Level 1 / 114 Williams St T 61 3 9642 4899 office@speechpathologyaustralia.org.au Melbourne Victoria 3000 F 61 3 9642 4922 www.speechpathologyaustralia.org.au Speech Pathology Australia s submission to the Department of Education and Training Skilled Occupations List Submission to 2016-17 SOL 29 October 2015 The Speech Pathology Association of Australia Limited ABN 17 008 393 440
Speech Pathology Australia s Submission to the SOL 2016-17 Industry Profession Health Professionals: Speech Pathology university trained professionals working across health, disability, education, aged care, mental health, justice and private practice. ANZCO Coding 2527-12 Speech Pathology Regulatory Environment Speech Pathology currently does not come under the National Registration and Accreditation Scheme. In all states and territories, Speech Pathology Australia regulates members through robust self-regulation mechanisms. Speech Pathology Australia is the recognised Assessing Authority for Skills Assessment of speech pathologists with overseas qualifications and is also the accrediting body for speech pathology training courses in Australia. Practising membership of Speech Pathology Australia is a requirement for Medicare, Private Health Fund and third party provider status. There is an increased focus on requiring certification/credentialing of practitioners with Speech Pathology Australia having a practitioner self-regulation / accreditation program in place, leading to the status of Certified Practising Speech Pathologist. From 2016, certified status will become the requirement for practising membership and hence eligibility for provider status for Medicare, PHIs, and government funded services, etc. Many employers will seek a speech pathologist who is a practising member of Speech Pathology Australia, or at the least, is deemed eligible for practising membership. Comments in relation to Speech Pathology Workforce Imbalances - medium to long term Speech pathology has long been considered a profession in shortage, with inclusion on DEEWR/Department of Employment skills shortage lists since 2000. However, since 2012, the profession has been rated as having no shortage due to the increased number of applicants for positions. The Department of Employment (February 2015) does acknowledge, however, that the increase in the number of applicants for positions doesn t seem to be having an impact on the ability to be able to attract suitably qualified candidates for specialist positions, and finding experienced (versus newly graduated or inexperienced) candidates: Employers attract large fields of qualified speech pathologists and generally recruit with ease. Training numbers for speech pathologists have increased significantly in recent years. A large proportion of applicants are new graduates, but employers typically seek experienced speech pathologists for their vacancies. Employers were generally seeking candidates with experience in a specific discipline or setting, such as experience in paediatrics, the disability sector, autism or neurological disorders, critical care or schools. (Department of Employment, Labour Market Research and Analysis Branch, Feb 2015) Page 2 of 5
Despite DoE s no shortage rating, Speech Pathology Australia is concerned about the profession s ability to meet the rapidly-accelerating demands for speech pathology services across a range of sectors, with difficulty accessing speech pathologists, inadequate levels of service and high waiting times for speech pathology services commonly reported. There has been a significant increase in the training of speech pathologists in Australia. There are currently 15 universities offering 24 speech pathology programs across 19 locations in Australia. 10 of these programs commenced in the last 5 years. In 2014, approximately 1,300 students commenced speech pathology programs. This reflects a more than two-fold increase from an intake of around 600 in the early 2000s. Approximately 720 speech pathologists are expected to enter the workforce in 2015, an increase of approximately 45 percent since 2005. This increase has led to a large number of new graduates seeking work. (Speech Pathology Australia (2014). From a report commissioned by Health Workforce Australia (2014) concerning the Speech Pathology workforce, it was noted that a common comment across some jurisdictions was that while there are sufficient numbers of speech pathologists to fill junior positions, there are insufficient numbers of more experienced speech pathologists with specialised clinical skill sets, who are also able to manage services. One jurisdiction noted high attrition at the senior level contributes to this, with reasons for attrition including demographics (it is a female-dominated workforce, with people leaving or reducing hours for family reasons), limited opportunities at a management level and limited pay progression. Reducing average hours of work, a result of an increasing part-time workforce, was highlighted as an issue affecting future workforce supply. The ability to provide clinical placements and sufficient practical time for the increasing number of speech pathology students was also noted as impacting on quality of education. The ageing population, particularly predicted increases in those with dementia and multiple comorbidities; increasing incidence of chronic disease; and increasing incidence of paediatric disability (for example autism spectrum disorders), along with the new National Disability Insurance Scheme, is expected to increase demand for speech pathology services. (Health Workforce Australia 2014) In this same HWA report, Speech Pathology Australia highlighted that the current attrition rate of speech pathologists is relatively high (at 13 per cent). Research highlights reasons for this include large caseloads, reduced effectiveness due to rationing of services, lack of autonomy, lack of career pathways, and remuneration ceilings. Additionally, Speech Pathology Australia indicated that the full-time speech pathology workforce peaks at approximately ten years post-graduation, then moves to part-time. High attrition and high levels of part-time work impact on workforce supply and capacity, including the number of experienced practitioners able to provide more complex speech pathology services, as well as training capacity both in terms of clinical supervision and academic/research activity. Speech Pathology Australia commented that new graduates are reporting difficulties in finding fulltime positions within the public sector. Consequently many are entering private practice, with the Association concerned this could potentially lead to even higher attrition rates, through limited job security and fewer professional supports than would traditionally be offered to new graduates and early career speech pathologists. Page 3 of 5
In relation to demand for speech pathology services, Speech Pathology Australia expects demand to increase due in part to the effects of an ageing population, improved survival rates of premature, chronically ill and disabled infants, an increase in the detection of early speech and language disorders and the increase in opportunities to provide support to participants of the National Disability Insurance Scheme. Changes in the disability and aged care sectors in particular are leading to a growth within the private sector. Mal distribution / Rural distribution of speech pathologists There is a maldistribution of speech pathologists with more speech pathologists working in metropolitan versus regional areas and even fewer speech pathologists working in rural and remote communities. It is noted that rural and remote courses have commenced in some areas of Australia with the intention of recruiting locals into the course with the aim they remain local and work within their communities. As reported by Health Workforce Australia (2014), maldistribution of the speech pathology profession was noted by many jurisdictions, with difficulty in attracting and retaining people to regional locations. Whilst it is not possible to determine the exact number of speech pathologists working in Australia, the Census 2011 data does show that the number of Speech Pathologists/Audiologists (SP/A) professionals available per capita is dramatically lower in regional and remote/very remote areas than in the major capital cities. Across all the very remote areas of Australia, there are only 0.64 SP/A professionals residing per 10,000 head of population; however, at Census 2011 some states (NSW, SA, TAS, and NT) had no SP/A professionals residing in very remote locations. Overall the figures illustrate that there are very few SP/A professionals available in areas classed as remote or very remote. (Speech Pathology Australia, 2014) Additionally, there is a larger number of speech pathologists working privately in more affluent areas than in areas of disadvantage. It is also reported that clients from Aboriginal and Torres Strait Islander backgrounds and lower socioeconomic populations have less access than other populations to publicly funded speech pathology services. Page 4 of 5
Trends in Medium to Long Term and Recommendation for Speech Pathology to remain on the SOL 2016-17 Over the last 5 years, there have been 320 applications of speech pathologists with overseas qualifications seeking eligibility of Speech Pathology Australia in order to migrate and/or practice in Australia. It is noted however that the numbers of applicants have been falling over this period, in successive years. Speech Pathology Australia would argue that while there have been a significant increase in the number of Australian trained new graduates, recruitment from overseas remains important with respect to attracting speech pathologists with more experience, with specialist clinical skills or with specific academic and research competencies. Additionally, although there appears to be insufficient new graduate positions in the public sector for the available graduates being trained, there is evidence of increasing demand for speech pathology services and growth in opportunities for employment in the private sector. It is recommended therefore that Speech Pathology (2527-12) remain on the SOL for 2016-17, with a continuing monitoring of training and employment trends. Other matters Speech Pathology Australia also wishes to highlight data gaps as a key area of concern. While information does exist on workforce supply and workforce activity, there are substantial limitations on both sides to be able to conduct workforce planning, or measure accurately the future needs for speech pathology services. While the profession does not come under the National Registration and Accreditation Scheme and therefore data is not collected on all speech pathologists practising in Australia, the Federal Department of Health has recently indicated their desire to capture workforce data on self-regulating professions, which includes speech pathology. For further contact: Gail Mulcair Chief Executive Officer Speech Pathology Australia Ph. 03 9642 4899 Email: gmulcair@speechpathologyaustralia.org.au References: Department of Employment, Labour Market Research and Analysis Branch, ANZSCO 2527-12 Speech Pathology, Feb 2015 Health Workforce Australia 2014: Australia s Health Workforce Series Speech Pathologists in Focus. Department of Health: Canberra Speech Pathology Australia (2014). Submission to Senate Inquiry into the prevalence of different types of speech, language and communication disorders and speech pathology services in Australia. Speech Pathology Australia, Melbourne Page 5 of 5