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Budget ‘excellent’ for remote healthcare: RACGP Rural Chair


Jolyon Attwooll


18/05/2023 4:21:51 PM

Associate Professor Michael Clements shares his view on measures for areas disproportionately affected by workforce and chronic health issues.

Remote town in Australia
The budget has been praised for its likely impact, with more financial incentives for rural work.

This month’s Budget included a raft of good news for general practice in regional and remote areas, the RACGP’s Rural Chair has said.
 
Associate Professor Michael Clements has called the measures introduced by the Federal Government last week – which heeded many of the calls made by the RACGP – as ‘an excellent, rurally loaded Budget’.
 
Among the moves that will most impact rural doctors is a tripling of the bulk billing incentive, a central request of the college’s pre-budget submission – and one which will particularly benefit rural general practices, given the way the measure is loaded.
 
‘For the first time we see a meaningful recognition for concession card holders who are bulk billed in a remote area – close to $80 for an item 23 – compared to an urban area,’ Associate Professor Clements told newsGP.
 
‘Overall, this has generated positive discussions in the regional, rural and remote spaces which already largely rely on bulk billing – and this will support them.’
 
He did sound a slight note of caution, however, saying that the true impact will not be understood until it is fully introduced.
 
‘Regional and rural sites have discussed that it will impact decisions such as delaying a move to private billing for concession card holders, or in some cases they may reverse [a previous move] – but we have to wait until 1 November to find out,’ he said.
 
Another major funding commitment which will have a positive influence on rural practices according to Associate Professor Clements is the $445.1 million over five years for the Workforce Incentive Payment (WIP) – Practice Stream.
 
This will increase the maximum payment per practice to $130,000, with Federal Health and Aged Care Minister Mark Butler also saying there will be annual indexation of the payment, and that criteria will be changed to make more practices eligible.
 
In its response to the Budget, the RACGP called WIP ‘critical’ for helping with the cost of employing nurses, allied health professionals, as well as Aboriginal and Torres Strait Islander health workers and health practitioners. Associate Professor Clements again believes the extra loading towards rural practices will make a difference.
 
While not specifically announced in the Budget, the Government has subsequently confirmed there will be an extension to telehealth item numbers for sexual and reproductive health until the end of the year.
 
It is a step that the RACGP Rural Chair welcomed, who added that he would like to see the measure made permanent – a view also recently expressed by Dr Christie Rodda, the Chair of the RACGP’s Doctors for Women in Rural Health Committee.
 
The acute workforce shortage felt in many rural parts of the country also received a potential budgetary boost, with $4.5 million allocated over five years to expand single employer model trials by a further 10 trial sites from 1 July.
 
The initiative, designed to help address chronic rural GP workforce shortages, has already been put in place in several locations since the change of government last year. In January, Prime Minister Anthony Albanese launched a state-wide Tasmania trial to help to 20 doctors into single-employer models, a move aiming to give aspiring rural GPs more certainty and stability when training.
 
Associate Professor Clements describes the investment as ‘valuable, as there is interest in this model, but it needs to be evaluated’.
 
He is also circumspect on the Government’s $31.6 million investment for International Medical Graduates to undertake GP training.
 
The college response welcomed the commitment ‘to measures that support a healthy distribution of the health workforce’, while the RACGP Rural Chair says he is waiting for more detail before reaching a conclusion on its likely impact.
 
As for ‘MyMedicare’, the label now designated to voluntary patient enrolment, Associate Professor Clements believes it ‘may well work for rural practices in a positive way, by rewarding them for whole person care, but we need to see the details before we can confirm support’.
 
In the meantime, there was unequivocal support for other funding measures, including an additional $29.1 million over two years for the Royal Flying Doctor Service, and the announcement of longer telephone consults and Level E consultations.
 
‘[These] will favour rural as well as we do often have to manage people in remote areas on the phone more than urban [practices], and also for our remote patients who rarely travel into the clinic,’ the RACGP Rural Chair said.
 
‘The option of a level E rebate means we can try and deal with more in the appointment.’
 
However, while the broad budgetary picture is a positive one for Associate Professor Clements, he is realistic about how quickly it will solve the challenges of general practice in regional and remote areas.
 
‘I think this will have a positive impact on rural workforce as it does financially incentivise more rural and remote work,’ he said.  
 
‘This should be seen as a start of a multiple stage process to reinvigorate rural workforce.
 
‘I think the Federal Government has shown significant new investment into rural health and now is the opportunity for state governments to come to the party as well.’
 
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Michael Clements Rural Faculty rural generalist rural workforce


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