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GPs should be central to disaster relief: RACGP


Matt Woodley


23/04/2020 4:24:20 PM

The college has called for governments to better utilise primary care when natural disasters strike.

Town under threat from bushfire.
GPs were prevented from helping at relief centres during the bushfires due to ‘red tape’.

The RACGP’s submission to the Royal Commission into National Natural Disaster Arrangements also recommends that GPs be formally recognised as frontline health providers in any future natural disaster planning in Australia.
 
RACGP President Dr Harry Nespolon said the emergency response to last summer’s unprecedented bushfires had exposed long-standing deficiencies that frustrated some GPs whose efforts to help had been blocked.
 
‘GPs weren’t sufficiently consulted because primary care is not integrated into emergency responses. There were just no formal arrangements in place to utilise hardworking GPs during the initial response phase when fires were tearing apart communities,’ he said.
 
‘The states and territories are responsible for emergency planning and the Federal Government has responsibility for general practice, so it creates confusion and makes it hard to include GPs in wider healthcare responses to natural disasters.
 
‘So you have the absurd situation of GPs rolling their sleeves up to help and being turned away from refuge and evacuation centres because they were not part of the area’s response plan.’
 
Dr Nespolon said this ‘red tape’ had prevented many GPs from helping people in need who had suffered serious injuries, a situation he described as unacceptable.
 
‘The majority of presentations to evacuation centres during the bushfires were for things a GP could treat. That includes an initial mental health consultation for people who had been to hell and back,’ he said.
 
‘Some of these people had lost loved ones and homes, and care and treatment from a local GP who knows the community would make all the difference.’
 
However, while the submission lists many areas for improvement, Dr Nespolon said there were also aspects of the bushfire emergency response that had worked well.
 
‘Following strong advocacy from the RACGP and other bodies we saw positive actions taken such as the funding for bushfire mental health support and expansion of telehealth and telephone items,’ he said.
 
Prioritising applications from GPs able and willing to work in practices in bushfire-affected communities was also welcome in addressing workforce distribution issues. These were sensible measures and we did all we could to make sure our GPs were taken care of.’
 
Going forward, Dr Nespolon would like to see increased general practice representation on recovery committees, as GPs support devastated communities for ‘months after the smoke clears’.
 
‘Information wasn’t being provided that could have made a real difference. For example, there were not accessible courses to support rapid mental health upskilling at a time when many people in affected areas were really struggling,’ he said.
 
‘Natural disasters, including this summer’s bushfires, are not going to go away – in fact it’s almost certain they are going to get worse. The RACGP recognises climate change as a health emergency so crises like we saw last summer are going to become more common.
 
GPs are on the frontline doing their best and we need all the support possible to help patients experiencing the most challenging periods of their lives.’
 
Major reforms featured in the RACGP’s submission include:

  • formal recognition of GPs as frontline health providers in any national natural disaster arrangements in Australia across preparation, mitigation, response and recovery
  • funding for the establishment of national and state-based health disaster response round tables with strong primary care representation via the RACGP
  • development of a standardised national framework for the engagement and coordination of general practice teams in support of isolated communities during disasters
  • requirement for Primary Health Networks to develop a skills register of practising clinicians (eg those who have anaesthetics training) who can respond during disasters, local trauma cases and pandemics, both in a locum and volunteer capacity
  • formal, funded general practice representation in state/territory disaster response plans
  • funded travel for GPs to work in affected areas during the recovery phase and increased funding for general practices to allow for the employment of extra locum GPs and psychologists/other mental health providers to support the recovery phase over the first year
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Dr Frederick Ross Wilson, OAM   24/04/2020 8:26:21 AM

This initiative was suggested via the Rural Faculty at least 10 years ago!


Dr Ian Mark Light   24/04/2020 9:31:53 AM

Disaster Medicine Training ought be expanded giving GPs the efficacy and confidence to meet the worst case scenario challenges of the future
Few predicted the COVID 19 though Bill Gates spoke about a pandemic threat at length at a TED talk in March 25 2015-"Not missiles but microbes "
Only partially correct a lot of deaths injuries and refugees from wars from 2015
The world has been distracted by global wars and natural disasters as in Australia with the Bush Fires
There is the Emergency Medicine Diploma 18 months full time training .


A.Prof Christopher David Hogan   24/04/2020 5:56:36 PM

It is a good idea.
It was a good idea over 30 years ago in Victoria when RACGP helped establish Medical Displan which did exactly this. It appointed 12 metropolitan Disaster Coordinators (of which I was one) and 45 rural Disaster coordinators.
It fell apart for several reasons- Full Time Emergency Services thought they could do a better job; people thought emergencies & disasters are the same thing (they definitely are not); Medical Displan was encouraged not to publicise its presence or activities & there was a lack of succession planning