Bill targeting rural GP shortage stalls

The shortage of GPs in rural and remote areas again featured in Federal Parliament this week, as a private bill to exclude all metropolitan and regional cities from being labelled as a ‘workforce priority’ fell short of a full debate.
 
Known as the Doctors for the Bush Bill, the legislation would have reversed changes put in place in mid 2022, which allowed all regional cities to gain Distribution Priority Area (DPA) status.
 
The shift allowed international medical graduates (IMGs) previously required to work in rural and remote areas to move to more built-up locations classified as Modified Monash Model (MMM) 2.
 
While the change significantly boosted the number of IMGs practising in built-up regional areas, the RACGP warned at the time that it would lead to greater shortages in more remote parts of the country.
 
Citing ‘a rural doctor shortage at crisis point’, independent New South Wales MP Andrew Gee attempted to force a debate of his own private bill on Monday.
 
Also supported by North Queensland MP Bob Katter, the bill proposed disallowing all MMM1 and 2 areas from DPA status.
 
However, Mr Gee’s motion to suspend standing orders and allow a debate was rejected by the Parliament.
 
For RACGP Rural Chair Associate Professor Michael Clements, the intent of the bill showed a clear understanding of the pressures on the general practice workforce in more remote areas.
 
He said with the recent overhaul to allow more overseas doctors to work in Australia, many more newly arrived IMGs are working in MMM2 population centres.
 
‘We can certainly see why this bill has come up,’ Associate Professor Clements told newsGP.
 
‘With the massive increase in international doctors moving into the country, most MMM2 areas probably don’t need DPA.’
 
However, he said he would not have supported the bill as it stands.
 
‘The reality is that the MMM tool is a poor use of Government policy to guide doctor behaviour,’ he said.
 
‘The college has always recommended that we use incentives and support as a guide to where they want doctors to go as opposed to sticks and restrictions.
 
‘Dancing about the edges whether a MMM1 or MMM2 is allowed to be a DPA doesn’t get at the core of the problem, which is that we provide our doctors with enough incentives and support to go to the most needful communities.’
 
Associate Professor Clements noted the Federal Government’s release of the recent ‘Working Better for Medicare Review’ report, which made 26 recommendations for improving healthcare worker distribution.
 
The review was announced by Federal Health and Aged Care Minister Mark Butler in 2023 to examine DPA and District of Workforce Shortage (DWS) classifications, as well as the use of MMM definitions.
 
It also set out to ‘develop a more appropriate balance between the domestically trained medical workforce and Australia’s high dependency on IMGs’.
 
One of its key suggestions is to establish a Health Workforce Independent Review Panel to oversee changes to the DPA, DWS and GP catchment methodologies.
 
‘This promises to be a more nuanced and effective tool, and that’s good in theory,’ Associate Professor Clements said.
 
The Federal Government is yet to respond in detail to the ‘Working Better for Medicare Review’ recommendations.
 
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