More than one in three says their practice ‘at risk of closing’

Jolyon Attwooll

27/09/2023 4:26:20 PM

The results of a newsGP survey suggest serious concerns about the sustainability of general practice remain front of mind.

Stressed GP
Workforce issues and a lack of sustainability are among the issues raised by general practice owners.

More than a third of newsGP readers say their general practice is at risk of closure in the next 12 months, according to the results of a new poll.
Conducted last week, the poll attracted more than 1000 votes, with 347 holding concerns about their practice’s viability in the coming year. Nearly half (44%) said there is no risk of their clinic closing, while a significant minority – 212 respondents, or 21% of the total – were unsure.
There is no way of telling from the survey results if more than one GP from each practice responded, nor the size of the practices which the respondents believe are at risk.
Nonetheless, the results are likely to add to concerns about the financial challenges faced by general practices.
Earlier this month, newsGP reported on 184 practices closing in the most recent 12 months of data available to Primary Health Networks (PHNs) around the country, with 110 confirmed as opening during the same time.
Overall, there was a net loss figure of 55 general practices for 16 PHNs that gave an indication of the reduction or increase in clinics in their respective regions.
However, only partial data was reported, with almost half of PHNs not responding with any details. Others also said their numbers are approximate.
A Department for Health and Aged Care (DoH) spokesperson told newsGP that it does not consider the ‘net loss’ analysis to be ‘sound’, while confirming it has no longitudinal dataset on openings and closings of general practices.
RACGP President Dr Nicole Higgins told newsGP the recent poll response is a cause for significant concern.
‘It is clearly a real worry that more than a third of newsGP readers say their practice is at risk of closing down over the next year,’ she said.
‘The question of sustainability has never been so important, and with the threat of increased payroll tax hanging over general practices, these issues are not going away.
‘There’s no doubt the Federal Government has recognised the strain general practice has been under and has taken steps to address it – but we will be watching very closely to make sure any new measures have the right impact.
‘As part of that, more needs to be done to track what is happening on the ground, including how many general practices are opening and closing, and the reasons for that.’
Dr Justin Oughton, a GP in regional NSW, commented on newsGP that his practice had announced its closure after 43 years of operation, and pinpointed workforce issues as the reason.
‘As a smaller practice with only two full time, and one part-time doctor and one registrar, we were unable to survive,’ he wrote.
Dr Oughton said the practice, for which he is an associate, had been looking for new doctors and cost cutting measures where possible, as well as moving away from bulk billing.
‘Unfortunately following the retirement of two doctors our income to overheads had become too marginal,’ he wrote.
‘The move towards private billing resulted in a decrease in patient visits – no doubt a win for the Government – but also meant we had to reduce our registrar training positions from two to one.
‘Moving forward from where we are now It appears that to be a healthy GP practice you will need a minimum of five full-time doctor equivalents completely booked up.
‘This means no capacity for on the day visits. Our local emergency department will now have to soak up the extra load.’
Several of the PHNs that responded earlier this month cited workforce pressures as a threat to the viability of general practices in their region, including retiring GPs that were not able to be replaced.
Financial pressures were also highlighted by several PHNs, as well as relocating GPs.  
One PHN covering the Nepean Blue Mountains area highlighted a reduction of 73 GPs working in the area since 2019 – or around 15% of the workforce – at a time when the estimated population of the region had increased by almost 7000.
On Monday, the Federal Government said measures to reduce bureaucracy in recruiting overseas doctors will help to address shortages.
In a press release, it cited the scrapping this month of a requirement for international medical graduates to include a Health Workforce Certificate (HWC) or Health Workforce Exemption Certificate (HWEC) as part of their employer-sponsored visa applications.
‘Visa applications in relation to healthcare occupations including GPs are still the highest priority amongst the Government’s processing directions, with assessment times down from approximately 30 days to 1–2 days for decision-ready applications,’ Federal Immigration Minister Andrew Giles said.
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Dr A Esin Dalat Ozme   28/09/2023 8:56:55 AM

So much red type paper work to much control interference we need to just look after our patients do real medicine

A.Prof Christopher David Hogan   28/09/2023 9:31:56 AM

I keep getting asked if General Practice will have a future. As a historian I can say that it has had a massive past & has existed under a variety of funding models.
It is the best & most affordable & efficient model of of health care.
We cannot continue with the expensive model of intense hyperspecialisation as a society.

Dr Geoffrey Ronald Greig   28/09/2023 6:29:06 PM

With ongoing miniscule indexation of rebates, limited application of bulk billing incentives and payroll tax imposition of around 5% with possible 5 years back payments I’m not surprised. My 20 yo hairdresser now gets more per 15 minutes than I do if I bulk bill a non concessional patient. What a joke
Why would anyone to own or buy a practice escapes me
All these changes will just accelerate corporate general practices and destroy general practice as we currently know it
Well done by politicians of both major parties.

Dr Andrew Milne   28/09/2023 10:42:01 PM

But if there re no GP's other specialists won't get referrals and can't make the big bucks!
As per yesterday's "news" post - ensure adequate rebates for the current GP fee for service model and there won't be an issue recruiting, training and retaining a thriving GP workforce. Keep the status quo and my generation of GPs will be the last.

Dr Ruth Sophie Ratner   29/09/2023 1:58:05 PM

Unfortunately the RACGP has not been helping, other than to encourage us to bill privately. There has been inadequate action on the onerous CPD requirements and there has been an enormous increase in Accreditation requirements which disproportionately impact smaller, older practices - the very ones that often provide the most comprehensive care.

Dr Abdul Ahad Khan   30/09/2023 12:54:19 PM

Dr. Andrew Milne,
Regarding your Statement : "
" But if there re no GP's other specialists won't get referrals and can't make
the big bucks! "
You are incorrect in that Assertion , because the Allied Health Professionals ( the Pharmacists / Physio-Therapists / Nurse Practitioners, etc. ) will be given full Referral Rights - GPs will be made DISPENSABLE.
GPs are near EXTINTION, unless the RACP & the ACRRM wake up & stand up for us Coal-faced GPs & call for a Nation-wide Strike each Monday ( all GPs should STOP WORK each Monday ) , with widespread Media Announcements - it will take only 1 or 2 such Mondays & the Govt. will 100% cave in .
The current Medicare Rebates equate to GPs doing SLAVE LABOUR.
Dr. Ahad Khan