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‘Fundamental’ regional healthcare shift needed: Report
The significant gaps identified in a new report has prompted an RACGP call for reforms aimed at enabling GPs to work at the top of their scope.
Allowing GPs work to the top of their scope of practice has been identified as a key response to overcoming health disparities in the regions.
Health insurance company Westfund has released a Regional Health Gap Report that highlights the disparities in healthcare access in rural and remote parts of the country.
The report, which is based on health claims data over a seven-year period and included 66,000 patients, found that there is ‘compelling evidence’ for a ‘fundamental shift’ in how healthcare is delivered in these areas.
Three central themes emerged from the analysis:
- Regional areas experience delayed screening and preventive healthcare
- Limited access to treatment options persist
- Service and equipment availability remains inadequate
RACGP Rural Council Chair and Townsville GP Associate Professor Michael Clements told
newsGP the findings reflect the realities of regional healthcare.
‘It fits with what we see and experience on the ground – that there is a general reduction in access to non-GP specialists and allied health services in these rural and remote areas,’ he said, adding that disease treatment prevalence rates reported in the claims data may reflect deficits in what is available through public health services.
‘Every rural town is different in terms of health needs and access to different health services. In Townsville, where I am, [the report showed the region had] one of the highest rates of cardiac disease.
‘I know that in my region there’s a good public service for things like cancer and some other diseases, but it’s less responsive to cardiac care.
‘We often recommend people take out insurance and go on their private health waiting list instead of the public health waiting list.’
According to Westfund, significant differences in chronic disease prevalence and service uptake exist not only within various regional communities when compared to their metropolitan counterparts, but also with each other.
As per one example, Townsville and Mackay had double the treatment prevalence for diabetes when compared to Mudgee and Orange.
RACGP President Dr Nicole Higgins, a regional GP based in Mackay, says the report adds to a growing body of evidence that points to the need for health reform and investment in rural and remote communities, and that GPs can be utilised to overcome healthcare access inequities.
‘Regional Australians deserve the same access to high-quality care as those in the big cities, and we shouldn’t settle for anything else,’ she said.
‘A big problem in regional Australia is lack of access to non-GP specialists, like psychiatrists, dermatologists, and cardiologists.
‘GPs do the same eight years of medical training as every specialist, yet they cannot initiate treatment or prescribe medication for many conditions, such as ADHD, acne, and dementia.
‘If GPs were allowed to work at the top of their scope, and provide more specialist services for patients, it would improve access for people in regional Australia, and be much more cost efficient.’
Associate Professor Clements agrees. He says the report reinforces the need for health policy that supports regional GPs who already adapt their knowledge and skillset in response to their community’s disease burden, while also helping patients navigate the patchwork of healthcare services that differ between regions.
‘GPs are the experts at picking up the skills that enable them to support their community. But sometimes, we are trying to do the job with one hand tied behind our back because of legislation,’ he said.
‘We might be servicing a community that has very high [rates of] paediatric ADHD, and the legislation in some states that prevents GPs from being able to initiate and maintain treatment for kids with that disorder is harming the community because we know they don’t have access to the same level of care that they do in the urban areas.
‘It’s important that we recognise that scope of practice is a changing and moving feast.
‘Every different community needs to be supported as best as they can by a GP that’s enabled through legislation and processes and policies – particularly when there’s only one or two GPs.’
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