) and Nursing (29%). In 2005, Indigenous students accounted for 11% of all graduates in the field of public health and less than 1% of nursing graduates. The welfare-related courses most commonly completed by Indigenous students were early childhood education (33%), Behavioural science, which includes psychology (23%) and social work (18%). Indigenous students accounted for around 1% of all early childhood education and social work graduates and less than 1% of behavioural science graduates in 2005.

In 2005, 13 Indigenous students completed a degree in Medical Studies, 48 in Nursing and 78 in Public Health. The number of Indigenous students who completed health-related courses was similar in 2003 and 2005 (168 and 166 respectively). The number of Indigenous students who completed welfare-related courses declined from 124 in 2003 to 83 in 2005.

10.13 INDIGENOUS STUDENTS WHO COMPLETED HEALTH AND WELFARE-RELATED UNDERGRADUATE COURSES(a) - 2003 and 2005
		2003			2005
		Indigenous		All persons	Indigenous		All persons
		%	no.	no.	%	no.	no.
Health
	Medical Studies	0.6	10	1 735	0.8	13	1 697
	Nursing	0.8	61	7 497	0.6	48	7 565
	Pharmacy	0.1	1	769	0.2	2	1 037
	Dental Studies	0.7	2	306	0.6	2	343
	Optical Science	1.7	2	121	1.1	1	92
	Public Health(b)	6.0	40	672	10.6	78	736
	Radiography	-	-	468	0.4	3	688
	Rehabilitation Therapies	0.5	12	2 193	0.2	6	2 451
	Complementary Therapies(c)	-	-	408	1.0	3	315
	Other health(d)	1.9	40	2 100	0.4	10	2 471
	Total(e)	1.0	168	16 269	1.0	166	17 395
Welfare
	Early childhood education	2.3	45	1 971	1.4	27	1 949
	Special education	1.2	3	253	1.1	2	186
	Human Welfare Studies and Services	4.6	16	347	3.0	9	296
	Social work	1.6	19	1 224	1.1	15	1 367
	Counselling	2.7	4	146	3.5	8	228
	Behavioural science(f)	0.8	27	3 317	0.5	19	3 561
	Other welfare(g)	2.2	10	456	0.6	3	485
	Total(e)	1.6	124	7 714	1.0	83	8 072
- nil or rounded to zero (including null cells)
(a) Based on ABS narrow field of education. Health course codes in order of appearance: 060100-060199; 060300-060399; 060500-060501; 060700-060799; 060900-060999; 061300-061399; 061500-061501; 061900-061999; 069900-069999. Welfare course codes in order of appearance: 70101; 70113; 90500; 90501; 90513; 090700-090799; 90503, 90505, 90507, 90509, 90511, 90515, 90599.
(b) Includes occupational health and safety, environmental health, Indigenous health, health promotion, community health, epidemiology and public health n.e.c.
(c) Includes naturopathy, acupuncture, traditional Chinese medicine, complementary therapies n.e.c.
(d) Includes nutrition and dietetics, human movement, paramedical studies, first aid and health n.e.c.
(e) The data take into account the coding of Combined Courses to two fields of education. As a consequence, counting both fields of education for Combined Courses means that the totals may be less than the sum of all fields of education.
(f) Includes psychology and behavioural science n.e.c.
(g) Includes children's services, youth work, care for the aged, care for the disabled, residential client care, welfare studies and human welfare studies and services n.e.c.
Source: AIHW analysis of Department of Education, Employment and Workplace Relations (DEEWR), Higher Education Student Statistics Collection

According to the 2004 VET Provider Collection, 111 vocational and training sector (VET) students had completed a course aimed at Aboriginal and Torres Strait Islander Health Worker occupations in Australia (table 10.14). The majority of these course completions were at the Certificate III or IV level (89%). Of all the VET sector students who had completed a course aimed at Aboriginal and Torres Strait Islander Health Worker occupations in 2004, 71% were female (79 course completions) and 28% were male (31 course completions).

10.14 ABORIGINAL AND TORRES STRAIT ISLANDER HEALTH WORKERS(a)(b), course completions by level of qualification - 2004
	Males	Females	Persons(c)
	no.	no.	no.
Certificate I	-	-	-
Certificate II	-	-	-
Certificate III	16	32	49
Certificate IV	13	37	50
Diploma or higher	2	10	12
Total	31	79	111
- nil or rounded to zero (including null cells)
(a) ASCO (Occupation) classification - 3493 Aboriginal and Torres Strait Islander Health Workers.
(b) An ASCO code assigned to the courses indicates the most likely occupation associated with this course. Students may enrol in more than one course.
(c) Includes one student for whom sex was not stated.
Source: NCVER 2004 VET Provider Collection, AHMAC 2006

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