Letters
Health services administration
Volume 199 - Issue 6

Further erosion of equality and job mobility of Australian junior doctors

Authors:  Dev A S Kevat and Fiona J Lander

Med J Aust 2013; 199 (6): 391. || doi: 10.5694/mja13.10756
Published online: 16 September 2013
Tension between the need for an integrated national health system and the self-interest of states has led to negative consequences, including discrimination against junior doctors.
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To the Editor: Tension between the need for an integrated national health system and the self-interest of states has led to negative consequences, including discrimination against junior doctors. Medical graduates who seek to move states to undertake their internships are considered a second priority by most states. Last month, Western Australia mimicked Victoria’s 2012 changes and now considers most interstate Australian citizen applicants to be “third class” applicants, and will not offer them a job unless all international students from their own state have been offered a job.

We regret to also report the development of new mechanisms to reduce the free choices of graduates, with the Australian Capital Territory now requiring that Priority 1 applicants forgo their chance of employment in other states to retain this priority category for a job in the ACT.1 Such a manifestation of insecurity is understandable — the ACT is a small region, and the much larger New South Wales no longer accepts ACT graduates on equal terms into its health system.2

The ACT’s changes, however, are draconian. As far as we are aware, penalising individuals for applying for other jobs is not the practice of any other public or private sector organisation in Australia. Such a requirement also goes against the spirit of the internship data sharing scheme, in which applicants voluntarily share confidential details of their internship applications in order to help plan and build a more efficient health system.

We fear that the ACT’s changes to intern and other postgraduate jobs will be adopted by larger states, and also by colleges. Already there are anecdotal reports of college selection committees discarding interstate applicants regardless of their merit. Such practices may seem efficient for voluntary committee members tasked with processing many applications, but are unfair, particularly to those applying from states with proportionately less training opportunities. They may also fall foul of Australia’s constitution, which seeks to ensure the equal treatment of citizens regardless of their state of residence.3

While we hope for a health system that treats its workers with the same equality as it aims to show patients, the current trend is unfortunately in the wrong direction.

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