How many practices have opened and closed in your area?

Jolyon Attwooll

18/09/2023 4:47:10 PM

This month, newsGP asked every PHN about new general practices and those that shut their doors over the past year. Here is what we were told.

Map of Australia.
Seventeen of the 31 PHNs contacted by newsGP provided information regarding practice closures and openings in their area.

On 1 September, newsGP emailed inquiries to PHNs all around Australia. The questions were simple. 

How many general practices had opened and closed in the PHN area in the past financial year, or the most recent 12 months for which data is available? And how many might be at risk of closure? 

There was also a request for context or comment if the PHN wished to provide it. 

As reported last week, the responses were mixed. There was a wide variety of detail supplied as well as insight offered into the situation of general practices in the different regions. 

Overall, newsGP received information for 17 of the 31 PHNs. Some acknowledged the information was not closely tracked. One only gave details for closures, not openings, making it impossible to discern a net loss or gain for that area. Others confirmed the type of practices that had closed, although most did not. 

All up, there were 184 closures and 110 new practices – although the net loss figure of at least 55 general practices was for the 16 PHNs that indicated the overall reduction or increase in practices. 

Several PHNs deferred to the Department of Health and Aged Care (DoH). However, when approached, the DoH provided no further detail for those areas and queried the usefulness of the results.

‘The DoH does not have a longitudinal dataset on openings and closings of general practices and does not consider the “net loss” analysis, based on partial data provided without a consistent methodology, to be sound,’ a spokesperson stated. 

It also questioned whether general practices closing and opening is the best measure of sustainability, a point also raised by some of the PHNs. 

For the sake of full transparency, here are the responses from each PHN with details of openings and closures, if any were supplied, as well as any additional comment. Some responses have been edited for length. 

Openings: Four practices. 
Closures: One practice, which was attributed by the PHN to ‘retiring GPs’. 

New South Wales
Central and Eastern Sydney    

No details supplied.

Hunter New England and Central Coast    
Openings: four practices. 
Closures: three practices. 

The PHN also reports eight practices at risk of closure for a range of reasons, including GPs relocating, retirements, patient demand exceeding GP and practice capacity, as well as lack of success with recruiting replacement GPs or accessing affordable locum coverage. 

A spokesperson highlighted several local initiatives to bring GPs to the region. 

No details supplied.

Nepean Blue Mountains
Openings: unconfirmed.
Closures: unconfirmed, but overall a net loss of three practices between June 2022 and June 2023.

The PHN supplied extensive extra detail and context. It confirmed the number of general practices over five years as: June 2023 – 133; June 2022 – 136; June 2021 – 139; June 2020 – 138; June 2019 – 139.                     
It also highlighted the number of GPs: June 2023 – 429; June 2022 – 446; June 2021 – 434; June 2020 – 494; June 2019 – 502.

As well as the reduction in GPs, a spokesperson pointed out that the estimated population has risen from 380,506 in 2019 to 387,316 in 2022. 

‘The number of general practices operating in our region is not a huge concern for us,’ they said. 

‘What is a real concern, however, is the decreasing number of GPs, while at the same time our population is increasing. 

‘Practices are not so much closing, as operating with fewer GPs, making appointment availability difficult for patients and putting pressure on the remaining GPs.’

Lizz Reay, CEO of Wentworth Health (the PHN for Nepean Blue Mountains), said she has seen a steady decline in GP numbers and that patients in some areas have to wait 1–2 weeks to see their regular GP, with ‘many reasons’ for the trend.

‘Previous under investment in primary care, fewer medical students choosing to go into general practice, complexity of recruiting overseas doctors, changes to Distribution Priority Areas, and the impacts of COVID-19 have all contributed,’ she said.

Ms Reay said one of the most pressing issues is ensuring enough new medical graduates come into general practice to replace the ageing GP workforce, with roughly 20% of GP full-time equivalents aged over 65. 

Healthy North Coast
No details supplied.

Northern Sydney
Openings: Nine practices.
Closures: 18 practices. 

A spokesperson said the general practice count in 2021–22 was 292 according to its annual report, and that the PHN region now has a net practice count of around 283 general practices. 

Reasons for the closures were given as: ‘Retiring GPs, merging with other practices; small practices closing, but with some GPs relocating to nearby practices, the selling of the building housing the practice; GPs renting rooms/space at other facilities; practice sold to/purchased by a corporate and merged with a nearby practice.’

South Eastern NSW
Openings: two practices. 
Closures: eight practices.

A spokesperson said there is a ‘less formal list’ of new practices, but they are aware of a couple in the region that have opened recently. 
The practice closures include six that shut their doors altogether, and two more that closed due to mergers with other practices. 

Another practice closed and reopened under new management. There are currently three known ‘at risk’ practices, according to the spokesperson. 

South Western Sydney    
Openings: not tracked. 
Closures: 19 practices since September 2022. 

A spokesperson said the closures occurred in Bankstown (three); Camden (two); Campbelltown (four); Fairfield (two); Liverpool (seven); Wingarribee (one). 

They said five further practices are due to close, with four more at risk of closing.

Western NSW
No details supplied.

Western Sydney    
No details supplied.

Northern Territory
No details supplied. 

Brisbane North 

No details supplied. A spokesperson said the PHN ‘is not at liberty’ to pass on the information requested.

Brisbane South
No details supplied. 

Central Queensland, Wide Bay, Sunshine Coast
No details supplied. 

Darling Downs and West Moreton    
Openings: 12 practices. 
Closures: 10 practices. 

A spokesperson said most of the new practices have opened in the West Moreton catchment, with the closures evenly distributed. 

‘The closures have been the result of a range of reasons including high rent increases and inability to attract new GPs to regional areas,’ they said. 

The spokesperson added that ‘a couple of regional practices’ are being monitored, ‘predominantly due to older GPs not having someone in place to succeed them’, which has prompted a GP Workforce Working Group, led by the PHN, to start ‘developing a plan to tackle the issues of long-term viability and sustainability’.

Gold Coast
Openings: five practices.
Closures: eight practices. 

A spokesperson said they ‘will not speculate on the individual reasons for closures’, and that the region is well-serviced by general practices.

Northern Queensland 
No details supplied. 

Western Queensland
No details supplied. 

South Australia
No details were supplied from either of the state’s two PHNs (Adelaide and Country SA). 

Eastern Melbourne

Openings: 14 practices.
Closures: 13 practices.

No details supplied. 

Openings: 13 practices. 
Closures: 20 practices. 

The spokesperson highlighted the Tristar Medical Group closure during this period. 

They said they are unable to tell from their data whether the number of GPs in the region has reduced, and said they have no clear indication of the reason for the closures.

They also said 50% of Victoria’s 153 GP catchments have moderate-to-high GP workforce need, and that the GP catchments with the highest need are all located in rural areas.

Matt Jones, CEO of Murray PHN, said all levels of government and health services need to collaborate to address the issue. 

‘For those of us working in rural and regional areas, it is clear that we need more tailored and nuanced models of general practice funding,’ he said.

‘Instead of simple fee-for-service funding models, we need long-term planning and support for communities to grow their own workforce and build systems and structures that provide high-quality healthcare as close to home as possible.  

‘We also need to support our medical professionals so they can work in satisfying and sustainable jobs.’

North Western Melbourne 
Openings: 19 practices.
Closures: 26 practices.

A spokesperson said the numbers should be seen as indicative rather than definitive. 

The reasons for closure were given as GPs retiring (19%); relocating (11%); unknown (61%); change of practice direction (7%). They said they do not have details of practices at risk of, or contemplating, closure. 

‘General practice owners aren’t obligated to tell us why they cease operation, but we are hearing through our GP Expert Advisory Group and other avenues that financial pressures are often a factor,’ Christopher Carter, the NWMPHN CEO said. 

‘Other reasons for closure include planned or early retirement, a decision to relocate, or a change of function.’

South Eastern Melbourne
Openings: 10 practices approximately.
Closures: 20 practices.

Approximately eight solo GPs and 12 general practices with two or more GPs have closed, the PHN indicated.

A spokesperson said ‘quite a few’ of the closures are due to mergers into existing practices. They also said there are approximately two general practices at risk of closure. 

Western Victoria
Openings: 10 practices. 
Closures: 18 practices. 
Practices at risk or contemplating closure: 13

Workforce shortages, relocating GPs and financial issues were listed as contributing factors. 

Western Australia 
Openings: Five practices.
Closures: 10 practices. 

After an initial inquiry to the WA Primary Health Alliance, newsGP was told the organisation was ‘not at liberty to disclose this type of information’.

However, the figures were subsequently supplied by Rural Health West, the Rural Workforce Agency (RWA) for Western Australia. 

According to a spokesperson, seven of the closures were in the Country WA PHN, two in Perth North – Outer Metro – North, and one in Perth South – Outer Metro – Peel. Five were group practices (although two of these were serviced by a sole GP when they closed), another was a partnership, and four were solo practitioners.

Reasons given for closures included corporates deciding to withdraw, staffing shortages, loss of GPs and a retirement.

Of the five openings in the same timeframe, three were in Country WA, and two were in Perth North – Outer Metro – North. Three are solo practitioners, one is a group practice, and another is a partnership.

A spokesperson said the RWA’s Workforce Solutions team ‘is working intensively with three practices who are at risk of closure and have worked with a further nine practices who were at risk of being without access to GP services; all of which were successfully resolved’. 

Those that shut their doors ‘were often by practices who did not engage Rural Health West prior to their closures,’ they said.  

Openings: three practices. 
Closures: seven practices. 

The PHN did not specify openings and closures, with the difference in net total inferred from information regarding year-on-year figures.

‘Tasmania currently has 128 accredited general practices and 136 in total including Aboriginal Medical Services,’ a spokesperson told newsGP. 

‘This compares to 136 accredited general practices out of 140 total the year prior. 

‘There have been a number of general practice mergers, closures and openings during this period, with new general practices established in Evandale, Beaconsfield and Campbell Town to replace practices that have closed.

‘There are several rural and remote areas in Tasmania facing significant shortages of GPs such as Tasman, Brighton and St Marys. This aligns with similar challenges across Australia.’ 

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A.Prof Christopher David Hogan   19/09/2023 8:55:52 AM

The PHNs were asked a simple question critical to the function of supporting the provision of General Practice services to the people in their communities .
At the very least PHNs are expected to be able to contact - in some way-the practices in their area .
However this appears to be beyond too many of them.
Others cite “privacy” or as it is more cynically known as”freedom from information “.

This is totally unacceptable & instantly calls into question the value of the existence of those PHNs unable or unwilling to provide such critical information to the public whose needs they apparently serve

Dr Edwin Kruys   19/09/2023 9:54:53 AM

It would be great if we could work towards a transparent, up-to-date national dashboard of all primary care providers, which can be used for service planning but also for clinical care/community referrals/social prescribing etc. Perhaps the national healthcare provider directory can be used for this purpose?