South Australia to address rural GP shortage

Matt Woodley

1/08/2019 4:18:15 PM

The South Australian Government has drafted a plan to try and fix the major shortfall in its rural primary care workforce.

Road sign indicating nearest clinic is 10km away.
All 35 vacancies in South Australia's general practice training program are outside major cities.

South Australia’s regions are crying out for GPs, with all 35 vacancies in the state’s general practice training program outside major cities.
The government is seeking feedback on its draft Rural Medical Workforce Plan from clinicians, stakeholders and Local Health Network (LHN) leads.
RACGP Vice President and Rural Chair Associate Professor Ayman Shenouda said the process for developing the plan has been ‘consultative’ and told newsGP the college has been involved in its drafting through South Australian representative Dr Ken Wanguhu.
‘We welcome the initiative by South Australian Minister for Health and Wellbeing Stephen Wade to try and establish a strategy to fix the existing rural workforce issues,’ Associate Professor Shenouda said.
‘We will continue to work with Minister Wade to ensure small country towns have adequately trained and skilled doctors to address the needs of their communities.’
SA Health overspent its original 2018-19 funding allocation by a reported $238 million.
Despite this, the department has struggled to provide regional health services to such an extent that a district hospital board member in a remote town resorted to crowdfunding to try and keep the local emergency department open.
Minister Wade said the draft plan is a broad strategy to grow and strengthen South Australia’s regional medical workforce and deliver world-class care in rural areas.
‘South Australia faces many challenges in recruiting, training and developing the health professionals needed to deliver public health services in rural areas,’ he said.
‘Vacancies affect both the services we can offer and the future general practice workforce supply.
‘Consultation on the draft plan will run through August and September, with … feedback [designed] to ensure we can secure the workforce needed for the future.’
The basis of the plan, developed under the leadership of the Rural Health Workforce Strategy Steering Committee, came from ‘The Future’s in Your Hands’ workshop in May and includes the following themes and objectives: 

  • Building a Skilled Workforce
    • Expand training pathways to meet the minimum required numbers for sustainable rural medical practice
    • Increase the number of doctors entering rural medical training and practice
  • New and Sustainable Models for Rural Health Care
    • Develop sustainable models of rural medical care
    • Increase support to rural General Practitioners
    • Increase integrated multidisciplinary clinical services
  • Developing a Collaborative and Coordinated Health System
    • Share the responsibility for rural health across the state
    • Work in partnership to support the rural health workforce 
According to the most recent head count contained in the draft, 430 GPs and 93 GP registrars were contracted to the state’s LHNs, along with 141 salaried medical officers.
Rural workforce challenges include a lopsided distribution of prevocational training positions within the state, with only 12 of the 250 South Australian interns based rurally; vacancies within the general practice training program; and long term challenges recruiting stable local GPs, leading to an overreliance on locums.
Consultation will remain open until 30 September.

government primary care rural South Australia workforce

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Prof Max Kamien, AM, CitWA   2/08/2019 7:59:11 PM

I have a déjà vu of 30 years past.
Kamien M, Buttfield IH. Some solutions to the shortage of general practitioners in rural Australia. Part 3. Vocational Training Med J. Aust. 1990;153:112-4.
Kamien M, Buttfield IH. Some solutions to the shortage of general practitioners in rural Australia. Part 4. Professional, social and economic satisfaction. Med J. Aust.1990;153:168-171.

South Australia's medStar emergency retrieval service is better than world class. So are its hospitals if rural GPs and patients could only access them. Their Ministers of Health have been 'hyperbolizing' about delivering world-class care in SA rural areas for over 30 years. Perhaps an examination of past reports, plans and the reasons for their successes and failures can inform planning for the future.

Dr Horst Paul Herb   2/08/2019 11:51:00 PM

Looks like the same useless top-down approach as ever. Lots of buzzwords and motherhood statements, no substance. Waste of money and manpower time and again.

Why not ask us full time locums or the few who stay long term why we chose to work in those rural and remote locations? As opposed to the suffering dwindling permanent workforce, we get fairer payment, friendly treatment by administration, good working conditions, variety, and ... a degree of professional autonomy I could only dream of when being either in private practice or on a fixed contract.

Give us a fair daily pay rate, professional autonomy, cut the pointless paperwork, and deflate the bureaucratic hydrocephalus - and we will flock to the workplaces. Throw in support for our partners who usually have to sacrifice their careers and dreams in order to support us in rural and remote locations, you would have us for life.

Dr Horst Paul Herb   3/08/2019 12:03:29 AM

PS: How many bona fide rural & remote health practitioners (with recent experience of what it is like to work in small places these days) are on that committee - as in people who lived and worked for at least a decade in small communities typical for those that are currently unsuccessfully recruiting? I could only identify two, any more?

Asitha   4/08/2019 1:35:54 PM

In my humble view as a GP working in Rural NSW for the past 7 years. the training program has got it wrong, they fill the training positions for a maximum of 1-2 years of training then the registra passes their fellowship and within few months move to a metropolitan city. The only way to prevent this from happening is to implement a system where the registra is required to serve the community for minimum 3 years( preferably 5)where they worked while obtaining their fellowship as a compulsory requirement irrespective of Aussie graduate or IMG, This way even if there are changes in number of doctors entering the training pathways these senior GPs will continue to provide quality senior care to the rural community.
What ever program the government comes up with regarding GP training will not work because soon as most of the registrars complete their training they will move to the cities, this trend need to be stopped.

Dr Nicole Annette Kerr   7/08/2019 4:58:46 PM

Forcing rural GPs to work in the ED when they do not feel that is their calling or skill set can be soul-destroying, and increases doctor burn-out. All ED work must be optional!