Continuing crisis in GP land

for GP trainees across rural, regional and remote New South Wales.

• That NSW Health work with the Australian Government, the Primary Health Networks, the university sector and the specialist medical colleges to increase rural GP and specialist training positions… • That NSW Health work with the Australian Government collaboratively to immediately invest in the development and implementation of a 10-Year Rural and Remote Medical and Health Workforce Recruitment and Retention Strategy. • That NSW Health acknowledge the significant cultural barriers that telehealth poses for First Nations communities and work to ensure face-to-face consultations are prioritised. • That NSW Health, in conjunction with The Australian and New Zealand Society of Palliative Medicine, the Royal Australian College of General Practitioners, the Royal Australasian College of Physicians and the Aboriginal Health and Medical Research Council of NSW urgently establish a palliative care taskforce… • That Portfolio Committee No. 2 – Health consider undertaking an inquiry into mental health, including into mental health services in rural, regional and remote New South Wales in the future.

• That the rural and regional Local Health Districts, and those metropolitan Local Health Districts that take in regional areas of the state, review their maternity services in order to develop plans for midwifery, GP Obstetrics, specialist Obstetrics and newborn services.

The inquiry urged the government to publish its evaluation of the 2021 rural health plan, and recommended another inquiry into regional health in two years’ time to monitor progress.

Regardless of the notable exclusions, it is clear that after two years’ work, and considerable pressure from health insiders, patients and families/friends, and the media, notably The Sydney Morning Herald, the tiger has at last roared. It remains to be seen whether it will have bite or be as toothless as many an inquiry before it, and perhaps the one to follow in two years’ time. There’s nothing new about the latest concern over the rising demand for GP services and the concurrent lack of practitioners available to meet it.

In fact, the problem was flagged more than two years ago in a report by Deloitte Access Economics for Cornerstone Health Pty Ltd, which found that there will be a 37.5% increase in the demand for GP services between 2019 and 2030 and a shortfall of 9,298 fulltime GPs or 24.7% of the GP workforce.

The General Practitioner Workforce Report 2019 made the issue clear to see and no one has convincingly refuted it since.

Perhaps it took a change of Australian government to bring the issue back to the table, raised this time by the Royal Australian College of General Practitioners (which welcomed the thenOpposition’s plan to invest $970 million in general practice care in communities across Australia).

The College has added some figures of its own, for example only 1394 medical graduates applied to do GP training in the latest intake, a 30 per cent drop from almost 2000 applications in 2017.

‘One of the determinants of the shortfall,’ Deloitte’s said, ‘comes about because of limitations on the number of overseas trained doctors permitted to work in urban areas. The diversion of overseas trained doctors to rural, remote and regional areas will have unintended consequences for patients’ access to healthcare in urban areas.’

It seems Canberra can’t get it right, whatever it encourages.

‘We are at serious risk of running out

of GPs,’ said RACGP president Dr Karen Price.

‘Young graduate doctors have so many choices, but it is not attractive to them to pursue a career in general practice.’

The number of young doctors choosing to specialise in general practice has fallen to its lowest level in more than five years, a trend doctors warn will push primary care further towards the brink of collapse.

Dr Price noted that COVID-19 had put the brakes on overseas doctors applying for training but the number of applications submitted to the college has been declining for years.

‘We have a big workforce issue and general practice has suffered. The system is on the verge of collapse because of a lack of investment in primary care,’ she said.

Various reasons are suggested for the problem, including Medicare cuts that push GPs to practise “faster medicine” or charge a gap fee, which families on the poverty line can’t afford.

Another problem, some say, is the lack of GPs teaching at universities, resulting in general practice often being portrayed poorly during medical school and hospital training.

However, a federal health department spokesperson said while COVID-19 had affected the arrival of international doctors, overall numbers have not fallen significantly, adding that, ‘The Australian General Practice Training program provides funding of over $200 million every year to support high quality training for GP registrars.’