Reform needed to save rural health services

from On Our Selection News - 11th May 2023

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The Rural Doctors Association of Australia (RDAA) says that the GP shortage in rural and remote areas will not change unless there is significant reform of funding models.

Dr Megan Belot, RDAA President, said patients right across rural and remote Australia suffer poorer health outcomes due to this reluctance to change.

“RDAA has welcomed the work of the Strengthening Medicare Taskforce that recognises that the Medicare Benefits Schedule (Medicare) as a funding model is not necessarily fitfor-purpose in rural general practice,” Dr Belot said.

“Bulk-billing rates are simply not enough to maintain a viable small business in a rural community, and to cover the significant overheads related to staffing, infrastructure, equipment and supplies.

“On top of this, for decades all types of rural health services have struggled to recruit and retain medical professionals and this has resulted in a maldistribution of the medical workforce across the country.”

Dr Belot said horrific climate-related events in recent years have disproportionately affected rural communities, and the fallout from the resulting loss of infrastructure is ongoing.

“Throw COVID-19 into the mix and the huge increase in demand for general practice care it created, alongside our aging population (and corresponding aging cohort of GPs retiring or approaching retirement), and you have a perfect storm of decreasing access to care coupled with increasing demand,” she said.

“The threat to the viability and sustainability of rural and remote primary health services is clear and present.

“We need immediate action on funding models that reflect rural communities’ need for multidisciplinary team care, with general practice at its core.

“To sustain rural health services into the future, new initiatives, alongside the strengthening of existing initiatives, is needed now – in this Budget – to improve the attractiveness of rural medical careers and support rural medical service viability and sustainability.”

RDAA is calling on the Australian Government to:

•Provide 150 more Full Time Equivalent (FTE) prevocational medical positions in rural areas.

•Establish a national e-credentialing infrastructure to streamline bureaucratic processes, and mobilise the medical workforce.

•Index rural incentives to support the viability and sustainability of rural medical practices.

•Implement rural priorities under the National Medical Workforce Strategy 2021-2031: full roll out of the National Rural Generalist Pathway, expansion of the single employer models for Rural Generalist trainees, investment in rural supervision across all medical specialties, investment in doctor wellbeing strategies.

•Expand the Workforce Incentive Program (WIP) to support rural consultant specialists to enhance viability of specialist services in rural and remote communities.

•Establish a housing program to support critical workforce recruitment and retention in rural and remote communities.

“Investment in medical workforce solutions provide significant returns in the future by delaying the onset of chronic diseases and preventing avoidable hospital admissions,” Dr Belot said.

“RDAA strongly urges the Government to prioritise rural health reform and invest in medical workforce programs to attract, support and retain doctors in rural communities and reduce rural health inequities.”

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