How could fuel price rises impact GP care?

With unleaded petrol prices up almost 40% and diesel by more than 66% in less than a month, the impact of the Iran war is reaching into all spheres of life – including general practice.
 
For RACGP Rural Chair Associate Professor Michael Clements, it is being felt right across rural and remote clinics and their patients.
 
‘It’s already affecting our planning,’ he told newsGP.
 
‘We know that the fuel prices are high now, and we know that even if the war ends tomorrow, they’re going to remain high.
 
‘A large proportion of our remote health services rely on drive-in, drive-out or fly-in, fly-out models of care.’
 
Associate Professor Clements notes that funding for travel to many remote services is fixed, with no scope to increase under existing government contracts in line with the fuel costs.
 
He also acknowledges the potential effect on general practice registrars on rural placements, with many working on a drive-in, drive-out basis.

‘We certainly do expect them to be impacted as well, and they may need to talk to their practices or their supervisors about what it might mean,’ he said.
 
As well as the challenges for carrying out care, Associate Professor Clements notes his patients are already de-prioritising their own healthcare due to the situation.
 
‘One farmer said they need 60,000 litres of fuel to plant the harvest, and if they don’t plant the harvest then they have no income at all, and so they have to try and source the fuel,’ he said.
 
‘So they make decisions like, “well, I’ll fill up the seeder and not the car”.
 
‘We’re already seeing patients prioritise their fuel over their health.

‘That includes patients delaying a face-to-face visit if they don’t think it’s necessary.’
 
That approach is also beginning to appear in metropolitan areas, according to Chair of RACGP Specific Interests Poverty and Health Dr Tim Senior, who works in south-west Sydney. 
 
‘One of my patients was booked to come in face to face, and they switched to a phone consult because of the petrol prices, and they told me that,’ he told newsGP.

‘I’m hearing from other GPs that telehealth has become more popular again this week.

‘Fuel price rises affect everyone – but the proportion of income that it affects for low-income households is higher, so it has a bigger impact and poses more limits on low-income households.
 
‘People have already been stretched by the cost-of-living crisis and will be watching household bills and costs really closely – any travel that’s avoidable will go early and that’ll happen more among people in families who have less income.’
 
While there have been reports of petrol stations running out of petrol, for Dr Senior the possibility of being unable to get to work is not yet a topic of serious discussion in his clinic – but he believes it could be, depending on what comes next.
 
‘There will be more discussions about telehealth, it depends how close doctors are to the practices they work in,’ he said.

‘That’s going to be variable from place to place, it will depend on availability of public transport as well.’

On a practical note, however, he suggests the situation should act as a prompt for practices to ensure patients are registered with MyMedicare to give them access to longer telehealth item numbers if they are required.
 
For Associate Professor Clements, the prospect of returning to widescale telehealth seen in the early stages of the COVID-19 pandemic is not a welcome one.
 
‘We relied heavily on telehealth, and we did that at the time because we had to,’ he said.
 
‘But with hindsight, we also now know that there are people who did have poorer health outcomes, that cancers were diagnosed later, disease was more advanced before we found it.
 
‘So yes, we have previous models of care we can lean on, but we also know those previous models of care weren’t sufficient for many people.’
 
He hopes it will not come to that and describes his current mindset as ‘alert but not alarmed’.
 
‘Obviously we’d all prefer the conflict is resolved and we find solutions that return the oil price back to where it needs to be,’ he said.
 
‘General practices and doctors can absorb a bit of risk now if we think it’s short-term, but if it looks like this is going to be a long-term thing, we will absolutely see people change their outreach and models of care.’

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