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COMMENTARY: PUBLIC HEALTH TRAINING IN AUSTRALIA

COMMENTARY: PUBLIC HEALTH TRAINING IN AUSTRALIA COMMUNITY HE.4 LTH STUDIES, VOLUME XII. NUiMBER 4. 1988 R.M. Douglas Facu1t.r. of Medicine. University of Adelaide. SO00 stage weak in social science, health economics, Public Health in Australia is currently enjoying a demography and the more traditional public health renaissance. The breakthrough came in 1986 with subjects such as toxicology, disease surveillance and The Better Health (Commission and Kerr White the investigation of infectious diseases. Aboriginal Reports, both supported by a sympathetic Federal and international health were also identified as Minister. In 1988 there has been The Australian lacking substantive development and there was felt Health Ministers‘ Advisory Council support for the to be inadequate coordination between report of its Targets and Implementation postgraduate public health developments within Committee and at the same time the Kerr White the States. Initiatives are beginning to flower. New money is Staffing of the new programmes was also becoming available to explore some of the black identified as a problem. The rapid expansion in holes we have been ccmplaining about for years, and courses has strained the limited supply of trained now posts are opening up in the Government health teachers. They are the same group who have been services. stretched in the research expansion and who are Ten years ago, there was only one Australian being called upon to participate in the burgeoning postgraduate training institution for those who public health committee structure. There was felt to aspire to a career in Public Health. Now there are be an urgent need to expand the pool of teachers eleven institutions which offer postgraduate degrees and leaders. in Public or Community Health and there are more Gifford’s report was considered by a two day in the pipeline. workshop at Leura, NSW convened by the Steering Some are asking whether we have overshot the Committee in July 1988. The 40 participants mark in respect to training. Can we really support included representatives from most of the tertiary high quality training at all of the tertiary institutions institutions which are involved in public health which are now offerirg it? Will the Australian health teaching, as well as senior health administrative staff system be able to absorb and benefit from the who are likely to be future employers of the growing army of trairlees?(In 1988,237 new students graduates of these programs. They generally entered these courses, a doubling of the number endorsed Gifford’s assessment of the current accepted in 1987.) situation and developed a consensus statement The Council of PHA, with Dr Blewett’s about future needs and developments. encouragement, sensibly embarked in 1987 on an attempt to answer some of these questions. A Steering Committee chaired by Jane Hall appointed What the Leura meeting concluded PHA will shortly release its official report which Sandra Gifford from Monash University to incorporates Gifford’s findings and those of the undertake a study of the emerging developments in Leura meeting. The full report deserves careful study training. Data were collected between October 1987 by those interested or involved in Public Health and January 1988, and a comprehensive report was training. rapidly assembled. Gifford found that at least one postgraduate The Workshop prepared a number of recommendations for PHA and for other bodies course now exists in every State; that all but one including the NH&MRC, Department of course is open to both non-medically qualified and Education. Employment and Training, and the medically qualified persons (60% of current students Commonwealth Department of Community are medically qualified); that the majority of current Services and Health. It recognized the need for a students are employed in the health care system at regular national forum of educators and training least half the time, and that 43 per cent are female. The Gifford Repctrf compared course offerings institutions to discuss among other things specialization within public health between around the country and suggested that while most institutions and special needs of overseas students. It courses are paying attention to epidemiology, biostatistics and computing, a number are at this also saw the need for special organizational and DOUGLAS 46 1 (‘OM M Uk‘lTY HEALTH STUI1II;’S financial arrangements to facilitate public health Australia with regular updates; that it should act asa training for students in remote locations; the need clearing house for programs or schools to share for professional development of the public health information about their range of courses, course workforce and for continuing education in this area. content and structure, teaching methods, staff It suggested that it is time for a working party to set profiles and related issues; that it should produce criteria for evaluation of the training programs regular reports on current developments in post- funded by Commonwealth funds which are due for graduate education; should create ajob employment review in 1990. It reiterated the need for a serious register; continue to monitor student intake by effort at public health workforce planning for the biannual or triannual surveys of training to current coming decades. and potential employers; and seek funding to carry The Workshop recognized that in the broad out in cooperation with other bodies a study of sweep of public health training, Masters courses are public health workforce issues and requirements in just one subset. They cannot be all things to all Australia. people and instead must be understood as providing It was felt that public health graduates may be a special training program for public health employed in a wide range of fields in the Public professionals and those who wish to apply the Service, academic and research institutions, the perspectives of public health to their work. private sector and other organizations. The core skills required in public health are It was recognized that several institutions have identified in the report and it was felt that Masters experienced difficulty in recruiting appropriately graduates should be able to: skilled staff and existing faculty are finding difficulty plan and implement small research projects in maintaining their research and service workloads. under supervision; At this time however, it was not felt possible to gather, analyse and synthesize the necessary data answer the question whether we have too many to describe the state of health of a defined training programs until further workforce needs and population including the critical evaluation and projections have been undertaken. synthesis of information from published studies on health problems; The role of the National Centre demonstrate a working knowledge of diseases of Kerr White recommended the development of a major public health importance including and National Centre for Epidemiology and Population understanding the definition of health problems Health to be based at ANU in Canberra. He saw the (diseases) is itself a social process; need for a national focal point which could train analyse the social, behavioural, cultural, leaders of the future public health network and political, economic and institutional context of complement the activities of the smaller centres. The the health problems of the population and Centre has been slow to begin. It expects to develop intervene effectively either alone or in strength in health economics, epidemiology, collaboration - in this context, employing sociology, health demography and statistics. It will appropriate managerial and team skills; work closely with the Australian Institute of Health make provisional assessments of threats to health and will be able to draw on strengths already present arising from the physical environment, at the John Curtin School and the Research School communicable disease, and be able to obtain of Social Sciences at ANU. further help in their assessment and It will not provide course-work degrees, but will management; offer research Masters and Doctoral degrees. It will design, implement and evaluate a small public probably also offer summer schools and workshops health program for a defined community, in areas which are under-resourced in the peripheral informed by a sense of what has proved effective schools. Its research program will be related to in past experience; national health targets. The Centre is likely to be demonstrate an understanding of the fully staffed by mid-1989. organization of health services adequate for operating effectively within them; Conclusion work with communities, governments and non- These are exciting times for academic public governmental agencies to set priorities for action health. It is important that in this phase of rapid based on awareness of competing needs and development, we demonstrate our utility as well as current policies; our rigour. Academia and health generally are going communicate effectively public health matters in through tough times. Many of our colleagues in both oral and written form. areas are watching our performance with some For PHA. the Workshop recommended that it scepticism and not a little envy. It is important that should publish a Guide to Public Health Training in we do not stretch ourselves too thin. Professor Douglas is now Director of the newly established National Centre for Epidemiology and Population Health. DOUGLAS 462 COMMI/"IT k' HEA LTH STUDIES http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Australian and New Zealand Journal of Public Health Wiley

COMMENTARY: PUBLIC HEALTH TRAINING IN AUSTRALIA

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Publisher
Wiley
Copyright
"Copyright © 1988 Wiley Subscription Services, Inc., A Wiley Company"
ISSN
1326-0200
eISSN
1753-6405
DOI
10.1111/j.1753-6405.1988.tb00613.x
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Abstract

COMMUNITY HE.4 LTH STUDIES, VOLUME XII. NUiMBER 4. 1988 R.M. Douglas Facu1t.r. of Medicine. University of Adelaide. SO00 stage weak in social science, health economics, Public Health in Australia is currently enjoying a demography and the more traditional public health renaissance. The breakthrough came in 1986 with subjects such as toxicology, disease surveillance and The Better Health (Commission and Kerr White the investigation of infectious diseases. Aboriginal Reports, both supported by a sympathetic Federal and international health were also identified as Minister. In 1988 there has been The Australian lacking substantive development and there was felt Health Ministers‘ Advisory Council support for the to be inadequate coordination between report of its Targets and Implementation postgraduate public health developments within Committee and at the same time the Kerr White the States. Initiatives are beginning to flower. New money is Staffing of the new programmes was also becoming available to explore some of the black identified as a problem. The rapid expansion in holes we have been ccmplaining about for years, and courses has strained the limited supply of trained now posts are opening up in the Government health teachers. They are the same group who have been services. stretched in the research expansion and who are Ten years ago, there was only one Australian being called upon to participate in the burgeoning postgraduate training institution for those who public health committee structure. There was felt to aspire to a career in Public Health. Now there are be an urgent need to expand the pool of teachers eleven institutions which offer postgraduate degrees and leaders. in Public or Community Health and there are more Gifford’s report was considered by a two day in the pipeline. workshop at Leura, NSW convened by the Steering Some are asking whether we have overshot the Committee in July 1988. The 40 participants mark in respect to training. Can we really support included representatives from most of the tertiary high quality training at all of the tertiary institutions institutions which are involved in public health which are now offerirg it? Will the Australian health teaching, as well as senior health administrative staff system be able to absorb and benefit from the who are likely to be future employers of the growing army of trairlees?(In 1988,237 new students graduates of these programs. They generally entered these courses, a doubling of the number endorsed Gifford’s assessment of the current accepted in 1987.) situation and developed a consensus statement The Council of PHA, with Dr Blewett’s about future needs and developments. encouragement, sensibly embarked in 1987 on an attempt to answer some of these questions. A Steering Committee chaired by Jane Hall appointed What the Leura meeting concluded PHA will shortly release its official report which Sandra Gifford from Monash University to incorporates Gifford’s findings and those of the undertake a study of the emerging developments in Leura meeting. The full report deserves careful study training. Data were collected between October 1987 by those interested or involved in Public Health and January 1988, and a comprehensive report was training. rapidly assembled. Gifford found that at least one postgraduate The Workshop prepared a number of recommendations for PHA and for other bodies course now exists in every State; that all but one including the NH&MRC, Department of course is open to both non-medically qualified and Education. Employment and Training, and the medically qualified persons (60% of current students Commonwealth Department of Community are medically qualified); that the majority of current Services and Health. It recognized the need for a students are employed in the health care system at regular national forum of educators and training least half the time, and that 43 per cent are female. The Gifford Repctrf compared course offerings institutions to discuss among other things specialization within public health between around the country and suggested that while most institutions and special needs of overseas students. It courses are paying attention to epidemiology, biostatistics and computing, a number are at this also saw the need for special organizational and DOUGLAS 46 1 (‘OM M Uk‘lTY HEALTH STUI1II;’S financial arrangements to facilitate public health Australia with regular updates; that it should act asa training for students in remote locations; the need clearing house for programs or schools to share for professional development of the public health information about their range of courses, course workforce and for continuing education in this area. content and structure, teaching methods, staff It suggested that it is time for a working party to set profiles and related issues; that it should produce criteria for evaluation of the training programs regular reports on current developments in post- funded by Commonwealth funds which are due for graduate education; should create ajob employment review in 1990. It reiterated the need for a serious register; continue to monitor student intake by effort at public health workforce planning for the biannual or triannual surveys of training to current coming decades. and potential employers; and seek funding to carry The Workshop recognized that in the broad out in cooperation with other bodies a study of sweep of public health training, Masters courses are public health workforce issues and requirements in just one subset. They cannot be all things to all Australia. people and instead must be understood as providing It was felt that public health graduates may be a special training program for public health employed in a wide range of fields in the Public professionals and those who wish to apply the Service, academic and research institutions, the perspectives of public health to their work. private sector and other organizations. The core skills required in public health are It was recognized that several institutions have identified in the report and it was felt that Masters experienced difficulty in recruiting appropriately graduates should be able to: skilled staff and existing faculty are finding difficulty plan and implement small research projects in maintaining their research and service workloads. under supervision; At this time however, it was not felt possible to gather, analyse and synthesize the necessary data answer the question whether we have too many to describe the state of health of a defined training programs until further workforce needs and population including the critical evaluation and projections have been undertaken. synthesis of information from published studies on health problems; The role of the National Centre demonstrate a working knowledge of diseases of Kerr White recommended the development of a major public health importance including and National Centre for Epidemiology and Population understanding the definition of health problems Health to be based at ANU in Canberra. He saw the (diseases) is itself a social process; need for a national focal point which could train analyse the social, behavioural, cultural, leaders of the future public health network and political, economic and institutional context of complement the activities of the smaller centres. The the health problems of the population and Centre has been slow to begin. It expects to develop intervene effectively either alone or in strength in health economics, epidemiology, collaboration - in this context, employing sociology, health demography and statistics. It will appropriate managerial and team skills; work closely with the Australian Institute of Health make provisional assessments of threats to health and will be able to draw on strengths already present arising from the physical environment, at the John Curtin School and the Research School communicable disease, and be able to obtain of Social Sciences at ANU. further help in their assessment and It will not provide course-work degrees, but will management; offer research Masters and Doctoral degrees. It will design, implement and evaluate a small public probably also offer summer schools and workshops health program for a defined community, in areas which are under-resourced in the peripheral informed by a sense of what has proved effective schools. Its research program will be related to in past experience; national health targets. The Centre is likely to be demonstrate an understanding of the fully staffed by mid-1989. organization of health services adequate for operating effectively within them; Conclusion work with communities, governments and non- These are exciting times for academic public governmental agencies to set priorities for action health. It is important that in this phase of rapid based on awareness of competing needs and development, we demonstrate our utility as well as current policies; our rigour. Academia and health generally are going communicate effectively public health matters in through tough times. Many of our colleagues in both oral and written form. areas are watching our performance with some For PHA. the Workshop recommended that it scepticism and not a little envy. It is important that should publish a Guide to Public Health Training in we do not stretch ourselves too thin. Professor Douglas is now Director of the newly established National Centre for Epidemiology and Population Health. DOUGLAS 462 COMMI/"IT k' HEA LTH STUDIES

Journal

Australian and New Zealand Journal of Public Health – Wiley

Published: Dec 1, 1988

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