RFDS demand soars amid rural GP shortage

A new Royal Flying Doctor Service (RFDS) report has exposed a grim reality of life in the bush, with thousands of sick Australians still unable to access a GP when needed.
 
The Best for the Bush 2023 analysis lays bare the ‘alarming’ crisis facing rural communities, saying ‘where the health need is greatest, there is the lowest supply of health professionals’.

In a bid to combat this spike, the report says hospitalisations could be avoided through appropriate preventive health interventions and early disease management within primary healthcare, including basing more GPs in regional towns.
 
‘Growing the rural generalist workforce will reduce hospital admissions, reduce the use of locum services and limit the need for patient travel,’ it said.
 
The paper also reveals that demand for RFDS aeromedical services increased by 9% in 2022–23, with 101 retrievals carried out every day.
 
The top reason for retrieval was angina, heart attack, and stroke, accounting for more than 18% of all calls for help.
 
More than one quarter of aeromedical services were for Aboriginal and/or Torres Strait Islander people living in rural and remote areas.
 
Additionally, people in very remote areas were 2.7 times more likely to die from potentially avoidable deaths compared to patients in major cities.
 
The RFDS said this is because currently, the medical workforce is not spread evenly across remote and very remote Australia, despite the increasing health complexities of people living in these areas.
 
RACGP Vice President and Rural Chair, Associate Professor Michael Clements, told newsGP the report is further evidence of why investing in the primary care system and giving people access to GPs reduces costs elsewhere.
 
‘Those retrieval increases are due to a failure of people getting access to primary care, having access to management for diabetes, or hypertension, or mental health, or lung disease,’ he said.
 
‘This often falls on deaf ears which is unfair because we need our rural and remote patients and communities out there being the engine room of Australia, doing everything from agriculture to industry.
 
‘There is still a large number of people who have barriers, and that’s not good enough in a country where we’ve got such a concentration of very expensive hospital services clustered in the big cities where people can have millions of dollars of interventions very quickly.’
 
The RFDS is now urging the Federal Government to establish an agreed definition of ‘reasonable access’, as well as provide specific funding for preventive and health promotion activities in rural and remote areas.
 
Those calls come as more than 32,000 people did not have access to general practice services last year.
 
Patients living in the Kimberley region of Western Australia were most impacted, with 4037 people left without GP access, followed by those in Alice Springs and Far North Queensland.
 
‘This report again demonstrates disparities in the health outcomes and service access for people living in rural and remote areas compared to people living in major cities, and the urgent need for improvement in the delivery of targeted, comprehensive and appropriate services,’ it said.
 
Associate Professor Clements said the RFDS has been able to adapt its models of care to support this increasing community need, but is worried about the increase in demand and its impacts on capacity.
 
‘Thank goodness for the RFDS. Thank goodness there is somebody that has been able to absorb the increase in community need and actually respond by increasing the number of retrievals,’ he said.
 
‘But more doctors are leaving the remote and rural areas, and we’ve had fewer people moving out there, so patients just do without healthcare.
 
‘I’ve had experiences where I’ve called RFDS but because of their workloads and because the planes are already busy, I’ve had to hold on to patients in communities for 24 or 48 hours longer than they should have been there.’
 
Last year’s Medicare claims data revealed out-of-hospital, non-referred attendances per person, such as GP visits, were 50% lower in very remote communities, and 33% lower in remote communities than in metropolitan areas.
 
Additionally, those living in outer-regional, remote, or very remote areas were more likely to delay or not see a GP due to cost compared to those living in major cities.
 
This comes at the same time as there is expected to be less than a fifth of the current number of GPs working in remote areas compared to major cities by 2028.
 
Associate Professor Clements said moving forward, different healthcare solutions must be specific to different communities.
 
‘We need to use this evidence to compel our decisionmakers to commit to an agreement on what reasonable access looks like and what rural communities deserve,’ he said.
 
‘People are extremely unwell and they don’t need to be, they just need the right preventive care.
 
‘What we need is the Government to invest in a primary and preventive healthcare system through GPs to actually prevent these kinds of statistics.’
 
Recent RACGP incentives to attract more general practice registrars to rural and remote regions are beginning to pay off, with 91% of new GP training places filled in 2024 and rural places increasing by 11%.
 
The financial incentive program has already seen healthcare offerings bolstered in the Kimberley town of Kununurra, which now has its highest placement rates in five years with four registrars beginning work this year.
 
A larger selection of incentivised offerings is now being extended to registrars for the next intake of placements.
 
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