In this section the characteristics of each of the Better Access occupational categories are described separately. A comparison between the potential and actual workforce is provided where possible.

2.1.1 Psychologists
2.1.2 Social workers
2.1.3 Occupational therapists
2.1.4 General practitioners
2.1.5 Psychiatrists

2.1.1 Psychologists

Psychology workforce – ABS Population Census 2001 estimates, pre Better Access

The Australian Institute of Health and Welfare (AIHW) report describing the Australian Psychology Labour Force provided a snapshot of the Australian psychology workforce as it was in 2003 (Australian Institute of Health and Welfare, 2006c), based on ABS 2001 census data. These data described the Australian psychology workforce as being predominantly female (ranging from 60.3% in SA to 73.7% in Victoria), with a mean age of 44.2 years (ranging from an average age of 41.5 years in QLD to 4l6.9 years in SA: see table 2.2). Psychologists worked an average of 35.7 hours per week, with approximately one third working part time (less than 35 hours per week) and 15% working 50 hours or more per week.

Table 2.2 Characteristics of the psychology workforce, 2003

NSWVICQLDSAACTTotal
Number
5,589
4,671
2,535
769
509
14,073
% male
29.4
26.3
32.1
39.7
28.5
29.4
Average age
45.3
43.9
41.5
46.9
45.4
44.2
Average hours worked
36.8
34.9
33.7
37.6
37.7
35.7
% working 50 hours or more
16.7
14.7
15.9
9.4
11.4
15.3
% working part time
31.6
40.1
35.9
30.2
31.3
35.1

Source: AIHW (2006c). Psychology Labour Force, 2003

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Numbers of psychologists, 2006-2008 – comparison of sources

Over the period 2006 to 2008, the actual Better Access psychology (clinical and registered) workforce increased by 3,170 (86%) between 2006 and 2007, 1,230 (18%) between 2007 and 2008, and 4,400 (119%) over the entire period (see table 2.3). The service providers that utilised Better Access items spent an average of 1.55 hours (93 minutes) per week on Better Access services in 2006; by 2008, this had increased to an average of 4.29 hours (257 minutes) per week.

When calculating the number of psychologists in the actual Better Access workforce, it was necessary to eliminate any duplication created by psychologists with the same provider number billing for both Focussed Psychological Strategies and Psychological Therapy Services. In 2006, for example, 297 psychologists provided both types of Better Access services, rising to 1096 in 2007 and 1181 in 2008 (MBS data 2006-2008). When discussing the numbers of psychologists in the Better Access workforce this duplication has been removed; when discussing numbers in each of the two psychology provider categories (registered and clinical), the actual number of providers utilising each type of service is used.

The size of the potential psychology workforce varied depending on the reference data source. In 2006, the number of psychologists registered in NSW, Victoria, Queensland, SA, WA, Tasmania and the ACT totalled 21,716; whereas, the number identified by the ABS 2006 Census for those states/territory was 13,440. However, according to the South Australian Psychological Board administrative data (the only detailed administrative data set); only 85% of those registered to practice were residing and employed in SA, in 2006. Assuming this was also true for the other states/territory, the deflated number of registered psychologists was closer to approximately 18,459, in 2006. Disregarding the methodological differences between the ABS Census and the registration board administrative data sources, the ABS Census undercounted the deflated registration board total figure (18,459) by approximately 38% (5,129).

Therefore, at the national level, the potential psychology workforce in 2006 was approximately 18,547 (i.e. the weighted ABS Census number). Based on this number, the actual Better Access psychology workforce was approximately 20% of the estimated potential psychology workforce, in 2006.

While we have taken the best estimate of the numbers in the potential Better Access psychology workforce to be that of the weighted ABS Census, further refinement of this number is possible by restricting estimates of the potential workforce to only those psychologists working in the health sector. This involves calculating the proportion of psychologists working in the health care industry (excluding residential care and social assistance services), providing a more accurate indication of the number of psychologists likely to utilise Better Access. Using the 2006 ABS Census, Australia and New Zealand Standard Industrial Classifications (ANZSIC) Codes 84 (Hospitals) and 85 (Medical and Other Health Care Services), approximately 49% of psychologists worked in these parts of the health care industry. Therefore, an estimate of the potential Better Access psychology workforce (health) in 2006 would be 9,088. Of this estimated number, 41% were Better Access service providers in 2006.

Table 2.3 Summary of estimates for psychologists

PsychologistPotential - ABS Census
2006
Potential - Registration Board
2006
Potential - Registration Board
2007
Potential - Registration Board
2008
Actual - MBS
2006*
Actual - MBS
2007
Actual - MBS
2008
Number of providers
13,440
21,716
22,912
23,708
3,688
6,858
8,088
NSW
4,333
7,716
8,140
8,513
1,229
2,235
2,612
VIC
3,766
5,731
5,988
6,215
1,248
2,201
2,531
QLD
2,428
3,154
3,416
3,484
572
1,084
1,321
SA
746
1,070
1,136
1,192
187
400
471
WA
1,437
2,878
3,002
3,061
279
614
762
TAS
261
448
457
468
75
121
140
NT
108
-
-
-
16
36
46
ACT
359
719
773
775
83
168
207
Services/provider
-
-
-
-
17
222
269
Hours on Better Access Items: average hours/week/provider
-
-
-
-
1.55
3.54
4.29

* Note: MBS data for 2006 was for November and December only.
Sources: ABS. 2006 Census of Population and Housing
NSW, VIC, QLD, SA, WA, TAS, ACT Psychologists Registration Board administrative data
Medicare Australia 2006-08 Medicare Provider Data and Medicare Benefit Schedule (MBS) data

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Characteristics of psychologists, 2006-2008

In the ABS Census (2006), the proportion of male and female psychologists (clinical and registered) in the potential workforce was 25% and 75%, respectively (table 2.4). Similarly, the gender balance of the service providers that actually provided services through the Better Access initiative in 2006 was 27% for males and 73% for females. Over time the gender balance of psychologists providing Better Access services remained relatively constant.

In 2006, the majority of the potential psychology workforce was relatively equally spread across the prime working age cohorts, 30-39 years, 40-49 years and 50-59 years, approximately 27%, 24% and 25% respectively. Conversely, the majority of psychologists that utilised Better Access Items in 2006 were slightly older, aged between 40-49 years and 50-59 years, approximately 28% and 33% respectively. Across the period from 2006 to 2008, however, the age distribution of the actual psychology workforce shifted more evenly across the prime working age cohorts. By 2008 the majority of the actual psychology workforce was aged between 30-39 years, 40-49 years and 50-59 years, approximately 25%, 25% and 28% respectively.

The geographical distribution of psychologists across state/territory jurisdictions was roughly similar between the potential and the actual Better Access psychology workforces. In 2006, the largest proportions of the potential workforce resided in NSW (32%), Victoria (28%) and Queensland (18%); similarly, the largest proportions of the actual workforce resided in NSW (33%), Victoria (34%) and Queensland (15%). This distribution is similar to that of the overall population distribution. Over the period from 2006 to 2008, the geographical distribution of the actual Better Access workforce remained relatively constant. For the three largest states, by 2008, there was only a slight decrease in the proportion of the psychologists utilising Better Access Items to 32% in NSW and 31% in Victoria, and a slight increase in the proportion to 16% in Queensland, bringing the proportions even more closely aligned with the potential Better Access psychology workforce.

At the urban, rural and remote level of geographical disaggregation the approximate distribution the potential and actual Better Access psychology workforces differed slightly in the proportion working in metropolitan and non-metropolitan areas. That is, in 2006, 73% of the actual workforce was located in highly populated areas (i.e. capital cities and large metro areas) compared with 79% of the potential workforce (in major urban areas). Over the period from 2006 to 2008, the geographical distribution of the actual Better Access psychology workforce remained constant.

Table 2.4 Summary of characteristics for psychologists

Psychologist
Potential ABS - 2006
MBS actual - 2006*
MBS actual - 2007
MBS actual - 2008
Gender - male
25%
27%
26%
25%
Gender - female
75%
73%
74%
75%
Age - 15-29
16%
4%
6%
7%
Age - 30-39
27%
22%
24%
25%
Age - 40-49
24%
28%
26%
25%
Age - 50-59
25%
33%
29%
28%
Age - 60+
9%
13%
14%
15%
Employed in public sector
35%
NA
NA
NA
Employed in private sector
65%
NA
NA
NA
Born in Australia
75%
NA
NA
NA
Born in country other than Australia
25%
NA
NA
NA
Australian citizen
95%
NA
NA
NA
Non-Australian
5%
NA
NA
NA
Distribution by state - NSW
32%
33%
33%
32%
Distribution by state - VIC
28%
34%
32%
31%
Distribution by state - QLD
18%
15%
16%
16%
Distribution by state - SA
6%
5%
6%
6%
Distribution by state - WA
11%
8%
9%
9%
Distribution by state - TAS
2%
2%
2%
2%
Distribution by state - NT
1%
0%
1%
1%
Distribution by state - ACT
3%
2%
2%
3%
Distribution by RRMA category - capital cities & large metro areas
NSC
73%
73%
73%
Distribution by RRMA category - other metro centre
NSC
9%
8%
9%
Distribution by RRMA category - large rural centre
NSC
7%
7%
6%
Distribution by RRMA category - small rural centre
NSC
6%
6%
6%
Distribution by RRMA category - other rural centre
NSC
5%
6%
6%
Distribution by RRMA category - remote centre
NSC
0%
0%
0%
Distribution by RRMA category - other remote centre
NSC
0%
0%
0%
Distribution by section of state - major urban
79%
NSC
NSC
NSC
Distribution by section of state - other urban
13%
NSC
NSC
NSC
Distribution by section of state - bounded locality
1%
NSC
NSC
NSC
Distribution by section of state - rural balance
6%
NSC
NSC
NSC
Distribution by section of state - migratory
0%
NSC
NSC
NSC

* Note: MBS data for 2006 was for November and December only.
Sources: ABS. 2006 Census of Population and Housing
Medicare Australia. 2006-08 Medicare Provider Data and Medicare Benefit Schedule (MBS) data
Key: NA = not applicable: the category is not applicable to this dataset
NSC = not standard classification: either the classification used differs between datasets or the data is not classified into standard (ABS or data dictionary) categories

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2.1.2 Social workers

Social work workforce – ABS Population Census 2001 estimates, pre Better Access

Beyond the ABS, there is little data on the social work workforce in published reports. What little has been published relates to the general social work workforce and is not specific to mental health. The ABS Census provides information on social workers as an occupational category, but not on the enumeration of mental health social workers. In 2003, the AIHW report on the Health and Community Services Labour Force (Australian Institute of Health and Welfare, 2003) produced tables which included the social work workforce, but did not explicitly discuss them in the report. Extracts from the report in table 2.5 indicate that as at the ABS Census in 2001 there were 9,130 social workers, most (81%) of whom were female. Across Australia there were 48 social workers for every 1000 people in the population. Three states had higher levels than this average: SA had 80 social workers per '000 population, while Victoria and Tasmania had 58 and 55 respectively.

Table 2.5 Characteristics of the social work workforce, 2003

NSWVICQLDWASATASACTNTTotal
Number
2,469
2,796
1,300
911
1,183
229
168
74
9,130
Per cent
27
31
14
13
10
2
1
2
100
Per '000 population
38
58
37
49
80
48
55
41
48

Source: AIHW (2003). Health and Community Services Labour Force, 2001

Numbers of social workers, 2006-2008 – comparison of sources

Over the period 2006 to 2008, the actual Better Access social work workforce increased by 363 (288%) between 2006 and 2007, 157 (32%) between 2007 and 2008, and 520 (413%) over the entire period (table 2.6). Social workers providing Better Access MBS Items spent an average of 1.08 hours (65 minutes) per week providing services, in 2006; by 2008, this had increased to an average of 2.52 hours (151 minutes) per week.

It is estimated from the ABS Census that the potential social work workforce was 12,442 in 2006 (table 2.6), but of that approximately only 3,981 (32%) identified as being employed in the health care industry15. However, the number of social workers registered with the Australian Association of Social Workers (AASW) in 2006 was 5,791, and of this only 150 (2.6%) were accredited mental health social workers eligible to utilise Better Access Items. The discrepancy in the potential workforce numbers between the two data sources is most likely due to methodological differences. The best estimate of the potential Better Access social work workforce is the number of accredited mental health social workers (i.e. able to immediately bill for MBS items).16 Hence, in 2006, the estimated potential Better Access social work workforce was 150, and, of this, approximately 84% used Better Access. By 2008, the number of accredited mental health social workers had increased to 839, representing approximately 15% of the number of social workers registered as a member of the AASW; however, the proportion of accredited social workers that utilised Better Access decreased to approximately 77%.

Table 2.6 Summary of estimates for social workers

Social WorkerPotential - ABS Census
2006
Potential - Professional Association (Total)
2006
Potential - Professional Association (Total)
2007
Potential - Professional Association (Total)
2008
Potential - Professional Association (Accredited Mental Health)
2006
Potential - Professional Association (Accredited Mental Health)
2007
Potential - Professional Association (Accredited Mental Health)
2008
Actual - MBS
2006*
Actual - MBS
2007
Actual - MBS
2008
Number of providers
12,442
5,791
5,862
5,714
150
571
839
126
489
646
NSW
3,159
1,481
1,459
1,426
-
-
-
49
140
180
VIC
4,088
1,546
1,579
1,569
-
-
-
36
180
249
QLD
1,793
1,144
1,152
1,154
-
-
-
22
83
101
SA
1,526
469
483
450
-
-
-
6
31
41
WA
1,144
626
647
625
-
-
-
12
35
48
TAS
372
178
178
175
-
-
-
1
12
14
NT
127
79
86
89
-
-
-
0
4
7
ACT
227
196
212
181
-
-
-
0
4
6
Services/provider
-
-
-
-
-
-
-
12
108
159
Hours on Better Access Items: average hours/week/provider
-
-
-
-
-
-
-
1.08
1.72
2.52

* Note: MBS data for 2006 was for November and December only.
Sources: ABS. 2006 Census of Population and Housing
Australian Association of Social Workers (AASW) administrative data
Medicare Australia. 2006-08 Medicare Provider Data and Medicare Benefit Schedule (MBS) data

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Characteristics of social workers, 2006-2008

In the 2006 ABS Census, the proportion of male and female social workers was 17% and 83%, respectively (table 2.7). The gender balance of the service providers that actually utilised the Better Access initiative in 2006 was 14% for males and 86% for females, with a slight decline over the period 2006 to 2008 in the strong female bias.

In 2006, the majority of the social work workforce was aged between 30-39 years and 40-49 years, approximately 25% and 27% respectively. Similarly, the majority of service providers that utilised the Better Access initiative were aged between 40-49 years and between 50-59 years, approximately 33% and 40% respectively, indicating that this group were slightly older than the social workers in the potential Better Access workforce. There was little change in the age distribution of the actual Better Access social work workforce across the period 2006 to 2008.

There was a degree of variation in the geographical distribution of social workers across state/territory jurisdictions between the total and actual Better Access social work workforces. In 2006, the largest proportion of the potential social work workforce resided in Victoria, approximately 33%; whereas, the largest proportion of the actual Better Access social work workforce resided in NSW, approximately 39%. However, over the period 2006 to 2008, there was a decrease in the proportion of the actual workforce residing in NSW and an increase in Victoria.

At the urban, rural and remote level of geographical disaggregation the approximate distribution of both the total and actual Better Access social work workforces differed slightly in the proportion working in metropolitan and non-metropolitan areas. That is, in 2006, 66% of the actual Better Access social work workforce was located in highly populated areas (i.e. capital cities and large metro areas) compared with 74% of the potential workforce (in major urban areas).

Table 2.7 Summary of characteristics for social workers

Social worker
Potential ABS - 2006
MBS actual - 2006*
MBS actual - 2007
MBS actual - 2008
Gender - male
17%
14%
18%
19%
Gender - female
83%
86%
82%
81%
Age - 15-29
18%
0%
2%
1%
Age - 30-39
25%
18%
14%
14%
Age - 40-49
27%
33%
30%
28%
Age - 50-59
24%
40%
41%
42%
Age - 60+
6%
9%
13%
15%
Employed in public sector
47%
NA
NA
NA
Employed in private sector
53%
NA
NA
NA
Born in Australia
74%
NA
NA
NA
Born in country other than Australia
26%
NA
NA
NA
Australian citizen
95%
NA
NA
NA
Non-Australian
5%
NA
NA
NA
Distribution by state - NSW
25%
39%
29%
28%
Distribution by state - VIC
33%
29%
37%
39%
Distribution by state - QLD
14%
17%
17%
16%
Distribution by state - SA
12%
5%
6%
6%
Distribution by state - WA
9%
10%
7%
7%
Distribution by state - TAS
3%
1%
2%
2%
Distribution by state - NT
1%
0%
1%
1%
Distribution by state - ACT
2%
0%
1%
1%
Distribution by RRMA category - capital cities & large metro areas
NSC
66%
71%
68%
Distribution by RRMA category - other metro centre
NSC
10%
7%
7%
Distribution by RRMA category - large rural centre
NSC
7%
8%
8%
Distribution by RRMA category - small rural centre
NSC
9%
7%
8%
Distribution by RRMA category - other rural centre
NSC
7%
7%
9%
Distribution by RRMA category - remote centre
NSC
0%
0%
0%
Distribution by RRMA category - other remote centre
NSC
0%
0%
0%
Distribution by section of state - major urban
74%
NSC
NSC
NSC
Distribution by section of state - other urban
18%
NSC
NSC
NSC
Distribution by section of state - bounded locality
1%
NSC
NSC
NSC
Distribution by section of state - rural balance
7%
NSC
NSC
NSC
Distribution by section of state - migratory
-
NSC
NSC
NSC

* Note: MBS data for 2006 was for November and December only.
Sources: ABS. 2006 Census of Population and Housing
Medicare Australia. 2006-08 Medicare Provider Data and Medicare Benefit Schedule (MBS) data
Key: NA = not applicable: the category is not applicable to this dataset
NSC = not standard classification: either the classification used differs between datasets or the data is not classified into standard (ABS or data dictionary) categories

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2.1.3 Occupational therapists

Occupational therapy workforce – registration data, pre Better Access

The occupational therapy workforce is the smallest of the allied mental health workforces. The AIHW (2006b) Occupational Therapy Labour Force report, provides a snapshot of this workforce as at 2003. The data presented in the AIHW (Australian Institute of Health and Welfare, 2006b) report refer only to those who responded to the Occupational Therapy Labour Force Survey. This means that estimates of the size of the occupational therapy workforce can only be obtained for those states in which occupational therapists must be registered to practice (Qld, WA, SA, and NT). The lack of accurate information available for the remaining states means that the numbers in table 2.8 are not weighted (as they normally would be) to reflect the total population of occupational therapists in Australia. It should be noted that the survey was administered by either the registration board or by OT Australia (national or state branch depending on the state), and thus response rates vary across states (Australian Institute of Health and Welfare, 2006b). The AIHW report does not distinguish between occupational therapists working in mental health and the broader labour force.

According to data in table 2.8, the occupational therapy workforce in Australia in 2003 was predominantly female (ranging from 100% in ACT to 89.4% in TAS), with a mean age of 37.0 years (ranging from an average of 33.8 years in NT to an average of 40.4 years in TAS). On average, the workforce contributed an extra 3.5 hours of work per week on top of their average paid working week of 32.7 hours. Approximately one third of the workforce was working part time (less than 35 hours per week), and only a small proportion of the workforce worked 50 hours or more per week.

Table 2.8 Characteristics of the occupational therapy workforce, 2003

NSWVICQLDWASATASACTNTTotal
Number
825
582
788
496
307
47
26
36
3,107
% Male
5.5
8.6
5.1
6.5
8.8
10.6
0
2.8
6.4
Average age
36.2
37.2
37.3
37.0
37.1
40.4
40.3
33.8
37.0
Average paid hours worked
33.1
32.3
32.9
31.3
33.2
35.0
32.4
36.2
32.7
Average total hours worked
36.8
36.4
36.0
36.0
34.5
37.3
37.1
42.4
36.2
% working 50 hours or more
11.3
11.1
10.7
11.1
10.0
11.1
7.7
19.4
11.0
% working part time
33.3
40.4
34.0
37.2
40.9
24.4
30.8
19.4
35.9

Source: AIHW (2006b). Occupational Therapy Labour Force Survey, 2002-03.

Numbers of occupational therapists, 2006-2008 – comparison of sources

The actual Better Access occupational therapy workforce increased by 92 (400%) between 2006 and 2007, and 57 (50%) between 2007 and 2008, a total increase of 149 (648%) over the entire period (table 2.9). The service providers that utilised Better Access occupational therapy Items, spent an average of 0.45 hours (27 minutes) per week providing services, in 2006; whereas, by 2008, this had increased to an average of 1.9 hours (114 minutes) per week. Similar to the potential psychology workforce, the size of the potential occupational therapy workforce varied slightly depending on the reference data source (table 2.9).

In 2006, the number of occupational therapists registered in Queensland, SA and WA totalled 4,248; whereas the number identified by the ABS Census for the three states was 2,666. However, according to the Occupational Therapy Board of South Australia administrative data (the only detailed administrative data set); only 84% of those registered to practice were residing and employed in SA. Assuming this was also true for Queensland and WA, the deflated number of registered occupational therapists was closer to approximately 3,568, across the three states, in 2006. Disregarding the methodological differences between the two data sources, the ABS Census undercounted the deflated registration board number (3,568) by approximately 34% (902).

Therefore, at the national level, the potential occupational therapy workforce in 2006 was approximately 9,160 (i.e. the weighted ABS Census number). The actual Better Access occupational therapy workforce was approximately 0.3% of the estimated potential occupational therapy workforce in 2006.

While we have taken the best estimate of the numbers in the potential Better Access occupational therapy workforce to be that of the weighted ABS Census, further refinement of this number may be possible. Similar to the estimated potential psychology workforce, only 70% (approximately) of occupational therapists in the 2006 ABS Census identified as being employed in the health care industry17. Therefore, an estimate of the potential Better Access occupational therapy workforce (health) in 2006 would be 6,412. Of this estimated number, 0.4% used Better Access in 2006.Top of page

Table 2.9 Summary of estimates for occupational therapists

PsychologistPotential - ABS Census 2006Potential - Registration Board 2006Potential - Registration Board 2007Potential - Registration Board 2008Actual - MBS 2006*Actual - MBS 2007Actual - MBS 2008
Number of providers
6,835
4,248
4,397
4,529
23
115
172
NSW
2,119
-
-
-
5
34
45
VIC
1,777
-
-
-
8
28
58
QLD
1,230
1,997
2,143
2,172
5
25
29
SA
547
788
728
783
2
10
16
WA
889
1,463
1,542
1,575
2
15
18
TAS
137
-
-
-
0
2
3
NT**
68
-
-
-
0
0
1
ACT
137
-
-
-
1
2
3
Services/provider
-
-
-
-
5
91
123
Hours on Better Access Items: average hours/week/provider
-
-
-
-
0.47
1.43
1.94
PsychologistPotentialActual
ABS CensusRegistration BoardMBS
2006
2006
2007
2008
2006*
2007
2008
Number of providers
6,835
4,248
4,397
4,529
23
115
172
NSW
2,119
-
-
-
5
34
45
VIC
1,777
-
-
-
8
28
58
QLD
1,230
1,997
2,143
2,172
5
25
29
SA
547
788
728
783
2
10
16
WA
889
1,463
1,542
1,575
2
15
18
TAS
137
-
-
-
0
2
3
NT**
68
-
-
-
0
0
1
ACT
137
-
-
-
1
2
3
Services/provider
-
-
-
-
5
91
123
Hours on Better Access Items: average hours/week/provider
-
-
-
-
0.47
1.43
1.94

* Note: MBS data for 2006 was for November and December only.
** Note: Administrative data from the Northern Territory Occupational Therapists Registration Board was not publicly available.
Sources: ABS. 2006 Census of Population and Housing
QLD, SA, WA Occupational Therapists Registration Board administrative data
Medicare Australia. 2006-08 Medicare Provider Data and Medicare Benefit Schedule (MBS) data

Characteristics of occupational therapists, 2006-2008

Across the potential occupational therapy workforce, in 2006, the distribution of males and females was 7% and 93%, respectively. Similarly, in 2006, the gender of service providers that actually utilised the Better Access Items were 4% male and 96% female (table 2.10). The strong female bias in the gender distribution of the Better Access occupational therapy workforce remained over the period 2006 to 2008.

In 2006, the majority of the potential occupational therapy workforce was aged between 15-29 years and 30-39 years, approximately 37% and 31% respectively. In comparison, the distribution of the age profile of those that actually utilised the Better Access initiative, in 2006, was slightly older with 30% aged between 30-39 years and 43% aged between 40-49 years (table 2.10). Over the period from 2006 to 2008, there was a slight redistribution in the age profile of actual Better Access occupational therapy workforce, from the 40-49 year cohort to the 15-29 year cohort. Overall, however, the actual Better Access workforce still remained slightly older than the potential workforce.

In 2006, the geographical distribution of occupational therapists across state/territory jurisdictions was comparable for both the potential and actual Better Access occupational therapy workforces for all states/territories, except NSW and Victoria. Furthermore, there was little change in the jurisdictional distribution of service providers that actually utilised the Better Access initiative across the period 2006 to 2008.

At the urban, rural and remote level of geographical disaggregation there was a disparity in the distribution between the potential and actual Better Access workforces. In 2006, 82% of the actual Better Access workforce was concentrated in highly populated areas (i.e. capital cities, large and other metro areas), compared with 93% of the potential workforce (in major and other urban areas) (see Table 2.10). By 2008, only 79% of the actual Better Access occupational therapy workforce was concentrated in the highly populated areas, indicating either the increased presence of occupational therapists in non-urban areas or increased utilisation of Better Access Items, or both.Top of page

Table 2.10 Summary of characteristics for occupational therapists

Occupational therapistABS potential 2006 %MBS actual 2006* %MBS actual 2007 %MBS actual 2008 %
Gender - male
7
4
10
9
Gender - female
93
96
90
91
Gender - total
100
100
100
100
Age - 15-29
37
0
15
16
Age - 30-39
31
30
26
30
Age - 40-49
21
43
25
22
Age - 50-59
10
22
25
23
Age - 60+
2
4
9
9
Employed in public sector
46
NA
NA
NA
Employed in private sector
54
NA
NA
NA
Country of birth - Australia
83
NA
NA
NA
Country of birth - other countries
17
NA
NA
NA
Citizenship status - Australian
95
NA
NA
NA
Citizenship status - non-Australian
5
NA
NA
NA
Distribution: state - NSW
31
22
29
26
Distribution: state - VIC
26
35
24
34
Distribution: state - QLD
18
22
22
17
Distribution: state - SA
8
9
9
9
Distribution: state - WA
13
9
13
10
Distribution: state - TAS
2
0
2
2
Distribution: state - NT
1
0
0
1
Distribution: state - ACT
2
4
2
2
Distribution: RRMA - capital cities and large metro areas
NSC
78
69
70
Distribution: RRMA - other metro centre
NSC
4
8
9
Distribution: RRMA - large rural centre
NSC
13
9
7
Distribution: RRMA - small rural centre
NSC
4
5
7
Distribution: RRMA - other rural centre
NSC
0
8
6
Distribution: RRMA - remote centre
NSC
0
1
1
Distribution: RRMA - other remote centre
NSC
0
0
1
Distribution: section of state - major urban
76
NSC
NSC
NSC
Distribution: section of state - other urban
17
NSC
NSC
NSC
Distribution: section of state - bounded locality
1
NSC
NSC
NSC
Distribution: section of state - rural balance
7
NSC
NSC
NSC
Distribution: section of state - migratory
-
NSC
NSC
NSC

* Note: MBS data for 2006 was for November and December only.
Sources: ABS. 2006 Census of Population and Housing
Medicare Australia. 2006-08 Medicare Provider Data and Medicare Benefit Schedule (MBS) data
Key: NA = not applicable: the category is not applicable to this dataset
NSC = not standard classification: either the classification used differs between datasets or the data is not classified into standard (ABS or data dictionary) categories

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2.1.4 General practitioners

General practitioner workforce, pre Better Access

The changes in the general practitioner (GP) workforce between 1998 and 2006 are detailed through a comparison of AIHW (Australian Institute of Health and Welfare, 2000, AIHW 2006a, AIHW 2008) data from the Medical Labour Force surveys.18 The data for these surveys is drawn from a survey sent to all medical practitioners in all jurisdictions as part of the registration renewal process. The response rate over the past 5 years has been around 70%, and these responses are weighted to medical practitioner figures provided by state and territory medical boards (AIHW 2009). There was a moderate increase in the overall size of the GP workforce between 1998 and 2006 (table 2.11). The proportion of females in the GP workforce increased between 1998 and 2006, and the average hours worked per week decreased.

Table 2.11 Characteristics of the GP workforce, 1998, 2000, 2004, and 2006

1998200020042006
Number
20,852
21,081
22,011
22,954
% male
66.8
66
63.5
62.4
Average age
-
47.8
49.0
49.8
Average hours
45.3
-
-
39.5

Source: AIHW (2008). Medical Labour Force Survey, 2006
AIHW (2006a). Medical Labour Force Survey, 2004
AIHW (2000). Medical Labour Force Survey, 1998

Numbers of general practitioners, 2006-2008 – comparison of sources

The actual number of general practitioners that utilised the Better Access initiative increased by 7,799 (65%) between 2006 and 2007, 1,461 (7%) between 2007 and 2008, and 9,260 (77%) over the entire period (see Table 2.12). The service providers that utilised Better Access GP Items spent an average of just 0.37 hours (22 minutes) per week on providing Better Access services, in 2006; by 2008, this had increased to an average of 0.47 hours (28 minutes) per week.

It is estimated from the ABS Census that the potential general practitioner workforce was 29,923 in 2006 (table 2.12). However, the number of GPs registered with Medicare in 2006 was approximately 22,641. The discrepancy in the potential workforce numbers between the two data sources is most likely due to methodological differences. For the purposes of this report, the potential workforce is estimated from the number of GPs registered with Medicare (i.e. able to immediately bill for MBS items) because DoHA advise that this is considered the most authoritative source. Hence, in 2006, the estimated potential Better Access GP workforce was 22,641 and, of this, approximately 53% billed services against Better Access; this had increased to approximately 87% by 2008.

Table 2.12 Summary of estimates for general practitioners

General Practitioner
Potential:
ABS - 2006
Potential:
MBS - 2006
Potential:
MBS - 2007
Potential:
MBS - 2008
Actual:
MBS - 2006*
Actual:
MBS - 2007
Actual:
MBS - 2008
Number of providers
29,923
22,641
23,698
24,593
12,064
19,863
21,324
Number of services/provider
-
-
-
-
8
51
64
Hours on Better Access Items: average hours/week/provider
-
-
-
-
0.37
0.37
0.47

* Note: MBS data for 2006 was for November and December only.
Sources: ABS. 2006 Census of Population and Housing
Medicare Australia. 2006-08 Medicare Provider Data and Medicare Benefit Schedule (MBS) data

Characteristics of general practitioners, 2006-2008

As shown in table 2.13, the proportion of males and females across the potential GP workforce in the 2006 ABS Census was 63% and 37%, respectively. In comparison, the gender balance of the service providers that actually utilised the Better Access initiative in 2006 was 58% for males and 42% for females, however by 2008 the balance more closely reflected that of the potential workforce.

In 2006, the majority of potential GP service providers were aged between 40-49 years and 50-59 years, approximately 30% and 25% respectively. In comparison, in 2006, the age distribution of GPs that utilised the Better Access initiative between 40-49 years and 50-59 years was 37% and 31%, respectively. There was little change in the age distribution of the actual Better Access GP workforce across the period from 2006 to 2008, indicating the actual workforce was older than the potential workforce.

The importance of immigration amongst GPs is highlighted by the large proportion that was born overseas. In 2006, approximately 50% of potential GP workforce was born in a country other than Australia. Of these, approximately 13% were not Australian citizens.

The geographical distribution across state/territory jurisdictions was comparable for both the potential and actual providers (2006) of Better Access GP services. There was little change in the jurisdictional distribution of service providers that utilised Better Access across the period from 2006 to 2008.

At the urban, rural and remote level of geographical disaggregation, the distribution of both the potential and actual providers was concentrated in highly populated areas (i.e. urban, capital cities and metro areas). However, there was a larger proportion of GPs that utilised Better Access Items working outside of metropolitan areas than the potential GP workforce.Top of page

Table 2.13 Summary of characteristics for general practitioners

General practioner
Potential ABS - 2006
MBS actual - 2006*
MBS actual - 2007
MBS actual - 2008
Gender - male
63%
58%
60%
60%
Gender - female
37%
42%
40%
40%
Total
100%
100%
100%
100%
Age - 15-29
8%
2%
2%
2%
Age - 30-39
22%
20%
18%
18%
Age - 40-49
30%
37%
33%
31%
Age - 50-59
25%
31%
31%
31%
Age - 60+
14%
11%
16%
17%
Employed in public sector
19%
NA
NA
NA
Employed in private sector
81%
NA
NA
NA
Born in Australia
50%
NA
NA
NA
Born in country other than Australia
50%
NA
NA
NA
Australian citizen
87%
NA
NA
NA
Non-Australian
13%
NA
NA
NA
Distribution by state - NSW
34%
28%
26%
25%
Distribution by state - VIC
25%
28%
26%
25%
Distribution by state - QLD
18%
18%
19%
20%
Distribution by state - SA
8%
7%
8%
9%
Distribution by state - WA
9%
9%
9%
9%
Distribution by state - TAS
2%
3%
3%
3%
Distribution by state - NT
1%
0%
1%
1%
Distribution by state - ACT
2%
1%
2%
2%
Distribution by RRMA category - capital cities & large metro areas
NSC
67%
63%
62%
Distribution by RRMA category - other metro centre
NSC
9%
8%
8%
Distribution by RRMA category - large rural centre
NSC
7%
7%
7%
Distribution by RRMA category - small rural centre
NSC
7%
8%
8%
Distribution by RRMA category - other rural centre
NSC
10%
13%
13%
Distribution by RRMA category - remote centre
NSC
0%
1%
1%
Distribution by RRMA category - other remote centre
NSC
0%
1%
1%
Distribution by section of state - major urban
77%
NSC
NSC
NSC
Distribution by section of state - other urban
15%
NSC
NSC
NSC
Distribution by section of state - bounded locality
1%
NSC
NSC
NSC
Distribution by section of state - rural balance
7%
NSC
NSC
NSC
Distribution by section of state - migratory
0%
NSC
NSC
NSC

* Note: MBS data for 2006 was for November and December only.
Sources: ABS. 2006 Census of Population and Housing
Medicare Australia. 2006-08 Medicare Provider Data and Medicare Benefit Schedule (MBS) data
Key: NA = not applicable: the category is not applicable to this dataset
NSC = not standard classification: either the classification used differs between datasets or the data is not classified into standard (ABS or data dictionary) categories

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2.1.5 Psychiatrists

Psychiatric workforce – RANZCP data, pre Better Access

Since 1999 there have been concerns about the possibility of an escalating undersupply of psychiatrists in Australia (AMWAC 1999, AMHWAC 2008). In response to these concerns, in 2000 the RANZCP increased the annual intake of trainees to 120 per year, with an average of 83 trainees successfully completing each year. This goal was reached in 2006 when the selection criteria changed. The proportion of female trainees increased from 42% to 51% within three years of the expanded program. The current aim is to achieve self-sufficiency in health workforce supply which would mean increasing the output of completions to 131 annually, requiring an annual intake of 176 trainees (Mental Health Workforce Advisory Committee, 2008).

The psychiatrist workforce is influenced by the large cohort (57%) aged 50 years and over (ABS Census 2006). A 2005 workforce survey undertaken by the RANZCP found that of the 31% of psychiatrists over the age of 55 years, 17% were planning to retire within five years and a third were planning to reduce their hours of work (Mental Health Workforce Advisory Committee, 2008).

Data collected in 2007 indicates that there is wide variation in the ratio of psychiatrists to population across states and territories (table 2.14).

Table 2.14 Ratio of RANZCP members to population

NSWVICQLDWASATASACTNTTotal
Number
733
685
378
199
232
38
35
10
2,310
Psychiatrists per 10,000 persons
1:9
1:7
1:1
1:1
1:7
1:1
1:9
1:2
1:9

Source: MHWAC (2008). RANZCP Workforce, March 2007 (unpublished)

Numbers of psychiatrists, 2006-2008 – comparison of sources

The actual number of psychiatrists that provided services through the Better Access initiative increased by 432 (40%) between 2006 and 2007, 90 (6%) between 2007 and 2008, and 522 (48%) over the entire period (see table 2.15). Better Access Items are only a small proportion of the MBS billing items for psychiatrists. Nevertheless, of those using Better Access, individual psychiatrists spent an average of 0.88 hours (52 minutes) per week on Better Access services (2006), with a slight increase to an average of 0.90 hours (54 minutes) per week by 2008.

It is estimated from the ABS Census that the potential psychiatric workforce was 2,180 in 2006 (table 2.15). However, the number of psychiatrists registered with Medicare in 2006 was approximately 2,877. Again, the discrepancy in the potential workforce numbers between the two data sources is most likely due to methodological differences. For the purposes of this report, the potential workforce is estimated from the number of psychiatrists registered with Medicare (i.e. able to immediately bill for MBS Items). Hence, in 2006, the estimated potential Better Access psychiatrist workforce was 2,877 and, of this, approximately 38% provided Better Access services; this had increased to approximately 51% by 2008.

Table 2.15 Summary of estimates for psychiatrists

General practitioner
Potential:
ABS - 2006
Potential:
MBS - 2006
Potential:
MBS - 2007
Potential:
MBS - 2008
Actual:
MBS - 2006*
Actual:
MBS - 2007
Actual:
MBS - 2008
Number of providers
2,180
2,877
2,989
3,123
1,086
1,518
1,608
Number of services/provider
-
-
-
-
13
62
63
Hours on Better Access Items: average hours/week/provider
-
-
-
-
0.88
0.90
0.91

* Note: MBS data for 2006 was for November and December only.
Sources: ABS. 2006 Census of Population and Housing
Medicare Australia. 2006-08 Medicare Provider Data and Medicare Benefit Schedule (MBS) data

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Characteristics of Psychiatrists, 2006-2008

The proportion of male and female psychiatrists in the potential workforce in 2006 was 60% and 40% respectively. In comparison, the gender balance of service providers that utilised the Better Access initiative was 72% for males and 28% for females in 2006, but shifted slightly in favour of females by 2008. The actual Better Access psychiatric workforce is therefore more heavily dominated by men than the broader psychiatric workforce.

Of the potential psychiatrist workforce in 2006, the largest proportion was aged between 40-49 years, approximately 30%. However, in 2006, the distribution of the age profile of the actual Better Access psychiatrist workforce was 32% aged between 40-49 years and 34% aged between 50-59 years. By 2008, the workforce had aged even further with 25% of psychiatrists actually utilising Better Access being over 60 years, compared to 21% in 2006.

The importance of immigration in supplying the potential psychiatric workforce is highlighted by the large proportion born overseas. In 2006, approximately 46% of the potential psychiatric workforce was born in a country other than Australia. Of those,vapproximately 14% were not Australian citizens.

In 2006, the geographical distribution across state/territory jurisdictions was comparable for both the potential and actual providers of Better Access psychiatric services. Furthermore, there was little change in the jurisdictional distribution of service providers that utilised the Better Access initiative across the period from 2006 to 2008. At the urban, rural and remote level of geographical disaggregation, the distribution of both the actual providers of Better Access services and the potential psychiatric workforce were generally comparable, with the majority concentrated in highly populated areas (i.e. urban or capital cities). Although there appears to be a greater proportion of psychiatrists working outside of capital cities in the actual Better Access workforce, the majority of these work in other metro areas and large urban centres.

Table 2.16 Summary of characteristics for psychiatrists

Psychiatrist
Potential ABS - 2006
MBS actual - 2006*
MBS actual - 2007
MBS actual - 2008
Gender - male
60%
72%
71%
69%
Gender - female
40%
28%
29%
31%
Age - 15-29
4%
0%
0%
0%
Age - 30-39
23%
13%
13%
13%
Age - 40-49
30%
32%
31%
30%
Age - 50-59
24%
34%
32%
32%
Age - 60+
19%
21%
24%
25%
Employed in public sector
38%
NA
NA
NA
Employed in private sector
62%
NA
NA
NA
Born in Australia
54%
NA
NA
NA
Born in country other than Australia
46%
NA
NA
NA
Australian citizen
86%
NA
NA
NA
Non-Australian
14%
NA
NA
NA
Distribution by state - NSW
30%
32%
30%
30%
Distribution by state - VIC
30%
30%
32%
32%
Distribution by state - QLD
16%
18%
17%
17%
Distribution by state - SA
11%
12%
12%
12%
Distribution by state - WA
10%
5%
6%
6%
Distribution by state - TAS
2%
2%
2%
2%
Distribution by state - NT
1%
0%
0%
0%
Distribution by state - ACT
2%
1%
1%
1%
Distribution by RRMA category - capital cities & large metro areas
NSC
83%
83%
81%
Distribution by RRMA category - other metro centre
NSC
7%
7%
6%
Distribution by RRMA category - large rural centre
NSC
4%
4%
4%
Distribution by RRMA category - small rural centre
NSC
3%
3%
3%
Distribution by RRMA category - other rural centre
NSC
3%
3%
4%
Distribution by RRMA category - remote centre
NSC
0%
0%
0%
Distribution by RRMA category - other remote centre
NSC
0%
0%
0%
Distribution by section of state - major urban
87%
NSC
NSC
NSC
Distribution by section of state - other urban
7%
NSC
NSC
NSC
Distribution by section of state - bounded locality
1%
NSC
NSC
NSC
Distribution by section of state - rural balance
5%
NSC
NSC
NSC
Distribution by section of state - migratory
-
NSC
NSC
NSC

* Note: MBS data for 2006 was for November and December only.
Sources: ABS. 2006 Census of Population and Housing
Medicare Australia. 2006-08 Medicare Provider Data and Medicare Benefit Schedule (MBS) data
Key: NA = not applicable: the category is not applicable to this dataset
NSC = not standard classification: either the classification used differs between datasets or the data is not classified into standard (ABS or data dictionary) categories


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Footnotes

15 For the purpose of this report, the 'health care industry' is defined by the ABS 2006 ANZSIC codes 84 (Hospitals) and 85 (Medical and Other Health Care Services). It excludes codes 86 (Residential Care Services) and 87 (Social Assistance Services).
16 These figures provide the best estimate at a national level, however, in chapter 3 the analysis of the distribution of the potential Better Access social work workforce used the numbers relating to the total AASW workforce provided by the AASW as these could be disaggregated by state.
17 For the purpose of this report, the 'health care industry' is defined by the ABS 2006 ANZSIC codes 84 (Hospitals) and 85 (Medical and Other Health Care Services). It excludes codes 86 (Residential Care Services) and 87 (Social Assistance Services).
18 The Australian Medical Workforce report (Department of Health and Aged Care, 2001) is based on the AIHW (2000) data. We have chosen to base our analysis on the source data from the AIHW (2000) rather than the DoHA (2001) report