Armidale Hospital, as with the Australian health industry in general, faces a number of serious issues with regards to current and future availability of health care workers (HWA 2011). This is compounded by reluctance within the health industry to change its training practices.
Key human resource planning issues
Shortages in the Australian health industry workforce are projected. The issues that combine to cause these shortages are complex, and include: demographic factors; socio-cultural factors; clinical and professional factors exerting influence on heath care workers; and the supply of health workers.
Additional uncertainty on these issues was the impact of the global financial crisis. As well, Australia’s tax rates are high, so it is not an attractive market for foreign professionals.
On the positive side, the federal and state governments have allocated additional funding (National Health Workforce Taskforce 2009). Other positive factors are: microeconomic reforms in the health industry; increased funding for universities by deregulation of capping for health profession students; increases in overseas recruitment; and increases in training overseas recruits to Australian standards.
The main factors impacting the demand and supply of health care professional (National Health Workforce Taskforce 2009) are: ever-increasing demands for health care workers; labour market competition; and an inhibited training system.
The demand for health care workers
The highest ranked factor for the increase in demand for health care workers is the changing population (National Health Workforce Taskforce 2009). Ageing, environment and lifestyle have caused an increase in chronic diseases, such as diabetes and heart disease. Ageing in particular has stretched resources for aged care services, dementia and other illnesses.
There have also been changes in service delivery, such as new technologies, medicines, treatment methods, policies and skill mixes. There are increased numbers of same day or overnight admissions, which increases the work demands health and ancillary staff.
Community expectations are traditionally very high in Australia. A decline in service standards has put increasing pressure on health care professionals to improve the standards, and perhaps even raise the standards to a higher level than was previously acceptable.
Workforce expectations are also placing higher demands on the number of health care workers needed in the industry. In the past, health care workers have worked absurdly long hours, but the trend now is for the health care workers to demand shorter hours of work. The emphasis now is on work/life balance.
Workforce specialisation is the fragmentation of the profession into many smaller professions, and sub-specialities. Here is increased control within each of these sub-specialities, which decreases the numbers of health care workers in the traditional general health care roles.
The strategies of the past, to alleviate demands on health care workers, have, in many instances, increased demands. The recruitment of overseas health professionals increased the burden of supervision on existing medical workers. Increases of recruitment of nurses to the general sector left shortages in the acute and specialised areas.
In the past, Australia has relied mainly on recruiting internationally, and increasing Australian admissions into education and training (National Health Workforce Taskforce 2009). However, other countries also have this strategy, to address their needs, and Australia is not so attractive on the international market. These are matters that the health systems cannot control.
Other countries are offering wage increases and tax concessions to attract and keep health care workers. Even many of our university graduates are being attracted overseas, by better financial incentives and career prospects.
The health industry training system
The number of undergraduate and postgraduate places in universities has, in the past, been capped by the amount of funding provided (National Health Workforce Taskforce 2009). Even now that has now been deregulated, and funding is made on the basis of numbers enrolled, there are still concerns.
In the past, because the numbers were capped, entry requirements were high. This could see a relaxing of those entry requirements, to attract more numbers. Greater numbers does not decrease then individuals abilities to achieve the requirements of the training in the medical profession.
As in the past, greater demands are being put on experienced health care workers to supervise and adequately prepare the undergraduates, as well as workplace training after their placement into the health care system.
As such, the training system has limited capability, especially with increased enrolments, to provide for the increase in numbers of students entering the system. The training system simply cannot satisfy their needs.
Future sources of labour for the health industry
Armidale Hospital will have to move into line with the integrated efforts of the combined health systems of Australia, and move away from the traditional strategies of increased recruitment and increased training in traditional roles. Australia’s financial situation and high tax rates make it less competitive on an international market, especially when considering there is an international shortage of health care professionals. There needs to be a focus on new strategies, such as are already occurring in the UK, the US and Canada.
Traditional roles are being extended, rather than limited. Nurses are taking on some of the doctors roles. Nurses Assistants are taking on some of the nurses roles. In short, new medical profession positions are being created, that increase the scope of the traditional roles in the health care workforce.
Armidale Hospital will need to identify where these roles can be implemented, forecast the future demand for these roles, and implement new training programs to fill the expected future roles.
The hospital will also need to implement information and training sessions for all staff, to ensure that everyone understands the new responsibilities and limitations of the new roles. The emphasis will need to be on a new way of working, while still retaining the traditional values that society expects.
Everybody in the community is a stakeholder when it comes to health care, so the needs of the entire community must be considered when the inevitable changes are introduced.
Because of the personal and dramatic effect that health care has on the individuals in the community, the community itself is the major stakeholder.
Transparent and trusted community awareness programs need to be implemented to ensure that natural fears about safety to the community are addressed openly and honestly.
Within the hospital, the main stakeholders are the health care practitioners, as well as any ancillary staff who might be expected to take on some of these traditional roles. Open and honest information needs to be provided, as well as a sound and practical introduction for the new roles.
BHP is a multi-national company that, though based primarily in Australia, has most of it’s operations overseas. It is increasing operations, but also moving it more isolated places to run these new ventures. Therefore, it’s major human resource planning issue will be finding and training skilled staff to work on these ventures. BHP’s human resource planning strategy is very closely aligned with it’s business strategy (BHP 2007).
Key human resource planning issues
The top issue that BHP face is that, in the Asian countries where it is expanding it’s operations, the Government of those countries insist that the staff are from that country. This presents a problem, in that the skill levels of the local market are way below what international and BHP standards.
Stemming from that, four issues will rise for BHP: recruitment, planning and training of expatriate and local staff; communication and culture shock between expatriates and local staff; international managers require cross-cultural training; and evaluating performance, motivating and compensating staff across a wide variety of cultures.
Recruitment, planning and training staff
BHP operates largely in developing countries in Asia and Africa. While these countries provide a large source of cheap labour, the Governments of the countries are often insistent that the workforce be made up of local labour. Unfortunately the labour is usually not skilled to a level that BHP or the international market requires.
Culture differences between expatriates and local staff
Many expatriates suffer culture shock when entering a new country for the first time. This has four phases: excitement at the new environment; irritation and hostility to cultural differences at work and home; gradual adjustment and acceptance; acceptance and appreciation allowing effective functioning. Globally, between 10-80% of foreign assignments fail, varying with industry type, because of failure to adapt to culture shock.
Cross-cultural training for international managers
Globally, about forty percent of foreign managers fail, because they fail to adapt to the new environment. Expatriate managers operating in a foreign environment need to be able to adapt to a different legal and financial system. There are also diverse markets, values and social systems.
Training and evaluation across a wide variety of cultures
Evaluation of performance has many issues, including the country of origin of the evaluator. Additionally, many expatriates have higher levels of skills than host country employees, and are in greater demand to train and develop the local employees. Often, they feel their contributions are unrecognised.
There are also often differences between what is seen as good performance in the host country, and what is not acceptable from the parent company country. The ability to undergo and retain knowledge during training of host country employees is often at a lower level than expatriates expect.
BHP Billiton’s human resource planning strategy
To address the issue of local labour requirements, BHP generally starts with expatriate Project manager and Chief Financial Officer. These are both BHP employees. BHP also recruits internally to place many employees on short-term assignments.
After the start up phase, some expatriate BHP employees remain for 2-3 years, or short-term on specific projects for several months. During this time, more locals are employed, especially younger graduates. Also, third-country specialists from the same continent are often employed.
BHP must then decide, on a project by project basis, what proportion of expatriates and local labour will be retained in the long term for the project. Many companies now tend to look internally for their future recruitment need (Luoma 2008), and BHP adopts this approach with it expatriates. However it is still required by local country laws and regulations to continue the traditional need-based strategies of employing outside the organisation.
The issue of culture shock is one that BHP has considered carefully. The failure rate of new-culture adjustment amongst Australians and Americans is fairly high, while among Japanese and Europeans, it is considerably lower. BHP are addressing.
BHP is introducing a global culture within its organisation (BHP 2007). This aims to ensure that globally diverse leaders, even in remote areas of the world, all behave in a manner that models the BHP Billiton Charter, and encompasses the BHP business strategy.
BHP also addresses the issue of its international managers operating in a cross-cultural environment. BHP is increasing training specific to the legal and financial systems, but is also increasing training in cultural issues, and language training, prior to and during the assignments.
The issue of training and evaluation across different cultures is being addressed by BHP in its first standard of human resource strategy: the development of a corporate culture within which all employees are expected to perform. The systems, procedures and behaviours of the corporation are expected to transcend the different national and ethical cultures, so that, in the long term, all employees are on an equal basis.
The key stakeholders in BHP’s human resource management and planning strategy are its employees (BHP 2007)
Though QANTAS is an international company operating in many countries around the world, 90% of its staff are based in Australia. For this reason, many of its issues are based around workplace conditions and practices in Australia. However, the issues are in line with the issues faced by many of the world’s leading airlines.
Key human resource planning issues
Qantas (2011) identifies its four main issues in human resource planning as: flexibility and adaptability in the workforce; developing management and leadership capabilities; improving productivity and labour unit costs; and developing a safer workplace. In this respect, it is looking internally for its future human resource needs.
A flexible workforce
Qantas have identified flexibility in the workforce as its top priority for human resource planning. The frontline of the QANTAS organisation is its cabin crews, and QANTAS recognises the inherent difficulties they face with irregular sign on and sign off times.
QANTAS also recognise that women, in particular, but all workers in general, have family commitments, and that these irregular hours impact on their life and family responsibilities. There is a need for greater flexibility in this area particularly.
An innovative work flexibility strategy has been implemented. This has caused concerns that productivity may suffer as a result. Also, with the increasing concerns over the airline industry worldwide, and the global financial crisis, QANTAS has recognised that it must improve productivity.
Increasing workplace safety
With the changes to work practices at QANTAS, as well as the ever increasing concerns world wide about safety and terrorism, QANTAS are aware that the future workforce must be trained in different aspects of safety and security.
Recruit internally for future human resource needs
Because of the innovations in QANTAS work culture, and the projections that further innovations will be implemented, QANTA sees that recruiting staff from external sources may not satisfy the requirements of the future QANTAS work place.
QANTAS human resource planning strategy
To provide for a flexible workforce, QANTAS have implemented a strategy coordinated by the Alternative Employment Committee (AEC). The AEC have been successful in providing a significant level of flexibility, particularly for flight crews. Traditionally, these positions were notoriously inflexible (QANTAS 2011).
Cabin Services have been provided with a formal and consistent approach to assessing a crew’s family and life commitments. The AEC has also provided all reasonable requests for flexibility, while continuing to meet the operational requirements of the business.
These innovations have been achieved because of senior managements commitment and drive to balance the crew’s requirements for work and family. QANTAS hope this retention rate will increase in the future.
QANTAS has seen a larger number of women managers accessing flexible working arrangements. This is true particularly in the Short Haul Services, and also shows QANTAS commitment to the advancement of women.
This strategy has proven to be successful, and is an innovative response to working above and beyond the workplace limitations to provide more opportunities for all staff, particularly women.
To address the issues of productivity, workplace safety and internal recruitment , QANTAS have become innovators world wide in training delivery.
Qantas College Online use a refined web-based system to provide training for over 30,000 staff worldwide (QANTAS 2011). They also provide training to the travel industry. Teaching approaches include business or workplace simulations, interactive course material and information support. The learner has access to a library of resources and communication facilities. Tutorial support is provided by tutors. Although blended approaches are used, predominantly courses are online.
QANTAS human resource strategy and the role of learning and development have changed deeply. They now emphasise internal consultancy to QANTAS business units.
All the organisations studied above have problems that are increasingly common in the workforce today. While they all plan for the future to predetermine how many employees they will need, all face a scarcity of talent (Stone 2009). All are planning for the long-term, rather than the short-term.
All the organisations look at the environmental factors when planning their long-term human resource requirements, including economic, social, demographic and technological factors. They all seek recruitment both internally and externally, and all recognise the need for changing work practices.
While not cited in the main body of the text, this report has also utilised the knowledge contained in two websites (DEEWR 2011) and (SSA 2001).
BHP Billiton. (2007).Human Resources Strategy and Standards.
Department of Education, Employment and Workplace Relations (DEEWR). (2011). SkillsInfo. Retrieved from http://www.skillsinfo.gov.au/
Health Workforce Australia (HWA). (2011). Australia’s Health Workforce Online. Retrieved from http://www.ahwo.gov.au/
Luoma, M. (2008) Investigating the link between strategy and HRD. Personnel Review, vol. 29, no. 6, pp. 769–790.
National Health Workforce Taskforce. (2009). Health Workforce in Australia and Factors for Current Shortages
QANTAS. (2011). Retrieved from http://www.careers.qantas.com.au
State Services Authority of Victoria (SSA). (2011). Workforce Planning. Retrieved from http://www.ssa.vic.gov.au/CA2571410025903D/0/2DEB92F64DB13F88CA2571AF008335DC?OpenDocument
Stone, R. (2009). Human resource planning. Human Resource Management, 6th ed., Wiley, Australia, pp.53-84
Werner, J. & DeSimone, R. (2009). Human Resource Development, 5th edition, Thomson South-Western, Ohio.