‘GPs get out to the bush, but have no team around them’: Allied health funding push

Doug Hendrie

21/09/2018 2:28:49 PM

GPs who are shouldering much of the rural health burden may soon have allies to help.

National Rural Health Alliance CEO Mark Diamond recently met with Federal Health Minister Greg Hunt to call greater attention to the lack of allied health professionals in rural areas.
National Rural Health Alliance CEO Mark Diamond recently met with Federal Health Minister Greg Hunt to call greater attention to the lack of allied health professionals in rural areas.

The National Rural Health Alliance (NRHA) is hopeful of a major funding boost to attract allied health professionals across areas of major rural need, such as mental health.
In this year’s Federal Budget, the Government announced a $550 million Stronger Rural Health Strategy aimed at boosting doctor and nurse numbers in under-served areas.
But allied health, which represents around one quarter of the healthcare workforce, has long lagged behind.
In 2013, there were 91 full-time equivalent (FTE) psychologists per 100,000 people in major cities, but the number plummets to just 30 in remote and very remote areas, according to the Australian Institute of Health and Welfare. There is also a lack of physiotherapists, mental health nurses, dietitians, occupational therapists and many other allied health professionals.
NRHA Chief Executive Mark Diamond last week met with Federal Health Minister Greg Hunt to call greater attention to the lack of allied health professionals outside of the cities.
‘Minister Hunt has asked us to come back with a proposal, and we interpret that very positively,’ Mr Diamond told newsGP.
‘The distribution of those professions [physiotherapists, mental health nurses, dietitians, occupational therapists, etc] is far worse than for GPs. They haven’t been able to recruit a psychologist in Kalgoorlie for 18 months.
‘The rate of suicide in Aboriginal communities is up to four times the national rate – and you can’t get psychologists out there.’
Mr Diamond said there is too much pressure placed on GPs to shoulder the healthcare burden in the absence of allied health professionals.
‘To think a sole GP can spot all these issues is unrealistic,’ he said.
‘GPs don’t want to be on call 24–7. Do they want to be in the emergency department and then delivering babies at 3.00 am later that night? The expectations are quite extraordinary of what can be a sole operator. 
‘GPs get out to the bush, but they’ve got no team around them. They can’t refer to a physio – where are they? Occupational therapists, dietitians, all these professionals are crucial in primary health.
‘And we know access affects 20% of a person’s health outcomes. So the [health] differences you see between metro and rural areas, 20% of that is access.’ 
Mr Diamond said that part of the issue is the fact there is no single policy lever that can be pulled, with many different professions and overlapping areas of responsibility between state and federal governments.
‘It’s going to be a big job,’ he said.
Mr Diamond said the NRHA is working closely with National Rural Health Commissioner Professor Paul Worley on rural generalist pathways for allied health professions, which would be similar to the Rural Generalist framework agreed upon by the RACGP, the Australian College of Rural and Remote Medicine (ACRRM) and Professor Worley early this year.
‘Longer term, we want to do for allied health what [Professor] Worley is doing for [general practice],’ Mr Diamond said.
One of NHRA’s 37 member organisations, Services for Australian Rural and Remote Allied Health (SARRAH), is working on an allied health rural generalist pathway, with its first program for seven professions launching in May last year.
Chair of RACGP Rural Dr Ayman Shenouda told newsGP it is hard to find allied health professionals in many rural communities.
‘The more rural you go, the less availability there is and the less support and collegiality is available,’ he said. ‘It’s hard for [allied health professionals] to keep their professional development happening in rural areas.
‘Rural GPs work with whoever is available to try and address a patient’s needs.’
Dr Shenouda said a multidisciplinary approach, including allied health, is vital to quality rural healthcare.
‘I’m very inclined to stress a team approach to patient care – the more we have, the better it is,’ he said. ‘In my practice [in Wagga Wagga, NSW] I have a model with allied health involved.

‘It works a lot better for patients to have a multidisciplinary approach. We can repeat messages to patients about health. It works well when we’re all under the same banner – we can see medical records and discuss case-managed patients as they come through.
‘There’s no doubt that teamwork does work.’
The Department of Health was contacted but did not respond to requests for comment.

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