Sunday, November 20, 2011

Education & the need for simplification

Staying with the education theme that began with The education trap and continued in A note on the economics of education & the reasons for the mess in Australian education, Tom Hyland's Sick system keeps doctors out of practice indefinitely (Sydney Morning Herald) looks at the mess created in Australian medical training through supply decisions dating back to the 1990s.

From my own perspective. Mr Hyland's conclusions fit with my own experiences during the two years that I was CEO of a specialist medical college. The Australian doctor mess, and it is a mess, is due to the interaction between three very different things:

  • Government decisions to limit the number of doctors in training to reduce health care cost funded by Government. There was a fear at the time that an oversupply of GPS was leading to over servicing.
  • Government decisions to change the rules for GP registration requiring prospective GPs to jump through more hoops. This was part of growing credentialism, the desire to turn GPs into "specialists", but was also influenced by the first factor, perceived oversupply.
  • Government decisions on recognition of overseas qualifications. This combined the desire to create common national standards and to reduce the power of the Colleges to assess medical qualifications because this was anti-competitive. The resulting system was complex and became more so because of concerns about standards and the need to avoid scandals such as the Patel case. 

These three very different things interacted in complex ways. The result was a mess.

I do not agree with skepticlawer's argument in Inflating ourselves into irrelevance that the expansion of mass university education was a mistake, although I do agree with some of her other points, I think that this, mass university education, was a good thing. I do think, and argued thus in my earlier posts, that just because an initial action made sense does not mean that consequent actions based on the same arguments make sense. I also think that our constant desire to improve standards through rule and mandate, our desire to avoid risk, has led to a complex mess.

Every one of current Australian Government education initiatives at all levels involves controls and rules. Most deal with perceived problems in isolation. All add to systemic complexity.

One of my constant plaints, and it's not limited to education, is the need to simplify. If we don't do this, Australian education will continue to go backwards.     


Evan said...

Yes. Bureaucracy (government's style of intervention) is not suited to some (most?) situations.

There are alternatives to this way of doing things!

Jim Belshaw said...

Evan, one of the public service difficulties is the difficulty of bringing about desired change but then moving away from the now entrenched change position once it has outlived its usefulness.