Ms Jessie Woodward started her fourth year as an optometry study at UNSW with nothing in the bank.
In order to do the numerous mandatory clinical placements in that year, optometry students must buy their own clinical equipment, which costs around $7000. To do that, Woodward used all of her savings.
She then had to make choices around food and other necessities to fund her regional placement, a flight to Coffs Harbour, a 50km daily commute by car and extra petrol costs.
All without pay and financial support for those placements.
“It’s essentially full-time work,” she said speaking to Optometry Australia (OA), “Monday to Friday, 9 to 5, often with long commute times.
“There’s no room to take on other paid work unless you give up your weekends or your wellbeing.”
Woodward’s is just one of many stories spurring new calls for an immediate expansion of the Commonwealth Prac Payment (CPP) and the inclusion of all allied health professions in the program, including training optometrists.
The allied health sector, supported by Optometry Australia (OA) and the UNSW School of Optometry and Vision Science, has urged Education Minister Mr Jason Clare and the Federal Government to make that happen.
The CPP, announced in the 2024–25 Federal Budget, started on 1 July this year for nursing, midwifery, teaching and social work students. The payment of $331.65 per week for eligible students on placement recognises the significant unpaid workload of clinical placements and the disproportionate impact that can have on many students.
But according to the Allied Health Professions Australia (AHPA), the program excludes most allied health disciplines, including optometry, leaving students to take on mandatory placements – often lengthy and in rural or remote locations – without financial support.
AHPA, of which OA is a member, said that allied health students completed between 500 and 1,000 hours of mandatory unpaid placements, with some courses and professions requiring up to 56 weeks of unpaid placement hours.
Evidence showed that financial barriers during those placements “impact completion rates, decisions about which placements to undertake, and ability to focus on learning”.
AHPA chair Ms Samantha Hunter said: “The decision to limit Commonwealth Prac Payments to a narrow set of disciplines fails to reflect the significant workforce shortages in many allied health professions, their vital role in Australia’s health, mental health, disability, education, and aged care systems, or the high volume of placement hours required to complete the training.
“Every part of the health workforce is critical, and every student should be supported to complete their education without facing financial crisis.”
AHPA said many allied health students reported significant hardship while on placement, including loss of income, housing insecurity, food insecurity, and increased mental distress – a growing problem dubbed “placement poverty”.
These challenges disproportionately affected students from low-income, regional, or diverse backgrounds, said the AHPA, threatening Australia’s diversity and the ability to build a future health workforce.
“As a sector, we are working closely with governments, universities, clinical educators, and placement providers to identify barriers and issues underpinning current workforce shortages across health, aged care, disability, and mental health,” said Hunter.
“There is clear evidence that students are dropping out, deferring or swapping to part-time study because they can’t afford to complete unpaid placement requirements. If the federal government is serious about addressing ongoing workforce shortages in the allied health sector, this is a policy blind spot that must be addressed.”
OA agreed.
CEO Ms Skye Cappuccio, also the AHPA deputy chair, said Woodward and other optometry students had shared experiences of “food stress, mental exhaustion and housing instability while on placement”.
“These are not isolated cases and they reflect a systemic problem – the lack of support is impacting optometry student wellbeing,” she said.
“Optometry students undertake extensive, full-time unpaid placements, often away from home and over long periods, and experience significant financial pressure as a result.”
She said placements, including those to regional, rural and remote areas, were crucial to developing a strong, well-distributed eyecare workforce for the future, but placement poverty had to be tackled.
“Optometry Australia believes extending the support offered by the CPP to optometry students will help ease placement-related financial pressures.”
As well as supporting the co-ordinated campaign to Canberra, OA was “participating in broader allied health advocacy efforts, contributing to cross-sector submissions and engaging directly with government decision-makers”, said Cappuccio.
“Through our Student Advocacy Placement program, we are also helping build future leaders who understand how policy and advocacy intersect to impact issues relevant to the profession, including funding and workforce design.”
Professor Lisa Keay, head of the UNSW School of Optometry and Vision Science, said a 2023 survey of the school’s students had confirmed that financial hardship was common, affecting more than half of its students.
She said the industry was supportive, often providing a student discount for equipment purchases.
“Further, there is often support and hospitality from our clinical placement hosts, particularly those in rural areas, which is much appreciated.”
Also, the school had received educational grants from Alcon and some donations from Young Optometrists, topped up by UNSW funds.
“However, these measures are limited and not sustainable,” she said. “Government support is a preferred, longer-term solution.”
The school said its own workforce projections indicated that optometry was not currently experiencing a shortage, but extending the support to optometry students would help ease those placement-related financial pressures.
Beyond widening the scope of the CPP, that support could include reducing the cost of public transport for students struggling with lengthy commutes to campus and clinical placements.
Like Cappuccio and others, Prof Keay had brought the issue to the attention of Clare’s office and provided data to support their advocacy work.
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