GP numbers stagnate amid population boom

The number of GPs per 100,000 people has risen just 2.7% in the past decade – significantly less than any other medical workforce.
 
That is according to new Australian Institute of Health and Welfare (AIHW) data, which revealed that while the overall number of GPs is on the rise, it is only just breaking even when it comes to keeping up with population growth.
 
Between 2013–22, the total number of GPs has jumped 24.4% and fulltime equivalent (FTE) positions rose 15.2%.
 
While more GPs entering the profession is welcome news, FTE positions per 100,000 population over the same period rose from just 111 to 114, 2.7%.
 
This is in stark contrast to other areas of the healthcare workforce – allied health professionals grew 53.1% per 100,000 population, medical professionals (excluding GPs) increased 21%, nurses and midwives grew 13.2%, and dentist rose by 12.5%.
 
Across all professions, an average rise of 22% was recorded over the decade.
 
Dr Michael Bonning, a member of the RACGP Expert Committee – Funding and Health System Reform, said this shortfall has lined up with an ‘explosion in patient complexity’.
 
‘When we put this alongside data that the average length of consultation and the number of issues dealt with in each consultation is going up, what we are seeing is that growth in GPs is not able to keep up with the growing needs of our community,’ he told newsGP.
 
‘There is no replacing high quality continuity of care with a community-based medical practitioner – our system is built around that, and we need to be really careful and thoughtful about how important that is for Australia’s long-term health system.
 
‘Governments putting money into nurse-led clinics or into urgent care centres is a false economy, when what we really need to see is them making sure that more Australians have more access to a GP who knows them, who knows their history and is willing to be there with them on their health journey.’
 
Across all healthcare professionals, the FTE rate varies by jurisdiction with the Northern Territory having the highest rate in the nation, 2874 per 100,000 people; however, it also has the lowest rate of FTE GPs at just 82.4 per 100,000 people, far below the national average of 115.2.
 
The lowest rates were seen in New South Wales with 2285 per 100,000 people, although it has the highest rate of FTE GPs at 119.4 per 100,000, while the highest growth was in Queensland with 30%.
 
The data also laid bare the dependence regional communities have on GPs.
 
‘Medicare claims indicates that rural and remote populations rely more on general practitioners to provide healthcare services, due to less availability of local specialist services,’ the AIHW said.
 
But at the same time, the nation, and particularly those living outside the major cities, are facing a critical block then it comes to access healthcare.
 
The AIHW says around 82% of health professional occupations are in shortage in 2023, and that is felt most acutely in general practice, mental health, registered nurse occupations, and specific allied health.
 
‘Projected demand for healthcare services may also exacerbate shortages,’ the AIHW added.
 
The RACGP has raised significant concerns that the nation’s healthcare sector is heading in the direction of the NHS – the UK system which has forced its own workers to flee their jobs in droves.
 
The failing system has seen lesser-trained UK health professionals missing life-threatening diagnoses, with a report describing the lack of primary care investment as one of the NHS’s most significant policy failures.
 
Dr Bonning has previously worked in the UK and fears the ongoing lack of investment into general practice will push Australia in a similar direction.
 
‘When we look around the world, we know that when you add more and more subspecialty practitioners you end up with a higher cost health system, and unfortunately, not a health system where people live longer,’ he said.
 
‘I work with a team of allied health professionals; they are fantastic and it’s phenomenal what we can do together, but trying to break up the parts of care that are consolidated within a general practitioner leads to poorer care and less comprehensive care.
 
‘It prioritises referral, it prioritises disjointed care as opposed to keeping it all with one person.’
 
The slowing rate of new GPs comes at a time when Australia’s population is older and sicker than ever before.
 
Life expectancy has dropped for the first time in decades, 60% of Australians live with at least one long-term health condition, and 43% of people aged 16–85 experience a mental disorder.
 
To attract more much-needed GPs, Dr Bonning said that while financial gain is one incentive for doctors, ‘seeing our patients live well and live better’ is much more rewarding for many.
 
‘Good general practice is invisible, and what I mean by that is those patients don’t present to a hospital, they don’t need urgent care clinics, and why is that? Because their GP looks after them,’ he said.
 
‘We need to recognise that paying upfront for excellent primary care, often where you aim at targets and you pay for great performance and great outcomes, is likely to have some added costs upfront, but massively reduced costs in a hospital setting.
 
‘If there was more incentive for some in the health system to manage the patient, to keep them out of hospital, to fix things before they’re a problem, and get paid well to do it, then all of a sudden, you have everyone wanting to be a GP.’
 
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AIHW Australian Institute of Health and Welfare workforce