The keynote speaker, Mr David Fillingham (Chief Executive Officer, National Health Service [NHS] Modernisation Agency), identified some healthcare challenges.2 These are not unique to the United Kingdom, and include:

• the ageing population;

• the burden of chronic disease;

• the emergence of information and communications technology supporting new forms of care delivery;

• the shift in emphasis from services centred on the healthcare professional to patient-centred services;

• technological advances in healthcare that are prompting changes in the demand for services (eg, increased interest in health and access to health-related information through online services are driving consumers’ expectations of quality and choice, and creating more discerning and demanding patients); and

• issues in relation to education, training, regulation, accreditation, and pay and reward.

Clearly demonstrating the commitment to workforce development and reform in the UK, he discussed the ambitious 10-year program that is underway to transform the NHS.2 This includes establishing the NHS Modernisation Agency, which has been set up to promote improvement within the UK health system, and the funding of a major “Changing Workforce Programme” in 2000.

This conference challenged participants to move away from traditional ways of doing things and to “open their minds and hearts” to different agendas.

Training and education were key discussion points by several speakers. Di Lawson (Chief Executive Officer, Community Services and Health Training Australia) spoke about “Changing work roles in the health services industry” and the effect this would have on the workforce of the future. She discussed the vocational education and training (VET) sector, which provides education and training for work, and ways to develop and recognise the competencies and skills of learners.

Work is under way in the VET sector to develop better training programs for a variety of health technicians and support workers. She highlighted that it is easy to forget that the work of high-performance healthcare professionals depends on the knowledge and skills of many others in the organisation. Although the health technicians workforce (numbering about 10 000) is a small proportion of the overall vocational workforce in health (about 150 000), it makes a vital contribution to service delivery.

Ms Lawson highlighted the constraints on modern healthcare (such as population factors, government policy, quality and safety of services, funding, workplace culture, productivity and staff retention), and challenged participants to consider the three noticeable trends that are emerging in the workforce (across the board, not just in health):

• People are moving very strongly towards work–life balance models.

• People are motivated by a complex structure of rewards that are heavily supported by non-financial benefits.

• People will move quickly if their expectations are not met.

These contributions were reinforced by Dr Michael Walsh (Chief Executive Officer, Bayside Health, Victoria), who also stressed that health is facing significant workforce challenges in the near future (Box).

The broadcaster Julie McCrossin, who has had a longstanding interest in consumer issues in health, highlighted that benefits will occur if healthcare professionals join with consumers in addressing the many and varied challenges in healthcare.

A review of Westpac’s workforce demonstrated a mismatch between its workforce and customer base. Eighty per cent of the future workforce growth will be in age groups 45 and over. Barnier pointed out that the current workforce age profile in banking does not match current Australian labour force projections3 (more than 36% of Westpac staff are aged between 26 and 35 years, whereas the current Australian labour force has only 23% in that age group and the number is declining). Nor do the projections match Westpac’s customer base (39% of its customers are aged 45 years or more, whereas 20% of employees match that age profile). Furthermore, Westpac research shows that older customers prefer to deal with more experienced staff, especially when discussing certain banking issues, such as superannuation and investment strategies. The bank is now actively recruiting older workers.

All the evidence internationally and in Australia4 suggests that many of the myths about older workers are wrong. Mature aged workers have

• a stronger work ethic;

• higher productivity or work quality;

• lower absenteeism due to sickness;

• better corporate knowledge; and

• an ability to learn new skills.

Westpac is also focusing on making itself more competitive in recruitment. All indications suggest that it is increasingly becoming a sellers market for skilled labour, whether in banking or health.

Westpac research shows that we already have a multigenerational workforce:

• Matures/veterans (aged 55–70);

• Baby Boomers (aged 38–54);

• Generation X (aged 23–37); and

• Generation Y (born after 1980).

Each generation has different drivers that will attract and retain them in the workforce.

Barnier questioned whether the healthcare sector faced similar issues with their workforce planning, recruitment and retention. The consensus was that it did. In coming years, the source of new recruits will change significantly for both industry sectors (banking and healthcare), effectively putting them in direct competition in the “war” for talent.

In addition to the banking industry, the conference turned to the airline industry as a model for lessons in safety and quality.

Both Dr Darryl Mackender (Gastroenterologist, Erromed, Brisbane — Human Factors in Health Training) and Professor Cliff Hughes (Cardiothoracic Surgeon, Royal North Shore Hospital, and Council Member, Safe Staffing Taskforce, Australian Council for Safety and Quality in Healthcare) highlighted the importance of communication skills and teamwork. They drew from the experiences of the aviation industry and its shake-up in the 1960s after some tragic accident statistics prompted the industry to look at staffing, work practices, rostering and how technology might be able to assist in reducing fatalities, and the reporting and investigation of “near misses”. In 1960, there were 45 major accidents per million departures, but by 1993 this figure had been reduced to two major accidents per million departures.5 Eighty per cent of airline accidents were shown to be due to avoidable human factors. Both presenters urged that health systems take note of these lessons and consider how successful approaches in other industries can be used in health. Of special relevance to health is the information about safe working hours and the effect of fatigue on performance.