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‘Doctors will move from remote areas’: DPA change under fire
In light of the policy shift, the RACGP’s Rural Chair has urged government to expedite measures to address the broader GP workforce crisis.
Remote general practices, such as this one on Magnetic Island, could find it harder to recruit under the changes.
‘This will absolutely lead to an immediate migration of doctors out of rural and remote areas.’
That is RACGP Rural Chair Dr Michael Clements’ blunt assessment of a new Federal Government decision to expand distribution priority area (DPA) status in Australia.
Under the changes, which were announced on Thursday, all GP catchments in Modified Monash Model 2 (MM 2) areas – which include many regional towns – automatically gain DPA status with immediate effect.
It means everywhere from MM 2 catchments to very remote parts of the country, categorised as MM 7, now have priority status, allowing them to recruit from an expanded pool of doctors, including international medical graduates.
The shift in classification will also mean a number of MM 1 catchments will be classified as DPA, although inner metropolitan areas remain automatically categorised as non-DPA.
It is a change that will channel doctors away from areas where the shortage is most acute, according to Dr Clements. He does not believe using the DPA classification system is the correct means to address well documented GP shortages in rural areas.
‘It’s a distribution tool, not a workforce tool,’ Dr Clements told newsGP.
‘It’s a tool that sits there to help direct the few numbers of doctors that we’ve got to the areas of most need.
‘This policy essentially takes any distributed capacity out of it – you’ve made most of Australia a “priority”.’
The Government’s announcement describes the move as ‘delivering on one of its core election commitments to make it easier for thousands of Australians in outer suburbs and regions to see a GP’. It stated that 700 areas will now have either full or partial DPA classification.
However, recently a number of GP practices have closed down in rural and remote areas – and Dr Clements expects more doctors to move imminently.
His own practice is in Townsville, which is within an MM 2 catchment. Under a new exceptional circumstances review system introduced last year, a bid for DPA status was not supported – but that status is now automatic.
‘I certainly feel that unless we do something dramatic and new, we are going to see more rural practice closures, because people just won’t be able to recruit,’ Dr Clements said.
‘What’s going to happen immediately is that doctors will move from rural-to-remote locations, where they’ve been required to work under the DPA rules, closer to big cities … as a direct result of this.
‘This will absolutely lead to an immediate migration of doctors out of the rural and remote areas because MM 2 is generally more desired.’
However, Dr Clements also recognises the acute pressures in many MM 2 areas and urged the Government to put in place measures to address broader workforce shortages and entice doctors to more remote areas.
‘We need to figure out programs and policies that are going to increase the total number of doctors, not just change the distribution of them,’ he said.
‘We must see immediate action taken to increase the incentives to draw people back out to rural and remote.
‘We’ve always been more supportive of carrots rather than sticks.’
Dr Clements says he would have liked to have seen more substantive measures in place to boost GP numbers before the DPA changes were announced.
‘What we would have preferred is that they invested in the rural incentives before they made the change,’ he said.
‘We would have preferred to have seen some of the $1 billion that’s been promised.’
Greater streamlining of overseas doctors’ visa applications would be another welcome step, Dr Clements said.
‘If I was to … recruit a doctor who’s overseas right now and might want to move to Townsville, the whole process is between 12–18 months, and roughly $20–30,000.
‘So you can see that … any immediate change is really just going to be drawing people out of the rural areas.’
The DPA classification system came into place from July 2019, replacing the District of Workforce Shortage assessment areas. Initially it was only the most remote areas MM 5–7 that automatically received DPA status.
From the start of 2022, regional and rural towns classified as MM 3–4 were granted automatic DPA status, a move undertaken by the previous government and supported by the college at the time.
However, the Dr Clements said the college again warned at the time that changes to the assessment of DPA status did not address the broader problems of workforce shortages.
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