Australia 'probably not' on track to meet paediatric rheumatology 2030 workforce target

Australia Broadcast Center

6 days ago

Aches and pains are a normal part of growing up, but persistent joint pain and swelling beyond six weeks is worth investigating, according to Adelaide-based paediatric rheumatologist Mark Friswell.
Dr Friswell said juvenile idiopathic arthritis affected about one in 1,000 children worldwide, but the average time from symptom onset to diagnosis was 10 months.
"Ten months is way too long," he said.
"I'm still seeing patients who have had symptoms for a year, two years, three years, and by the time they come, there's already established damage to their joints, and that we can't do much about."
Ruth Colagiuri, founder of the Juvenile Arthritis Foundation Australia (JAFA), said early diagnosis was "critical" to avoid lifelong pain and disability.
"It's an auto-inflammatory disease that attacks the joints and the eyes and sometimes the skin and internal organs," she said.
"[Children] might be OK one day — and two days later, they might be barely able to walk … barely able to get out of bed, limping around.
"People, including teachers, often think that they're putting it on."
Fourteen-year-old visual artist Sinead Gannon said the waitlist for paediatric rheumatology in the public system was "very long", but they were able to get a diagnosis on the spot from a private clinician.
The 2024 Young Archie finalist said growing up autistic helped them to mask pain caused by juvenile idiopathic arthritis, but the condition significantly affected their mental health and ability to create art.
"I couldn't walk, my wrist was really sore and that was around the time when I had to stop drawing," they said.
"I had to take almost an entire term off school, spent most of those days in my bed and I was very tired. I had a lot of depression."
A 2022 parliamentary inquiry into childhood rheumatic diseases recommended Australia triple its number of paediatric rheumatologists by 2030 to meet the international standards of one full-time equivalent paediatric rheumatologist per 200,000 children, or about 32 clinicians.
There were 20 paediatric rheumatologists in 2022, according to the inquiry, but the 2021 Australian Rheumatology Workforce survey said there was a shortfall of about 41 clinicians, and 61 part-time equivalent paediatric rheumatologists were needed.
As of 2025, Australia had increased its number of paediatric rheumatologists to 27, according to Australian Paediatric Rheumatology Group (APRG) chair Jonathan Akikusa — but there were none in Tasmania, the Northern Territory and Canberra.
A small number of "dedicated adult rheumatologists" were filling the gap in those states and territories, he said.
"None are employed full time in public and quite a number do not do private work, so the effective paediatric rheumatology consultant workforce is probably only about 15 equivalent full-time [positions] or less," Dr Akikusa said.
In response, a spokesperson for the Tasmanian health department said the Royal Hobart Hospital provided a "fortnightly paediatric rheumatology clinic, which was run by a rheumatologist — who had extensive paediatric experience — and a specialist rheumatology nurse practitioner".
"A paediatric rheumatologist from Melbourne visits Tasmania as a Visiting Medical Specialist (VMS) four times a year – twice in Hobart and twice in Launceston," the spokesperson said.
In the Northern Territory, a spokesperson for NT Health confirmed it did "not currently employ a paediatric rheumatologist", but that the territory's paediatricians consulted with interstate paediatric rheumatologists to provide appropriate care.
"There is an ongoing, nationwide shortage of this medical specialty," the spokesperson said.
In the ACT, a Canberra Health Services spokesperson said Canberra Hospital had an "outreach paediatric rheumatology service" which was provided by Sydney-based specialists under an agreement with Sydney Children's Health Network.
Dr Friswell said Australia was "probably not" on track to reach the 2030 paediatric rheumatology workforce target outlined in the inquiry.
"If we are going to train another 40-odd people in the next few years, we're going to have to step up and train more," he said.
"We then need the hospitals and the public systems in particular to actually create those jobs for people."
A spokesperson for the Federal Health Department said it provided $180 million per year for specialist medical training, including paediatric rheumatology.
It said the department was undertaking supply and demand modelling which would be complete by the end of year.
Jennifer Martin, President of the Royal Australasian College of Physicians, said there was a "clear shortage" of paediatric rheumatologists.
"While the RACP is ready to train more, governments need to create the necessary positions," she said.
Dr Friswell said until recently, people living in Australia wanting to train in paediatric rheumatology had to travel overseas.
And although there were now four training sites across the country — in Adelaide, Melbourne, Brisbane and Perth — he wanted to see five or six.
"It is getting better, but it needs to get better quicker," he said.
Sinead Gannon said they had a good support system and encouraged other young people with juvenile idiopathic arthritis to keep pursuing their hobbies.
"Even when my wrist is really swollen, I can still draw," they said.
"I can still express myself creatively in other ways.
"Don't be mad at yourself, don't think that you're a burden … because of your disability."