News

New GP visa program a stop-gap solution


Matt Woodley


13/03/2019 1:41:13 PM

Chair of RACGP Rural Associate Professor Ayman Shenouda has described the Federal Government’s Visas for GPs initiative as only a short-term solution to the wider problem of GP maldistribution.

Australian map and visa
The initiative to address maldistribution has been described as a short-term measure.

The Visas for GPs initiative, which came into effect this week, will result in 800 fewer overseas-trained GPs over the next four years and ensure international medical graduates (IMG) who are part of the skilled migration program are sent to areas with the greatest need.
 
According to the Federal Government, GP numbers have increased at a rate three times faster than population growth over the past decade, due to a surge in locally trained medical graduates and a continued high intake of overseas-trained doctors.
 
However, Chair of RACGP Rural Associate Professor Ayman Shenouda told newsGP that while it ‘makes sense’ to reduce the intake of IMGs and more effectively distribute them where they are most needed, investment in long-term strategies to encourage local graduates to work in rural areas is the key to addressing maldistribution.
 
‘The real issue is not the number of doctors, it is the maldistribution we still have in rural communities that have no accesses to quality healthcare. It is a huge problem and it needs to be urgently addressed,’ he said.
 
‘The proposed National Rural Generalist Pathway offers a clear pathway for locally trained young doctors, with flexibility that allows entry and exit at different stages.
 
‘We need to ensure adequate funding for the pathway itself, alongside essential factors in establishing a critical mass of trainees with enough flexibility for it to work within the varying jurisdictions.’

The National Rural Generalist Pathway is currently in its implementation phase, and the RACGP is urging federal and state governments to fund and support the program.
 
‘Supporting local graduates and IMGs to train and work rurally is an important concept, as the evidence is clear that doctors who train and upskill rurally tend to stay rurally,’ Associate Professor Shenouda said.
 
‘Adequate remuneration and recognition are essential elements of the equation, as is allowing lateral entry for practising GPs and other rural doctors who want to acquire new skills to address the shifting needs in these communities.
 
‘We need to couple this strategy with educational programs for overseas-trained doctors, who might not be oriented with the Australian health system, to ensure they are well supported.’

Ayman-Shenouda-Hero.jpg
Chair of RACGP Rural Associate Professor Ayman Shenouda believes the Federal Government’s Visas for GPs initiative is only a short-term solution to the much bigger isssue of GP maldistribution.
 
According to the Productivity Commission’s 2019 Report on Government Services, there are 103.5 full-service equivalent GPs per 100,000 people in major cities, compared with around 90 per 100,000 in outer regional, remote and very remote areas.
 
Under the new regime, all employers that attempt to fill a position with an IMG are required to obtain a Health Workforce Certificate for each GP.
 
The certificates, issued by Rural Workforce Agencies, are designed to confirm the ‘genuine need’ for an IMG to fill a primary healthcare position in a given region, and direct GPs away from well-serviced metropolitan areas.
 
The initiative, which the Government expects to generate savings of $415 million, will work in combination with a data ‘planning tool’ intended to support effective distribution. It only applies to overseas-trained GPs hoping to work as skilled migrants in Australia and won’t affect other medical professions, such as specialists.
 
Department of Health (DoH) guidelines will help assess the suitability of an IMG filling a particular position, while rural workforce agencies will also use local knowledge to supplement the criteria. It will not assess the IMG’s suitability for a visa.
 
Federal Minister for Regional Services, Senator Bridget McKenzie, said the Visas for GPs initiative will allow the Government to manage GP numbers and better distribute the national medical workforce.
 
‘The Visas for GPs initiative won’t reduce the number of GPs currently providing services, but will reduce the rise in doctors in city areas and improve numbers in rural areas where they are needed,’ she said.
 
‘The new requirements will ensure the right balance of specialist GPs is available to the Australian community, while also providing opportunities for Australian-trained doctors.’
 
The Visas for GPs initiative was announced in the 2018–19 budget as part of the Government’s 10-year $550 million Stronger Rural Health Strategy, which is aimed at meeting current and future health workforce needs in remote and regional Australia.



IMGs international medical graduates national rural generalist pathway visas



Dr Agatino Ferraro   14/03/2019 9:38:47 AM

Rate of growth of GP numbers three times to that of the population is not necessary and if continued would eventually lead to unemployment among GP's. Therefore reducing the entry of overseas trained doctors is appropriate at this stage. Need to assess whether there are also too many locals coming through and possibly reduce the number of training places. The government can provide even greater financial incentives for GP's to work in the country.
On a different note general practice is being starved of funds. Our fees are even lower those of allied health and especially those of psychologists. We's had a 2% increase in the past 4-5 yrs while staff and other costs and requirements have sky rocketed. Since I cannot increase my revenue I've had to cut costs in the form of reducing my secretarial working hours by half in the past 3 yrs (staff costs are the biggest expense). Perhaps there should be another push for non-compulsory co-payments. Agatino Ferraro.


GK   14/03/2019 12:35:03 PM

There's Definitely no need for Overseas trained Doctors. The GPs entering into GP Regsitrar programme must be made compuslorily to do dop 1 year of Rural GP experience before getting the award of Fellowship. Secondly, most of the practice operating from Metro region should have the Provider No restrictions applied irrespective of Overseas or Australian Graduate. This shall stop mushrooming of Medical Centre, especially Corporates and others trying to syphon the PIP/ PNIP funding, This way The DOH shall save on the PIP/PNIP and organise distribution of Doctor to other area of Need.


Nadia Baradaran Noveiri   14/03/2019 1:20:02 PM

Does this rule include IMG who got a metropolitan position in 2018 and passed the Pesci exam for that clinic and went through AHPRA limited registration?(not yet registered),but open the 482 visa application and got the clinic nomination.


Dr Peter j Strickland   14/03/2019 1:34:44 PM

The problem does not lay solely with having locally trained GPs going to rural areas ---it is specialists, and in such areas as obstetrics, anaesthesia, orthopaedics, neurology, urology, radiology etc. etc.. The best way to run medical and hospital practice is to have a requirement for all training specialists to have a rural term of at least one year before claiming specialist status ---many may stay rural, but they need government support and lack of interference by bureaucrats who often unneeded, and a spoke in the wheel of good medical practice, and ever since Medicare (Medibank) came into existence. A few rural specialists do a lot of work 'gratis' now, but are unappreciated.


M. S.   14/03/2019 1:48:47 PM

This is not right Program to attract Overseas Trained GP to work in Rural area of Australia, even these overseas trained GP to come to work in Australia rural area under this program, they will move to city after several years work in rural area once they get P.R., and most of these Overseas trained GP are poor experienced and poor skill, no any prior Australia Hospital working experience, particularly Emergency Department working experience, they should not work in Rural area without any training in ED of Australia Hospital, it's very dangerously and very harmful to rural area people, many Overseas trained GP provided GP working experience from Overseas are likely not true. Australia government should make a policy and law to make Australia trained GP to work in the rural area for at least 10 years as a condition before they want to move to city to practice, and also Australia Government should make a policy to support Australia citizen who are OTD to work in the rural area .


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