Here is the fundamental question Australian policymakers should have asked themselves years ago: if we have 121 separate federal health workforce policies, why is Australia facing simultaneous shortages of psychiatrists, aged care workers, emergency nurses, and regional healthcare providers?
The answer is uncomfortable because it suggests the problem is not a lack of policy activity. It is a governance failure so complete that activity itself has become an obstacle to progress. When the Medical Journal of Australia published its analysis of all federal health workforce policy documents in 2025, researchers found something remarkable: a patchwork of 121 separate policies addressing health workforce challenges, with 81% of them structured as time-limited grants or programmes rather than coherent long-term strategy.
Strip away the talking points and what remains is this: Australia is treating health workforce planning as a series of short-term political interventions rather than a systemic, generational challenge. The result is predictable. Australia currently has just 16 psychiatrists for every 100,000 people. With nearly a third of the workforce approaching retirement, the Royal Australian and New Zealand College of Psychiatrists forecasts a 20.7% undersupply of psychiatrists by 2048. In some remote regions, the figure drops to 1.4 psychiatrists per 100,000. Consider this: 93% of Australian psychiatrists say the current workforce crisis is already harming patient care. Over 3 in 10 are planning to leave the profession within the next five years.
The story repeats across aged care and disability services. Australia faces a shortage of at least 110,000 direct aged care workers within the next decade. Annual shortfalls currently run at around 35,000 workers. Over 60% of providers report difficulty filling key roles. The NDIS operates under price caps that constrain how much providers can pay their workers, creating a perverse incentive: keep wages low to stay viable, then watch workers leave for better-paying sectors. Emergency departments, already at record-high waiting times, are losing staff to this same logic.
The counter-argument deserves serious consideration: perhaps the issue is not fragmentation but rather that governments at various levels have been unwilling to invest adequately in the first place. If federal, state and territory governments simply funded health workforce development properly, the argument runs, policy fragmentation would matter less. This position has merit. Australia's health spending as a share of GDP is reasonable, but the distribution of that spending heavily favours acute hospital care over prevention and aged care. The fundamental distribution question is legitimate.
But here is where that argument breaks down: even accepting that investment levels should be higher, the fragmentation itself is now a constraint on effective deployment of available resources. Consider the evidence. When the policy review examined coverage across different health professions, it found 35 separate policies focused on rural health workforce, 22 on aged care, and 19 on Aboriginal and Torres Strait Islander health. It found just three policies focused on pharmacy and one for allied health. This is not accidental. It reflects the fact that separate political constituencies and advocacy groups have successfully lobbied for their own policies, creating an archipelago of initiatives with no connecting strategy.
The Medical Journal study was explicit about what is missing: Australia needs to re-establish a dedicated national body for health workforce planning, similar to the former Health Workforce Australia. Without such a body, governments lack the institutional capacity to see the system as a whole, to forecast demand across all professions simultaneously, and to coordinate investment over the long term. Every government says it believes in health workforce planning. None has committed the governance resources to make it work.
This is not a left-right issue; it is a competence issue. A government of any political stripe that accepted the current state of affairs would be failing in a basic duty. Yet it is easy to understand how this happened. Health workforce policy touches every state and territory, crosses federal-state jurisdictions, involves multiple professional colleges with their own interests, and requires investment that competes against visible, short-term political priorities. It is much easier for a government to announce a new time-limited grant programme (thus claiming credit for policy action) than to commit to a 25-year health workforce strategy that will only bear fruit long after the announcing minister has moved on.
The practical path forward is clear, even if the political will to take it remains uncertain. Australia should establish a statutory national health workforce planning body with sufficient independence to develop multi-decade forecasts for all health professions, not just some. This body should be funded through the normal budget process (not grant cycles) to ensure continuity. Its remit should include all health professions, from psychiatrists to allied health to pharmacy. It should work across federal, state and territory boundaries, and it should have real power to shape training place allocations at universities and training organisations.
Will this happen? History suggests governments will continue to prefer announcements of new initiatives to the harder work of building institutions. But patients in emergency departments waiting hours for care, young people unable to access psychiatric treatment, and aged care residents going without proper supervision should remind us all what the cost of that preference really is.