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Landmark review to address ‘uneven spread’ of GPs


Michelle Wisbey


21/11/2023 4:24:29 PM

Policies used to attract healthcare workers to regional Australia will go under the microscope, as part of an effort to address ongoing maldistribution.

Federal Health and Aged Care Minister Mark Butler.
Federal Health and Aged Care Minister Mark Butler. (AAP Image/Mick Tsikas)

The Federal Government is set to scrutinise Medicare’s impact on healthcare worker distribution, Health and Aged Care Minister Mark Butler has announced.
 
The Working Better for Medicare Review will consider three main policy levers – the Monash Modified Model, District of Workforce Shortage, and Distribution Priority Area – to better allow doctors to work in the areas they are needed most.
 
It will also examine overseas doctors and their experiences working in Australia, as well as how expanded Medicare funding can help GPs work to their full scope of practice.
 
Minister Butler made the announcement during a keynote address to the Committee for Economic Development (CEDA) in Melbourne, promising to rebuild the depleted system and create a stable workforce.
 
‘The global health workforce crunch is not going to be solved overnight,’ he told attendees.
 
‘While part of the solution will be in changing who Medicare supports to deliver care, the other part will be in changing how and where Medicare supports them to deliver that care itself.
 
‘[The] levers we have to spread doctors and health workers around the country are from a very different time … which is why we are going to undertake a wide-ranging review to urgently investigate how to more equitably distribute doctors and other health workers across the country.’
 
The review comes as remote GPs continuously report being overloaded with work as they grapple helping sicker communities within a Medicare system that works against them, as the same time as cost-of-living pressures rise.
 
RACGP doctors working rurally have described shortages as becoming ‘catastrophically worse’ in recent years, saying remote areas are turning into ‘professional wastelands’.
 
Minister Butler said years of Medicare neglect means it has ‘never been harder or more expensive to see a doctor’.
 
‘The largest investment in bulk billing in the history of Medicare is making it cheaper to see a doctor and the Working Better for Medicare Review will make it easier to get in to see one,’ he said.
 
Despite a recent surge in healthcare workers overall, it is predicted Australia will be short 10,600 GPs by 2031, as the same time as demand for GP services is expected to increase by 58% over the next decade.
 
A recent newsGP investigation also revealed at least 184 general practices have closed around Australia in just one year, with not enough new openings to fill the gap.
 
RACGP President Dr Nicole Higgins welcomed the latest review, telling newsGP Australia is currently battling through a ‘significant problem’ not just in general practice, but in the broader primary care workforce.
 
‘We need to be looking at the pipeline from attraction to recruitment and retention, and having a look at the barriers and the red tape so we can make sure that we get the GPs where they’re needed,’ she said.
 
‘It’s huge problem for our rural and regional GPs, we are all struggling with workforce, and we’ve got significant barriers to overcome.
 
‘But as this workforce shortage gets closer and closer to our cities, politicians are becoming more aware of the impact that it’s having on our communities.’
 
In a bid to attract more overseas doctors to Australia, the RACGP has already committed to making changes to its accreditation processes and investigate how to simplify applications for international medical graduates.
 
But according to the latest Health of the Nation report, released last week, the lower numbers of GPs in rural and remote areas is already having an impact on healthcare overall, with half of all patients out of the cities waiting 24 hours or more for an urgent GP appointment.
 
Dr Higgins said the first concern that needs to be addressed is how to better attract GPs and healthcare professionals to where they are needed most.
 
‘It’s about making sure that our GPs and GPs in training are funded for paid parental leave, study leave, and incentives to come into general practice,’ she said.
 
‘In terms of recruitment, that means ensuring our doctors who are wanting to work and coming in from overseas countries are supported to work, and then having a look at retention of the workforce and sustainability.
 
‘It’s about addressing state payroll taxes and ensuring we get funding for our multidisciplinary care teams to support our GPs.’
 
The Working Better for Medicare Review will be led by nurse and remote health expert Professor Sabina Knight, and former senior health bureaucrat and academic Mick Reid.
 
The review’s findings are expected to be provided to the Government in mid-2024.
 
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Dr John Anthony Crimmins   22/11/2023 7:14:54 AM

Its good to see the term Uneven distribution of GPs is being used than GP shortage.

As a former remote rural GP (procedural) for over 8 yaers and 10 yaers rural all up, you cpould always earn more money in the city and never have to set a bone or deliver a baby or attend a car accident at 2am. The Medicare figues will show a GP in a Monash <3 see the same patient at least 5 times more than a GP in Monash >4 and GP/Patient numbers in city/large regional are at laest half or even a third of that in the remote rural . It a maldistribution noyt a shartage and VPE then compulsory Patient enrolment is a strategy that may solve this.


Dr Nahyan Asif   22/11/2023 7:49:44 AM

Solution is simple. Stop treating international medical graduates as second class citizens / pushing them into forced slavery and instead create a 10 year moratorium for all local graduates to work rurally.

The very fact the later notion has never even been considered speaks volumes about the discriminatory attitude the government has towards IMGs.


Dr Saluay Kidson   22/11/2023 9:49:07 AM

Your second last paragraph is telling; with respect, doctors have been pushed to the back of decision making policy processes, largely replaced by nurses. We have nurses as CEO's, nurses as heads of health boards, etc. Yet they do not carry PI insurance so ultimately the responsibility for poor outcomes are passed on to others. Consider the levels of training doctors undertake, then consider what nurses do. As a profession we take ownership of poor management decisions made clinically. As a group we must own poor cohesion which has contributed to this exclusion from many aspects of policy determination. With Australia highly urbanized especially in major cities, incentives for rural practice need to be serious and focussed. As a former regional GP I can attest to the great satisfaction of practice outside big cities. The realities of higher costs, longer hours, higher stakes, significant educational challenges for family need to be addressed rather than ignored.


Dr Angela Maree Roche   22/11/2023 10:58:57 AM

They are two separate problems. Rural and remote , and the impending shortage of GPs overall and decline in recruitment to the profession . Don’t confuse the two. If you do , you will end up worsening the recruitment at the medical student level . At that won’t help anyone .


Dr Michael Rice | Mununjali Country   22/11/2023 7:47:07 PM

I hate to say it: but when medical students and junior doctors observe rural GPs to be better off than city-centric consultants (better-off in more ways than simply cars, holidays and houses) then the balance will even-up. After a decade or so.


Dr Christopher Brian Maclay   19/01/2024 10:24:37 AM

If I see another landmark review I think I will .......