New Figures Underline Urgent Need For Action On "Appalling Shortage" Of Rural Doctors, Australia

Main Category: Public Health
Article Date: 22 Oct 2009 - 11:00 PDT

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The latest medical workforce figures from the Australian Institute of Health and Welfare (AIHW) continue to underline the "appalling shortage" of doctors in rural Australia, and show that rural Australians are losing out substantially to the major cities when it comes to attracting doctors to their towns, the Rural Doctors Association of Australia (RDAA) has warned.

RDAA says the latest figures "should be ringing alarm bells from the rooftops" for governments, and convincing them that real and urgent action-including the introduction of a Rural Rescue Package-is urgently required to entice and retain more doctors in rural and remote areas.

RDAA is also warning that the Federal Government's proposed plan to introduce from July 2010 revised rural doctor retention payments based on a new geographical classification system is unlikely to increase the number of doctors in rural communities, and may in fact reduce the ability of some small rural communities to attract doctors.

The AIHW's Medical labour force 2007 report shows that while the number of primary care practitioners grew in the major cities by 7.7% between 2003 and 2007, inner regional areas saw just 1.7% growth in their primary care practitioner workforce and outer regional areas just 1.5% growth in the same period. Inner and outer regional areas comprise the bulk of rural towns across Australia and consequently most of the nation's rural population.

In terms of doctor-to-patient ratios, the news is even worse with significant declines in inner and outer regional areas. When taken on a full-time equivalent (FTE) rate of primary care practitioners:

- Australia's major cities had 95 primary care practitioners per 100,000 people (down 4% on 2003 figures)
- inner regional areas had only 85 primary care practitioners per 100,000 people (down 10.5% on 2003 figures)
- outer regional areas had only 84 primary care practitioners per 100,000 people (down 7.7% on 2003 figures)

The bulk of primary care practitioners across Australia are general practitioners (GPs). In rural and remote areas, many GPs also provide inpatient and procedural services at their local hospital (including obstetric, anaesthetic and emergency care as well as general surgery), hence the reduced rate of FTE primary care practitioners in inner and outer regional areas means that many rural communities are probably even worse off than the new figures suggest when it comes to accessing a full range of healthcare services.

"The latest figures from the AIHW are yet another strong warning for the federal and state governments that things are not getting better in the bush when it comes to accessing general practice-based healthcare, and more must be done urgently to rectify the situation" RDAA President, Dr Nola Maxfield, said.

"Governments must be doing much more to entice additional doctors to rural Australia, and to retain existing rural doctors in the bush.

"A key way of achieving this would be for the Federal Government to introduce a Rural Rescue Package put forward by RDAA and the AMA in 2007, comprising a Rural Isolation Payment to be paid to all rural doctors (including GPs, specialists and registrars) to reflect the isolation associated with rural practice, and a Rural Procedural and Emergency/On Call Loading to better support rural procedural doctors (including procedural specialists) who provide obstetric, surgical, anaesthetic or primary emergency on-call service in rural communities.

"The very small growth (at 1.5% and 1.7%) in the number of primary care practitioners in inner and outer regional areas-particularly compared with the 7.7% growth rate in the major cities-should be of extreme concern, as should the decrease in FTE practitioners in inner and outer regional areas compared with that in the major cities.

"Some rural patients already have to wait 6 weeks for a basic consultation with a local doctor, or travel hundreds of kilometres to see a doctor in a distant town-the growing shortage of doctors in inner and outer regional areas is only going to make this situation worse.

"These latest figures should be a strong warning to the Federal Government that its proposed plan to introduce revised rural doctor retention payments based on a new geographical classification system from 1 July 2010 is unlikely to increase the number of doctors in rural communities, and may in fact reduce the ability of some small rural communities to attract doctors.

"Under the Government's plan, doctors in many large regional cities (and even doctors in the dress-circle suburbs of Hobart) will become eligible for exactly the same incentives as those doctors working in smaller rural towns such as Gundagai in NSW, Kingaroy in Queensland, Glenrowan in Victoria, Balaclava in South Australia, and Busselton in Western Australia.

"Why on Earth would the Government want to make the current shortage of rural doctors even worse by making it harder for many country towns across Australia to attract and retain them? Hopefully this latest report from the AIHW will persuade the Government to work with RDAA to improve the targeting of rural incentives under its plan."

Source
Rural Doctors Association of Australia