Diversity in Healthcare Workforce of Australia

This paper discusses the diversity in the healthcare workforce of Australia, the challenges it brings, and recommendations for managing diversity and promoting inclusivity.

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Diversity in Healthcare Workforce of Australia

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Introduction
Australia is considered as the multicultural country, which has approximately 44% of the
population born overseas or have the parents from different country. This also makes the
Australia a culturally and linguistically diverse country. This diversity can also be seen in the
Australian workforce. In the last two decades, the Australian healthcare workforce has
become significantly diverse, due to increasing immigration of nurses and other health
professionals in the country. The diversity of the workforce is increasing with the increasing
diversity of general population that demands culturally safe, appropriate and responsive care.
Therefore, managing the diversity within workforce is significant to deliver high quality care.
However, workforce diversity can also result in increasing many challenges related to
communication, information sharing, language barriers, cultural differences and may also
result in increasing the complexity in team integration and collaborative working. This paper
will discuss that how diversity occurs in a healthcare organisation, what issues can be raised
by workforce diversity, benefits of diversity followed by the recommendations for
maintaining culturally safe and inclusive workforce.
Challenges of Diversity in Healthcare Workforce
The demand of the healthcare professionals, including nurses and other professionals has
significantly increased in Australia.1 The demand of the healthcare workforce is increasing
due to various reasons that include, rapidly ageing population, increasing prevalence of
chronic non-communicable disease and increasing expectations of the consumers from the
healthcare systems. Studies have informed that Australian population would reach to 30.6
million by 2051 and proportion of aging population in Australia would also reach to 29% by
2050.2 Therefore, the main challenge for the healthcare system is to respond to the increasing
demand of the consumers. The diverse workforce may have their own cultural values, belief
and attitude that may affect the delivery of high-quality care to at-risk population.
The first year of the employment can be very difficult for the culturally diverse workforce, as
they may face the problem of cultural shock, difficulty in intercultural communication,
difficulty in conflict resolution and intercultural communication. The situation can be worse
1 Jongen, Crystal, Janya McCalman, and Roxanne Bainbridge, ‘Health workforce cultural competency
interventions: a systematic scoping review’ (2018) 18(1) BMC health services research 232.
2 Freund, Tobias, et al, ‘Skill mix, roles and remuneration in the primary care workforce: who are the healthcare
professionals in the primary care teams across the world?’ (2015) 52(3) International Journal of Nursing
Studies 727-743.

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for the people, who are from non-English speaking background, as it has been identified that
interprofessional communication becomes significantly difficult for them that also affects the
quality of their practice.3 Studies have also identified that migration can be beneficial for the
healthcare systems, as it improved the flow of experience and knowledge across the border
and can significantly contribute towards global development.
However, migration to a culturally and linguistically different country can significantly affect
one’s own capabilities and resilience. For example, a study conducted by Balasubramanian et
al, identified that Australia is one of the most popular country for the migrant dentists and
dentists from120 different countries of the world migrate to Australia. The data have also
informed that every one in four practising dentists in Australia is a migrant from overseas.4
These dentists may have to face many issues in the workplace, such as poor communication
or lack of inter-personal communication, collaborative working and information sharing, due
to cultural and linguistic diversity. However, there is a lack of workforce planning and
migration policies that could promote workforce integration.5
The evidences have also informed that workforce has become highly progressive and global.
Therefore, affect the communication among the workforce within organisation. The process
of communication is influenced by different factors, such as the race, ethnicity, religion and
national background. A study conducted by Hunt in formed that workplace is the most
appropriate site, where the people from diverse background collaborate and convene, which
results in improving the competitive advantage and relevancy of the organisation.6 However,
the cultural difference can result in increasing conflicts and miscommunication that could
affect the productivity of whole organisation.
Addressing Diversity Issues
3 Covell, Christine L., Elena Neiterman, and Ivy Lynn Bourgeault, ‘Scoping review about the professional
integration of internationally educated health professionals’ (2016) 14(1) Human resources for health 38.
4 Balasubramanian, Madhan, et al, ‘The life story experience of" migrant dentists in Australia: Potential
implications for health workforce governance and international cooperation’ (2017) 6(6) International journal
of health policy and management 317.
5 Balasubramanian, Madhan, et al, ‘The ‘global interconnectedness’ of dentist migration: a qualitative study of
the life-stories of international dental graduates in Australia’ (2014) 30(4) Health policy and planning 442-450.
6 Hunt, Vivian, Dennis Layton, and Sara Prince ‘Diversity matters’ (2015) 1 McKinsey & Company 15-29.

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For the managers and organisational leaders, managing the workforce diversity and equality
is the major challenge.7 Diversity management is the process that “focus on valuing
difference in addition to non-discrimination and concerns on respecting every individual in
the workplace regardless of their race and gender among other variables”8. Therefore,
management of the diversity at the workplace, requires to comply with different
organisational and legislative requirements. Australia have many legislations and standards
that require organisations to comply with their provisions in order to maintain cultural
diversity in workplaces9. For example, Australian Human Rights Commission Act
1986 informs that every individual must be treated as equal at the workplaces, regardless of
their differences or disability status.10
Racial Discrimination Act 1975 informs that every Australian organisation are under the
obligation of this Act and therefore, must eliminate all forms of discrimination in order to
establish positive workplace diversity.11 Therefore, the organisations are bound to comply
with these legislations, as they also provide a framework through which effective diversity
can be maintained. The main aspect of maintaining cultural diversity is to ensure the
environment of collaboration and team work prevails, as well as there is mutual respect and
cohesion.12 Tension and conflict between the diverse workforce is the common issue, which
could arise due to difference in values, belief and attitude. However, organisational leaders in
healthcare have the responsibility of assessing and preventing such issues. Developing an
organisational culture that promotes and supports diverse population is the main strategy to
prevent such issues.13
Studies have identified that culturally competent workforce in the healthcare systems is the
one that understands, acknowledges and integrates culture at all levels. This process involves
the assessment of the cross-cultural relations among the employees, being vigilant towards
7 Sharma, Angel, ‘Managing diversity and equality in the workplace’ (2016) 3(1) Cogent Business &
Management 1212682.
8 Sharma, Angel, ‘Managing diversity and equality in the workplace’ (2016) 3(1) Cogent Business &
Management, 14
9 Ali, Shahnaz, Christine Burns, and Loren Grant, ‘Equality and diversity in the health service: An evidence led‐
culture change’ (2013) 3(S1) Journal of Psychological Issues in Organizational Culture 190-209.
10 Australian Human Rights Commission Act 1986
11 Australian Human Rights Commission, Legislations (2019)<
https://www.humanrights.gov.au/our-work/legal/legislation>
12 Ali, Shahnaz, Christine Burns, and Loren Grant, ‘Equality and diversity in the health service: An evidence led‐
culture change’ (2013) 3(S1) Journal of Psychological Issues in Organizational Culture 190-209.
13 Dauvrin, Marie, and Vincent Lorant, ‘Leadership and cultural competence of healthcare professionals: a
social network analysis’ (2015) 64(3) Nursing research 200.

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the dynamics that can arise as the result of cultural difference (such as conflict, tension and
miscommunication), focuses on enhancing cultural knowledge and adaption of the strategies
that could meet the unique culturally diverse needs of workforce. Developing a culturally
competent system is also significant for managing diverse workforce and promotes the
integration and interaction of belief and behaviour of culturally different people.14 It has been
found that interaction between the migrant workforce and host workforce is significant in
influencing the workplace integration. Where negative interactions can increase conflict and
issues and can also influence patient outcomes; positive interactions are associated with
cultural respect, cultural understanding and egalitarianism.15
The diverse healthcare workforce has many significant benefits because people from diverse
backgrounds bring different skills, knowledge and experience within organisation. Therefore,
their advantage is that culturally and linguistically diverse professionals can provide more
effective care to the culturally and linguistically diverse patients.16 It has also been found that
workforce that includes the doctors and nurses from different culture enable more empathy,
responsiveness and flexibility in delivering healthcare in Australia.17 Through the
collaborative efforts, the diverse workforce within healthcare system of Australia can be
utilised in more effective manner.
Recommendations
The evidences included in the aforementioned sections informed that diversity is a common
place in healthcare organisation. The workforce within these organisations has become
diverse as the result of globalisation. However, diversity can significantly increase the risk of
conflict, increasing tension, causing communication barrier and affecting the collaborative
working.18 Therefore, Okoro and Washington recommended that supervisor-subordinate
communication must be an important approach in managing diversity and cultural
difference.19 Such communication between supervisor or organisational leaders and
employees will also promote equality and integration at workplace. Another recommendation
14 Dauvrin, Marie, and Vincent Lorant, ‘Leadership and cultural competence of healthcare professionals: a
social network analysis’ (2015) 64(3) Nursing research 200
15 Ting-Toomey, Stella, ‘Applying dimensional values in understanding intercultural communication’ (2010)
77(2) Communication Monographs 169.
16 Australian Medical Association, Equity Inclusion and Diversity (2019) < https://ama.com.au/equity-inclusion-
and-diversity> assessed 3rd May 2019
17 Ozdowski, Sev, ‘Australian Multiculturalism: the roots of its success’, University of Western
Sydney, <https://www.westernsydney.edu.au/equity_diversity/equity_and_diversity/tools_and_resources/
reportsandpubs/australian_multiculturalism_the_roots_of_its_success> accessed 3 May 2019.
18 Jongen, Crystal, Janya McCalman, and Roxanne Bainbridge, ‘Health workforce cultural competency
interventions: a systematic scoping review’ (2018) 18(1) BMC health services research 232.

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is the promotion of inter-cultural communication practices among the workforce, can help in
reducing intercultural conflicts and tension. These communication practices can be promoted
through cultural training and education of the diverse workforce. The training and education
of the professionals will help in improving their skills towards displaying cultural respect and
integrating to organisational culture by reducing difference.20 Cultural safety and mutual
respect is significant, so that health professionals from diverse backgrounds can work in
collaboration and harmony and towards the common organisational goal.
Another recommendation is to develop the inclusive workplace for the diverse workforce.
The organisations must develop the inclusive policies, which must be led and endorsed by the
senior managers and organisational leaders.21 Organisational leaders and managers must also
focus on developing and implementing the cross-cultural communication strategies that can
promote better communication and cultural respect among the workforce.22 Improving the
conflict resolution and problem-solving skills among the workforces can also be an important
strategy for promoting an inclusive workforce.
Conclusion
Diversity of the population is a main characteristic of the Australian population. The diversity
of population has also led to increased diversity in the workforce. People from different
origins, culture, race and ethnicity participate in the Australian workforce. This is the main
reason that healthcare workforce of the nation is highly diverse. This paper analysed the
different issue that could arise at the workplace, due to the diversity of workforce. Some of
the important issues that can affect the efficacy and productivity of the organisation are,
conflicts and tensions among employees, cultural barriers, language barriers and lack of
collaboration and team work. Therefore, this paper concludes that developing the inclusive
workplaces is very significant in the case of Australian diverse workforce in order to promote
equality, integration and team work. Inclusive workplaces are highly significant in healthcare
19 Okoro, Ephraim A., and Melvin C. Washington ‘Workforce diversity and organizational communication:
Analysis of human capital performance and productivity’ (2012) 7(1) Journal of Diversity Management (Online)
57.
20 Ting-Toomey, Stella, ‘Intercultural Communication Ethics’ (2010) Handbook of communication ethics. Taylor
& Francis New York, 335-354.
21 Shore, Lynn M., et al, ‘Inclusion and diversity in work groups: A review and model for future research’ (2011)
37 (4) Journal of management 1262-1289.
22 Sharma, Angel, ‘Managing diversity and equality in the workplace’ (2016) 3(1) Cogent Business &
Management 1212682.

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system, as the interpersonal relations, communication and interactions of the professionals
can significantly influence the health and safety of patients.

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References
Ali, Shahnaz, Christine Burns, and Loren Grant, ‘Equality and diversity in the health service:
An evidence‐led culture change’ (2013) 3(S1) Journal of Psychological Issues in
Organizational Culture 190-209.
Australian Human Rights Commission Act (1986)
Australian Human Rights Commission, Legislations (2019)<
https://www.humanrights.gov.au/our-work/legal/legislation> assessed 3rd May 2019
Australian Medical Association, Equity Inclusion and Diversity (2019) <
https://ama.com.au/equity-inclusion-and-diversity> assessed 3rd May 2019
Balasubramanian, Madhan, et al, ‘The life story experience of" migrant dentists in Australia:
Potential implications for health workforce governance and international cooperation’ (2017)
6(6) International journal of health policy and management 317.
Balasubramanian, Madhan, et al, ‘The ‘global interconnectedness’ of dentist migration: a
qualitative study of the life-stories of international dental graduates in Australia’ (2014)
30(4) Health policy and planning 442-450.
Covell, Christine L., Elena Neiterman, and Ivy Lynn Bourgeault, ‘Scoping review about the
professional integration of internationally educated health professionals’ (2016) 14(1)
Human resources for health 38.
Dauvrin, Marie, and Vincent Lorant, ‘Leadership and cultural competence of healthcare
professionals: a social network analysis’ (2015) 64(3) Nursing research 200.
Freund, Tobias, et al, ‘Skill mix, roles and remuneration in the primary care workforce: who
are the healthcare professionals in the primary care teams across the world?’ (2015)
52(3) International Journal of Nursing Studies 727-743.
Hunt, Vivian, Dennis Layton, and Sara Prince ‘Diversity matters’ (2015) 1 McKinsey &
Company 15-29.
Jongen, Crystal, Janya McCalman, and Roxanne Bainbridge, ‘Health workforce cultural
competency interventions: a systematic scoping review’ (2018) 18(1) BMC health services
research 232.

9
Okoro, Ephraim A., and Melvin C. Washington ‘Workforce diversity and organizational
communication: Analysis of human capital performance and productivity’ (2012) 7(1)
Journal of Diversity Management (Online) 57.
Ozdowski, Sev, ‘Australian Multiculturalism: the roots of its success’, University of Western
Sydney, <https://www.westernsydney.edu.au/equity_diversity/equity_and_diversity/
tools_and_resources/reportsandpubs/australian_multiculturalism_the_roots_of_its_success>
accessed 3 May 2019.
Sharma, Angel, ‘Managing diversity and equality in the workplace’ (2016) 3(1) Cogent
Business & Management 1212682.
Shore, Lynn M., et al, ‘Inclusion and diversity in work groups: A review and model for future
research’ (2011) 37 (4) Journal of management 1262-1289.
Ting-Toomey, Stella, ‘Applying dimensional values in understanding intercultural
communication’ (2010) 77(2) Communication Monographs 169-180.
Ting-Toomey, Stella, ‘Intercultural Communication Ethics’ (2010) Handbook of
communication ethics. Taylor & Francis New York, 335-354.