Many things about Australia and our health are changing—from our lifestyle behaviours and working habits, to the medicines, technology and workforce that help tackle our health problems.
Some demographic trends (such as where we live and number of people in a family), and patterns in health service use, can have important implications for health.
The face of Australia
The number of people in Australia (22.3 million at June 2010) is constantly changing as people are born, die or move in and out of the country. More slowly, the composition of the Australian population is changing, for example, there are more older people than before.
As a nation, we are ageing, our birth rate is declining, and we are living in smaller households. We are less likely to be married and more likely to be divorced. More of us are living in capital cities than ever before, and we are more likely to be born overseas.
Assisted reproduction increasing
Assisted reproductive technology (or ART) is a group of medical interventions used to help a woman get pregnant, particularly after a long period of unsuccessful attempts at getting pregnant naturally (known as infertility).
Australian clinics performed more than 65,000 ART treatment cycles in 2009. Of these treatment cycles, about 23% resulted in a pregnancy and 17% in a live delivery. While the number of cycles initiated increased between 2005 and 2009, the proportion resulting in pregnancies and live deliveries has remained relatively stable.
The success rate of ART decreases substantially as a woman gets older. For women aged 45 and over using their own eggs, one live delivery resulted from every 800 initiated cycles in 2009, compared with one live delivery from every four initiated cycles in women aged 25–34.
Growth in mental health services
A 2007 national survey shows that mental health problems are relatively common in Australia (see ‘Burden on our minds’). Mental health care services can be delivered in a range of facilities by different health professionals, although not everyone who needs help seeks it.
Medicare subsidises some mental health-related services: in 2009–10, there were 1.8 million services provided by GPs, nearly 2 million by psychiatrists, and 3.2 million by psychologists and other allied health professionals.
Between 2005–06 and 2009–10, there was a 34% average annual increase in the number of Medicaresubsidised mental health-related services, with most of this growth in psychologist services. In part, this is due to a program introduced in 2006 that subsidised the cost of seeing psychologists and other allied health providers.
Greater supply of palliative care
Palliative care aims to improve the quality of life of patients and their families facing the problems associated with life-threatening illness and end-of-life care. This may involve prevention and relief of suffering and treatment of pain and other problems, be they physical, psychosocial or spiritual.
In Australia, there was a 51% increase in the number of palliative care hospitalisations between 2000–01 and 2009–10. This is a ‘real increase’ caused by factors other than population growth and ageing.
Cancer patients comprise the majority of those using hospital-based palliative care services: 59% of palliative care hospitalisations had a primary diagnosis of cancer, or 76% when both primary and secondary diagnoses were taken into account.
Health workforce growing and ageing
Access to health care and advice is critical for good health, hence the people who provide and support these services are essential to Australia’s health.
In 2010, there were 766,800 people working in health occupations, such as GPs, dentists, nurses, pharmacists and psychologists among others. Between 2005 and 2010, the number of people in health occupations increased by 26%. This was higher than the increase of 12% across all occupations over the same period.
On average, the health workforce is ageing faster than other workforces in Australia. Between 2005 and 2010, the proportion of people aged 55 or older in health occupations increased from 15% to 19%, while the proportion for other occupations increased from 14% to 16%.
Keeping up with demand
The health workforce is dynamic: large numbers of individuals join and leave over time, which has implications for ensuring there is an adequate workforce to meet the health-care needs of Australians.
Many factors can affect the number of health workers available, including how many people complete health courses, how many move to Australia to work in health occupations (and how many move overseas to work), and how many are retiring from the workforce.
Another major factor in the availability of health workers is the hours they work each week. Combining the number of workers with the hours worked gives the workforce supply. Between 2005 and 2010, average weekly hours worked in health occupations fell from 31.3 to 30.9. However, because more workers were available, the supply of workers in health occupations increased by 14%.
Reforming the health system
Given the transformations taking place in Australian society, it comes as no surprise that the health system has also evolved and continues to change in response to existing needs and future challenges. These are just a few examples of what’s on the radar.
- Australian governments are undertaking reforms to the health-care system, including the establishment of Medicare Locals and Local Hospital Networks.
- Associated with these reforms is a new emphasis on performance reporting and accountability— information will be available on the performance of each Medicare Local, each Local Hospital Network, and each public and private hospital.
- A personally controlled electronic health record (PCEHR) will be introduced from 1 July 2012, aiming towards a reliable and secure environment for individuals and health-care services to access and share health information.
These changes, and the health information arising from them, are expected to contribute to improved health for all Australians.