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Australian Journal of Pharmacy : April 2005
perspectives Workforce supply and demand academic perspectives Professor Colin Chapman, Dean, Victorian College of Pharmacy, Monash University T HERE have been many discussions and debates recently about the shortage of pharmacists in Australia—an issue that seems to be diminishing in importance as unforseen events and a rapid increase in the supply of new grad- uates combine to swing the pendulum in the direction of an oversupply and, with it, a different set of issues and problems to address. How quickly things can change! The workforce study that sought to predict supply and demand in the period between 2000 and 2010 concluded that there would be a continuing, even widening, gap between supply and demand—a shortage of several thousand was in prospect! And the major reason was an increased demand associated with a pro- jected increase in the dispensing of pre- scriptions, along with a modest increase in demand associated with an expected increase in the provision of cognitive ser- vices. When the report was released, changes in pharmacy education were already under way—there was a greater intake of students into the established schools of pharmacy and the first of the new schools had opened for business. There are now 17 schools of pharmacy in Australia and New Zealand—a growth of 10 in 10 years. Ironically, an acute shortage of one particular group of phar- macists has been created by this rapid growth. There are nowhere near enough suitably qualified and experienced phar- macists to teach in the schools, such that there are unfilled vacancies in most schools, and there are vacancies for asso- ciate professors and professors in every new school. This situation is of concern to the body that accredits schools of phar- macy in Australia and New Zealand, the Council of Pharmacy Registering Authorities, to the extent that some schools have only been granted short- term accreditation while the staff shortage is addressed. Interestingly, a similar situation is occurring in the United Kingdom where the proliferation of new schools prompted one well-informed writer to the Pharma- ceutical Journal to ask recently: ‘What will be the bust following the boom?’ The number of new graduates pre- dicted in the much-publicised workforce study managed by the Pharmacy Guild of Australia and released about three years ago was expected to be 706 in 2006. The actual number will be approximately 1,100—almost 400 more! And from 2008 the number of graduates could exceed 1,300 a year—an almost three-fold ‘What will be the bust following the boom?’ increase in the annual number of gradu- ates over a 10-year period. Already this massive increase has resulted in an acute shortage of pre-registration places in Aus- tralia and it is conceivable that some grad- uates will be unable to register in the future simply because of an inability to undertake the required period of super- vised training. Other events also have an impact on the supply and demand equation for pharmacists. Most notable of these are: a marked increase in the number of over- seas-trained pharmacists being registered to work in Australia; changes to some aspects of the practice of pharmacy in New Zealand; and the soon-to-be can- celled reciprocity agreements with phar- macy authorities in the United Kingdom and Ireland. The net result is that more pharmacists are coming to Australia to work and more are likely to stay in Aus- tralia after registration. The decision by pharmacists to quit full-time or even part-time practice in the two major sectors of the profession is often raised as a major concern, particularly when there is a shortage. But it is far from clear what proportion cease working in hospital or community pharmacies, what their reasons were, and for how long they are usually absent. The attrition rate of about 5 per cent seems likely—a rate common to most professions in Aus- tralia—although some believe it to be much higher and go so far as to blame the feminisation of the pharmacy profession, the ‘over education’ of recent graduates, and the advent of graduate-entry medical courses for the high rate. There is little or no evidence that any of these factors are increasing the attrition rate over what it has been for many years, but if the rate is higher than acceptable, two immediate solutions come to mind: improve the attractiveness of the work- places in terms of job satisfaction and salaries; and recruit pharmacists back from other careers by offering regular re- entry programs rather than only offering them once a year. No matter how well the supply and demand equation can be balanced there is always likely to be a shortage of phar- macists in some locations and an over- supply in others. Because of the complex- ities associated with attracting profession- als of any type, not just pharmacists, to some rural and remote areas of Australia, it is to be expected that an undersupply will always exist to some extent. Simply increasing the supply side is not going to solve it, nor will the further estab- lishment of schools of pharmacy in large towns and cities outside the major metro- politan areas of Australia. Available evi- dence indicates the new graduates from the current ‘rural’ schools are no more likely to work much beyond where they went to university than graduates from the established ‘urban’ schools. ¦ The opinions expressed in this column are not necessarily those of the AJP’s management or staff THE AUSTRALIAN JOURNAL OF PHARMACY VOL.86 APRIL 2005 ? 235