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‘First meaningful commitment’: Coalition outlines rural health measures

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‘We welcome it, but we would like to see it be part of a wider reform package looking at general practices as a whole.’
 
That is the assessment of RACGP Rural Chair Dr Michael Clements, following a new $146 million Coalition funding commitment for rural healthcare ahead of the Federal Election.
 
The pledge, announced on Tuesday, focuses on bringing more doctors to under-resourced rural areas, and expanding training to meet the varied requirements of remote communities.
 
Much of the commitments reflect college advocacy requests, Dr Clements said, although he highlighted the omission of a significant recommendation from the recent Senate Committee inquiry.
 
‘It’s worth noting that the key recommendation of that whole Senate inquiry, which was increased Medicare rebates, has still been left unanswered,’ he told newsGP.
 
‘We’re pleased to see that there has been a very specific and targeted effort at the recruiting and the training space for these GPs.
 
‘[But] we’d just like to see more on the retention and the sustainment phase for our hard-working rural doctors.’
 
The Coalition’s commitment includes:

• $15 million to expand the John Flynn Prevocational Doctor Program to more than 1000 annual placements in rural Australia by 2026
• The proposed expansion of the Murrumbidgee single employer model trial to more regions across rural Australia
• $9 million for training posts outside for GPs, GPs in training and rural generalists to develop skills training in areas such as obstetrics, palliative care, paediatrics and mental health
• $87 million for further workforce incentives to general practices and allied health professionals to provide further support to rural generalists, with additional education and skills and to help take on nurses, nurse practitioners and allied health professionals.

 
The announcement also said GP catchments given Distribution Priority Area status under the exceptional circumstances review would retain that status for a further 12 months until the end of June 2023.
 
Dr Clements noted the announcement is the first to focus on the healthcare challenges of rural communities in the election build-up.
 
‘This is the first meaningful commitment we’ve had from [the Coalition or Labor] in the rural health space,’ he said.  ‘It’s good to see.’
 
RACGP President Adjunct Professor Karen Price also said the commitment is a step in the right direction.
 
‘As the college that represents four-out-of-five rural GPs, the most of any organisation in Australia, the RACGP welcomes any new investment in rural and regional healthcare,’ she said.
 
‘It is important to keep in mind though that the measures announced today will not solve all the challenges facing rural and regional general practice.
 
‘We have a long way to go, particularly since general practice has been neglected and underfunded for many years.’
 
Regional Health Minister Dr David Gillespie said he believed the proposed investment would increase access to services and retain doctors in places where recruitment has been an issue.
 
‘These measures – coupled with our investment through the Stronger Rural Health Strategy – will help rebuild the country hospital doctor workforce, incentivise more multidisciplinary teams and protect and preserve the long-term viability of rural general practice,’ he said.
 
However, Dr Clements raised concerns about retaining doctors after long-term under-resourcing.
 
‘Our rural health system … has been underinvested in for many years already,’ he said.
 
‘As much as we can incentivise the training components, which is good, and we welcome it, there does need to be the support for those that are already qualified and there doing the job, to retain those that are out there.’
 
He also sounded a note of caution on a complete assessment of the proposals without full detail.
 
‘We’ve seen a promise for workforce incentive payments,’ he said.
 
‘We’d like to see the detail on that. We saw, for example, in the budget last year, a very small increase in bulk-billing rebates the more rural you are. That’s a great idea, but the incentive was nowhere near enough to make a difference.’
 
‘We’d like to see to see whether it’s going to be enough to deliver change, or whether it’s just window dressing.’
 
Many of the measures also focused on rural areas with hospitals, according to Dr Clements.
 
‘We have seen over the last a year or two a lot of the talk and a lot of the investment in the rural generalist pathway has been focused on the towns where there’s a dual role for a GP who works both in the state-run hospital and the community practice,’ he said.
 
‘Many of our towns need that … but we need to see the towns without hospitals, and the GPs without these additional skills, be recognised and part of the solution.’
 
Several of the proposals, including the workplace incentive payments, and the expansion of the John Flynn Prevocational Doctor Program, feature in the recommendations outlined in a preliminary report published by the recent Senate inquiry into rural and remote general practice.
 
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Federal Election government funding GP workforce shortage rural and remote health

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