Health workforce reform remains a major challenge for Australia. The recent Productivity Commission report provided some guidance, but, sadly, few of the recommendations have been implemented. Health economies (and with them the health workforce) will continue to expand as the burden of disease increases. The important issue is to expand the current workforce but provide for a generalist stream that allows flexibility and retraining. The future health workforce needs to be able to provide patient-centred care, to have a focus on public health and disease prevention, use information and the new communication technologies, to be able to work as part of a team and partner with a range of organisations and to be dedicated to quality improvement within the health system.