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Aboriginal and Torres Strait Islander Health Workers

Overview

This page provides information and data on the Aboriginal and Torres Strait Islander Health Worker workforce.

Aboriginal and Torres Strait Islander Health Workers and Practitioners play a significant role in meeting the health needs of Aboriginal and Torres Strait Islander communities. The roles that they perform vary and are dependent on the needs of the community they serve, and they often work in collaboration with a range of clinical health practitioners, allied health practitioners and many other types of workers across the health sector to ensure the needs of individuals are adequately met.

There is no new Training Package development work proposed for 2019–2020, as identified skills needs and challenges are being addressed through the current Training Package development project which involves the update of seven qualifications, 78 units of competency and 18 skill sets.

The Aboriginal and Torres Strait Islander Health Worker Industry Reference Committee (IRC) is responsible for seven qualifications, packaged in the HLT – Health Training Package.

Information sourced from the most recently available Skills Forecast, the Aboriginal and Torres Strait Islander Health Worker IRC’s 2019 Skills Forecast.

For information on other health-related training and employment, visit the Health industry page and the various sectors.

All data sources are available at the end of the page.

IRC and skills forecasts

The Aboriginal and Torres Strait Islander Health Worker Industry Reference Committee (IRC) was not required to submit an annual update to their 2019 Skills Forecast during 2020. As such, the version published in 2019 remains the most recently published Skills Forecast for this industry.

Employment trends

Please note: any employment projections outlined below were calculated by the Australian Bureau of Statistics prior to COVID-19.

Employment snapshot

In 2020, there are approximately 1,700 Aboriginal and Torres Strait Islander Health Workers. This number is projected to decline to 1,300 by 2024.

Training trends

Training snapshot

Program enrolments in Aboriginal and Torres Strait Islander Health Worker-related qualifications have increased each year between 2015 and 2018, but declined in 2019 to approximately 1,960 enrolments. Program completions rose between 2015 and 2016, remained largely stable to 2018 before declining slightly in 2019 to about 320 program completions. Approximately 61% of enrolments were at the certificate IV level. The intended occupation for all training was Aboriginal and Torres Strait Islander Health Worker.

Just under half (49%) of training was provided by TAFE institutes and 44% by private training providers. The majority of training (86%) was government funded.

Queensland had the single highest proportion of students enrolled in Aboriginal and Torres Strait Islander Health Worker-related qualifications in 2019, with 30%, followed by New South Wales with 25% and Western Australia with 16%.

Approximately 31% of training was delivered in Queensland, followed by 25% in New South Wales and 15% in Western Australia.

There were insufficient enrolments in apprenticeships or traineeships to allow analysis.

For more data specific to your occupation, industry or training package, please visit NCVER’s VET Students by Industry. If you are prompted to log in, please select cancel and you will continue to be directed to the program.

For more data specific to your region please visit NCVER’s Atlas of Total VET.

If you are interested in extracting NCVER data to construct tables with data relevant to you, please sign up for a VOCSTATS account.

Industry insights

Industry insights on skills needs

The Aboriginal and Torres Strait Islander Health Worker IRC's 2019 Skills Forecast identified the top priority skills for the sector as teamwork and communication, problem solving, resilience, stress tolerance and flexibility, technical / job specific skills and self-management.

The top five identified generic skills are:

  • Language, Literacy and Numeracy (LLN) (Foundation skills)
  • Science, Technology, Engineering, Mathematics (STEM) skills
  • Communication / Virtual collaboration / Social intelligence
  • Learning agility / Information literacy / Intellectual autonomy and self-management (adaptability)
  • Managerial / Leadership.

According to the job vacancy data, the top requested attributes and skills by employers in the sector were Aboriginal and/or Torres Strait Islander Descent and communication skills. The most advertised occupations were Aboriginal Health Worker, followed by Aboriginal Mental Health Worker. The top employers were the New South Wales Government and the Government of Western Australia.

According to the Aboriginal and Torres Strait Islander Health Worker IRC's 2019 Skills Forecast, the health care environment in which Aboriginal and Torres Strait Islander Health Workers work has been experiencing several challenges which are impacting workforce skill requirements and which, in summary, include:

  • A lack of career progression opportunities
  • Government policy and legislation changes
  • Skills and workforce supply shortages and the need to increase the number of entrants to the sector.

The absence of a robust career progression framework for Aboriginal and Torres Strait Islander Health Worker roles is shifting Aboriginal and Torres Strait Islander Health Workers towards job opportunities outside the health sector, where there are perceived greater career progression opportunities. Indeed, wide consultation with Aboriginal and Torres Strait Islander health workforces and other stakeholders, as part a review of Queensland’s Aboriginal and Torres Strait Islander Health Worker Career Structure 2007, found the existing Career Structure no longer achieves its original intent and change is required. The Review’s report identifies seven key themes and finds there is a strong case to develop a new Career Structure that clearly affirms the pivotal role and recognises the unique skills, cultural expertise and community focus, and enables the participation and growth of Aboriginal and Torres Strait Islander health workforces.

Further, the tertiary education system structure is inflexible for Aboriginal and Torres Strait Islander Health Workers to easily transition into formally accredited health professions. For instance, Aboriginal and Torres Strait Islander Health Workers report frustration regarding a lack of Recognition of Prior Learning (RPL), which inhibits qualifying for certain courses or gaining unit exemptions for certain degrees. A lack of professional development incentives is also an issue impeding career progression (and retention) across the sector. Putting in place mechanisms to enable more flexible career pathways for Aboriginal and Torres Strait Islander Health Workers at the tertiary education stage and onwards can create better job prospects and assist with the retention of Aboriginal and Torres Strait Islander Health Workers within the health sector.

The Victorian Government’s Royal Commission into Family Violence, established in 2015, was tasked with a number of responsibilities, including identifying more effective ways to prevent family violence; improving early intervention to identify those at risk, supporting victim-survivors and, better coordinating community and government responses to family violence. Aboriginal and Torres Strait Island peoples, especially women and children are more likely to be affected by family violence and face unique barriers to obtaining help. Aboriginal and Torres Strait Islander Health Workers are in a unique position to identify and respond to family violence. The Commission made a range of recommendations to improve health sector responses, through strengthened screening and risk assessment procedures, greater workforce training and development, and better coordination and information sharing between different parts of the health care system.

Each Australian state and territory has its own legislation regarding working with medication, including administration and management. Workers are bound by this legislation when working in the respective state or territory. There are significant variations between these pieces of legislation that can restrict Aboriginal and Torres Strait Islander Health Practitioners from developing the full scope of practice.

For instance, to qualify for registration as an Aboriginal and Torres Strait Islander Health Practitioner with the Australian Health Practitioner Regulation Agency (AHPRA), a person must complete the qualification HLT40213 - Certificate IV in Aboriginal and/or Torres Strait Islander Primary Health Care Practice, which includes the core unit HLTAHW020 - Administer medications. Due to varying state and territory legislation, this core unit acknowledges that assessment should take place “in the workplace, unless state or territory legislation prevents practice in the workplace”. Where state or territory legislation prevents practice in the workplace, simulated assessment environments may be used in lieu. Due to these varying legislative requirements, not all Aboriginal and Torres Strait Islander Health Practitioners are able to develop the full scope of practice in a workplace setting, and as a result are faced with barriers to registration with AHPRA as well as to employment and service delivery. It is important to establish opportunities in which Aboriginal and Torres Strait Islander Health Worker students/graduates can develop the full scope of their practice in a workplace setting.

The National Disability Insurance Scheme (NDIS) Aboriginal and Torres Strait Islander Engagement Strategy was developed to ensure Aboriginal and Torres Strait Islander communities were at the heart of driving processes and service delivery outcomes that best meet the needs of individuals with a disability, their families and carers. Aboriginal and Torres Strait Islander Health Workers play a significant role in these communities, and the continued roll-out of the NDIS across the country will impact the ways in which workers engage with and support the complex and multi-levelled needs of individuals.

Australia's health care system is facing significant challenges, including an ageing population and health workforce; a growing burden of chronic disease; people experiencing a disability; and an increased demand for health services, particularly for complex and long-term care. To face these challenges, it is especially critical for the Aboriginal and Torres Strait Islander health care workforce to plan both for now and the future. Skills shortages are particularly challenging in regional locations, where the skills and the supply of workers are not meeting current demand. If this shortage continues, further issues across the sector may arise, compromising its ability to support and treat Aboriginal and Torres Strait Islander patients in the community and the ability to maximise patient outcomes. There is a low uptake of vocational and education and training (VET) qualifications in this field which is a contributing factor to the supply shortages across the country.

Using Census data, the journal article A National Profile of Aboriginal and Torres Strait Islander Health Workers, 2006–2016, highlights pressing concerns about the lack of growth and the ageing workforce of Aboriginal and Torres Strait Islander Health Workers. The authors remain concerned that little is being done to increase the recruitment and retention of Aboriginal and Torres Strait Islander Health Workers, and state greater effort is needed, particularly to attract younger age groups and males. As such, the authors argue a National Aboriginal and Torres Strait Islander Health Workforce Strategy needs to be implemented. See also Beyond the Pipeline: a Critique of the Discourse Surrounding the Development of an Indigenous Primary Healthcare Workforce in Australia which examines what happens outside of ‘supply’ measures to develop the Indigenous health workforce.

COVID-19 impact

The following consider the impact of COVID-19 on Aboriginal and Torres Strait Islander health workforce. Information may also be available from the Australian Government Department of Health and the Australian Heath Practitioner Regulation Agency

COVID-19: Resources for Aboriginal and Torres Strait Islander Health Professionals published by the National Association of Aboriginal and Torres Strait Islander Health Workers and Practitioners, provides a guide to being prepared, looking after oneself, and resources for helping keep communities safe. COVID-19 Updates are also available.

In considering public policy perspectives in response to the COVID-19 crisis on Indigenous Australians, the Centre for Aboriginal Economic Policy and Research (CAEPR) reflects on the Indigenous health workforce (see pages 18-20). It states that during pandemics Aboriginal and Torres Strait Islander people in the health workforce play a vital role in addressing the significant risks to Indigenous communities. They ameliorate risks, reduce impacts and improve health outcomes by providing culturally relevant information and culturally safe forms of care. The number of Indigenous health professionals are increasing, but too slowly. CAEPR concludes important lessons will emerge in addressing the impacts of COVID-19 for supporting and growing this crucial workforce in the future.

Over 30 Indigenous leaders in mental health and wellbeing contributed to A National COVID-19 Pandemic Issues Paper on Mental Health and Wellbeing For Aboriginal & Torres Strait Islander Peoples. This Report calls for a coordinated response based on best practice research in Indigenous mental health and wellbeing. Indigenous governance must be prioritised to manage the COVID-19 recovery in communities through equitable, needs-based funding to support strengths-based, place-based, Indigenous-led, and community-led initiatives that address the social and cultural determinants of health and wellbeing.

Links and resources

Below is a list of industry-relevant research, organisations and associations. Hyperlinks have been included where available.

 

Relevant research

Aboriginal and Torres Strait Islander Health Worker Career Structure Review: final report – Queensland Health

A National Profile of Aboriginal and Torres Strait Islander Health Workers, 2006–2016 – Alyson Wright, Karl Briscoe and Ray Lovett

A National COVID-19 Pandemic Issues Paper on Mental Health and Wellbeing for Aboriginal & Torres Strait Islander Peoples – P Dudgeon, K Derry and M Wright

Beyond the Pipeline: a Critique of the Discourse Surrounding the Development of an Indigenous Primary Healthcare Workforce in Australia – Chelsea Bond, Mark Brough, Jon Willis, Janet Stajic, Bryan Mukandi, Condy Canuto, Shannon Springer, Deborah Askew, Lynnell Angus and Tara Lewis

COVID-19: Resources for Aboriginal and Torres Strait Islander Health Professionals - National Association of Aboriginal and Torres Strait Islander Health Workers and Practitioners

Indigenous Australians and the COVID-19 Crisis: Perspectives on Public Policy – F Markham, D Smith and F Morphy

 

Government departments and agencies

ACT Health

Australian Government Department of Health

Northern Territory Government Department of Health

NSW Health

Queensland Health

SA Health

Tasmanian Government Department of Health

Victoria Government Department of Health and Human Services

Western Australia Government Department of Health

 

Peak and industry associations

Aboriginal Health & Medical Research Council of New South Wales (AH&MRC)

Aboriginal Health Council of South Australia (AHCSA)

Aboriginal Health Council of Western Australia (AHCWA)

Aboriginal Medical Services Alliance Northern Territory (AMSANT)

National Aboriginal Community Controlled Health Organisation (NACCHO)

Queensland Aboriginal and Islander Health Council (QAIHC)

Royal Australian College of General Practitioners (RACGP)

Tasmanian Aboriginal Corporation trading as Tasmanian Aboriginal Centre (TAC)

Victorian Aboriginal Community Controlled Health Organisation (VACCHO)

 

Health professionals’ organisations

National Aboriginal and Torres Strait Islander Health Worker Association (NATSIHWA)

 

Employee associations

Australian Nursing and Midwifery Federation (ANMF)

Health Services Union (HSU)

United Workers Union

 

Regulators

Aboriginal and Torres Strait Islander Health Practice Board of Australia

Data sources and notes

Department of Employment 2020, Employment Projections, available from the Labour Market Information Portal

  • by ANZSCO, selected occupations, employment projections to May 2024
    • 4115 Indigenous Health Workers.

Australian Bureau of Statistics 2020, Employed persons by occupation unit group of main job (ANZSCO), Sex, State and Territory, August 1986 onwards 6291.0.55.003 - EQ08, viewed 1 August 2020 https://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/6291.0.55.003May%202020?OpenDocument

  • Employed total by ANZSCO 4 digit occupations, 2000 to 2020, May quarter
    • 4115 Indigenous Health Workers.

Training data has been extracted from the National VET Provider Collection, Total VET Students and Courses from the following training package or qualifications:

  • HLT – Health Training Package
    • HLT20113 - Certificate II in Aboriginal and/or Torres Strait Islander Primary Health Care
    • HLT21307 - Certificate II in Aboriginal and/or Torres Strait Islander Primary Health Care
    • HLT21312 - Certificate II in Aboriginal and-or Torres Strait Islander Primary Health Care
    • HLT30113 - Certificate III in Aboriginal and/or Torres Strait Islander Primary Health Care
    • HLT33207 - Certificate III in Aboriginal and/or Torres Strait Islander Primary Health Care
    • HLT33212 - Certificate III in Aboriginal and-or Torres Strait Islander Primary Health Care
    • HLT36115 - Certificate III in Indigenous Environmental Health
    • HLT40113 - Certificate IV in Aboriginal and/or Torres Strait Islander Primary Health Care
    • HLT40213 - Certificate IV in Aboriginal and/or Torres Strait Islander Primary Health Care Practice
    • HLT43907 - Certificate IV in Aboriginal and/or Torres Strait Islander Primary Health Care (Practice)
    • HLT44007 - Certificate IV in Aboriginal and/or Torres Strait Islander Primary Health (Community Care)
    • HLT50113 - Diploma of Aboriginal and/or Torres Strait Islander Primary Health Care
    • HLT50213 - Diploma of Aboriginal and/or Torres Strait Islander Primary Health Care Practice
    • HLT52107 - Diploma of Aboriginal and/or Torres Strait Islander Primary Health Care (Practice)
    • HLT52207 - Diploma of Aboriginal and/or Torres Strait Islander Primary Health (Community Care).

This includes superseded qualifications and training packages.

Data covers a range of selected student and training characteristics in the following categories and years:

  • 2015 to 2019 program enrolments
  • 2015 to 2019 program completions.

Total VET students and courses data is reported for the calendar year. Program enrolments are the qualifications, courses and skill-sets in which students are enrolled in a given period. For students enrolled in multiple programs, all programs are counted. Program completion indicates that a student has completed a structured and integrated program of education or training. Location data uses student residence. Subject enrolment is registration of a student at a training delivery location for the purpose of undertaking a module, unit of competency or subject. For more information on the terms and definitions, please refer to the Total VET students and courses: terms and definitions document.

Low counts (less than 5) are not reported to protect client confidentiality.

Percentages are rounded to one decimal place. This can lead to situations where the total sum of proportions in a chart may not add up to exactly 100%.

HLT – Health Training Package apprentice and trainee data has been extracted from the National Apprentice and Trainee Collection, including:

  • 2010 to 2019 commencements
  • 2010 to 2019 completions
  • 2019 apprentices and trainees in-training October to December 2019 collection, by qualification and state and territory of data submitter.

Priority skills data have been extracted from the Aboriginal and Torres Strait Islander Health Worker IRC’s 2019 Skills Forecast.

Job vacancy data have been extracted from Burning Glass Technologies 2020, Labor Insight Real-time Labor Market Information Tool, Burning Glass Technologies, Boston, viewed July 2020, https://www.burning-glass.com.

Data shown represent most requested generic skills, occupations and employers according to internet job postings in Australia between July 2017 and June 2020 filtered by ANZSIC and ANZSCO classification levels listed below.

ANZSCO occupations have been used as industry filters because they provide more relevant job vacancy data for this sector.

  • Generic skills / Occupations / Employers
    • 4115 Indigenous Health Workers.
Updated: 25 Nov 2020
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