5. Training and Development / Research

During 1997 - 98 review of the framework for the allocation of the Training and Development Grants has continued. This work is not complete, but significant enhancements to allocation systems have been implemented while others are foreshadowed for 1999 - 2000.

5.1 Medical

In 1997 - 98 the Grant was allocated as a block payment based on pre-existing funding levels to clearly indicate that the Grant should not be seen as a salary payment, but rather as a contribution towards the costs inherent in professional training and development.

In 1998 - 99, 5 per cent of the Grant will be linked to an evaluation of hospital performance in relation to training to ensure that expenditure of the Grant results in training of an acceptable quality. The proportion of the Grant applied to performance will rise in the following year to 10 per cent. Subsequent changes to this proportion will be dependent on a review of performance criteria and compliance by hospitals.

Performance Criteria for Eligibility for the 5 per cent payment include:

• ITAC accreditation for all subsidised intern positions;
• College accreditation for specialist training positions;
• Certification of candidate training plans available on an annual basis;
• Documented rural training agreements for rural rotations;
• An annual report from supervisors to provide details of the program, achievements and plans for the forthcoming year; and
• An evaluation tool administered for all positions attracting the Grant providing information on quality and comprehensiveness of training experience.

In March of each year, hospitals will be surveyed to record the number and variety of training positions to enable the Department of Human Services to maintain an overall picture of the training component of the medical workforce.

The 1998 survey has quantified the disparity between funded and actual positions. In light of the pending implementation of recommendations by the Commonwealth's Medical Training Review Panel, and consolidation of service changes at metropolitan networks changes, no changes are proposed for funding levels in 1998 - 99. It is anticipated that during 1998 - 99 the Department will undertake further analysis and benchmarking. Further the March 1999 survey and pending recommendations of the Australian Medical Workforce Advisory Committee (AMWAC) will inform possible reallocations in 1999 - 2000.

In 1998 - 99 the medical component of the Training and Development Grant has been reduced by $16.5 million equivalent to the amount of funding provided for medical officers only on the basis that they are full-time employees. This component of the Training and Development Grants does not relate to teaching and training but is a vestigial element of the original Training and Development Grant pool which included input funding as a surrogate for complexity. As the AN-DRG system and cost weight data have become more sophisticated, the Training and Development Grant pool has been progressively reshaped. This component of funding has been absorbed into the WIES funding pool and reduces the productivity saving requirement on WIES price.

5.2 Nursing

1997 - 98 saw the introduction of funding allocations for continuing nursing education programs. Networks and hospitals were asked to submit detailed business plans and subsequently $1.7 million has been allocated. This initiative will continue and it is anticipated that this pool of funds will increase to $4 million in 1998 - 99. A similar process to that employed in 1997 - 98 will inform allocations, however it is intended that clearer guidelines will be provided to assist with the preparation of program proposals.

Modifications to the funding levels paid per nurse were implemented in 1997 - 98 and a rural supplement of $250 was introduced for nurses undertaking post-graduate nursing courses requiring metropolitan clinical placements. In 1998 - 99 the payment per graduate undertaking a nurse program will decrease further while the amount for nurses undertaking post-graduate nursing courses will increase. The rural supplement will remain the same at $250.

In 1997 - 98, funds were made available to hospitals providing clinical placement of 50 days or more in an academic year to student midwives, who previously had not been funded through the post-graduate payment under the Training and Development Grant. $3000 per student was provided to hospitals. It is anticipated that this will increase in 1998 - 99. It is proposed that over time, parity be sought between this payment for clinical education of student midwives and that paid for student midwives under the post registration training program.

5.3 Allied Health

Initial work on a review of the undergraduate allied health component of the Training and Development Grant has commenced, and it is anticipated that 1998 - 99 will be used to develop an output based formula for allocation on the basis of clinical placement days. Financial modelling and industry consultation will occur prior to changes being implemented.

5.4 Research

The 1998 - 99 Budget included additional funding ($4 million) for medical research. These funds, managed by the Public Health Division, are expected to flow predominantly for increased infrastructure support for medical research institutes, with some funds allocated for specific medical and public health research initiatives.

Hospital funding for research support within the casemix funding model will not change from 1997 - 98. Hospitals should take note of the 1997 Report of the Parliamentary Economic Development Committee Inquiry into Medical and Public Health Research in Victoria and ensure that they fully and transparently account for research support funds.

Capital funding for independent or co-located medical research institutes will continue to be considered on an annual basis as part of the overall capital program.