Qld hospitals under pressure as medical students abuse scheme

Queensland hospitals are under the pump as medical students abuse a scheme that sees taxpayers foot the $100,000 bill for their university education.

Medical students are abusing a scheme that sees taxpayers foot the $100,000 bill for their university education in return for them practising in the bush when they graduate.

Just four per cent of the 13,521 participants (597 participants) have completed their return-of-service obligations and 779 participants (5.7 per cent) have withdrawn from the program.

There are 12, 145 remaining active participants and while half of them 6904 (56.8 per cent) are still studying, the rest have yet to fulfil their pledge to work in the bush after graduating the Department of Health has revealed.

Medical students have 18 years in which to fulfil their promise to work in the bush for three years. Those who still refuse have to pay back the cost of their medical degree “plus interest”.

The failure of the program comes as a Senate committee reports that bush towns can’t find doctors and patients are waiting months to see a GP.

Australia Health Alliance said their clinics are turning away up to 100 patients per day and Dr Bradley Cranney, who owns and manages four general practices, said his clinics were turning away 200 patients a day.

Dr Hamish Meldrum from Ochre Health, a business which provides doctors to the bush, said medical students in the Bonded Medical Places scheme “laugh at me” when he asks why they want to go rural.

Most students taking part in the bonded program never intended to work in the bush and were simply using the scheme to get a free place in medical school, he told the Senate committee.

‘Nobody wants to go rural. We just put down that we want to be rurally bonded students so that we can get into medical school,” is what students told him.

The Senate report also makes the startling revelation than half of all Australia’s GP are now overseas trained as local medical students shun the career because of poor pay and conditions.

Australia now has more specialists than GPs.

The Senate Community Affairs Committee was told the reason no-one wants to be a GP is they are paid just $150,000 a year, three times less than a specialist who can earn $500,000 to $1 million in a year.

GPs also miss out on workplace conditions like maternity leave, long service leave, annual leave or sick leave which is available if they work as a hospital specialist.

Those who train to be general practitioners are increasingly deciding not to set up their own medical practice because they can earn more working as a fly in fly out locum doctor.

“Witnesses commented that this discrepancy in the pay between what an average GP can earn in a day compared with a locum acts as a disincentive to people taking on positions and staying long-term in an area,” the Senate Committee report said.

Dr Gerard Quigley, Principal, Lower Eyre Family Practice, said a doctor could work just three months of the year as a locum and earn more money than a full time rural GP.

To solve the problem the parliamentary committee has called on the government to increase the $39.10 Medicare rebate paid to GPs.

RACGP president Professor Karen Price welcomed the report.

Royal Australian College General Practitioners President (RACGP) president Professor Karen Price said that the interim report vindicated what GPs had been saying for many years.

“It is music to my ears that the committee is recommending the federal Government investigates substantially increasing Medicare rebates for all levels of general practice consultations, as well as other general practice funding options,” she said.

“Medicare rebates for patients simply haven’t kept pace with inflation and the cost of providing high-quality general practice care. In addition, the current Medicare rebate structure devalues longer consultations because patient rebates decrease significantly the longer a person spends with their GP.

In rural Queensland, the shortage of GPs is having a knock-on effect.

The Queensland town of Chinchilla, with a population of just under 6000 people, told the Senate Committee recruitment of a general practitioner could take over 12 months.

Local Government Association of Queensland told the inquiry in the Barcaldine Region: “The tyranny of distance between outlying communities is a key cause of fatigue for these doctors, where they are often forced to drive for hours into a rising sun, work a very busy clinical day and then drive for hours into a setting sun to return to Barcaldine”.

Dr David Molhoek, Acting Director of Medical Services, Central Highlands, Central Queensland Hospital and Health Service, told the committee the most common reason for attending the hospital was for business that should have been done by a GP.

There were 4,961 people who attended the hospital for a “scheduled follow-up examination, administration of medication, surgical dressings, blood collection—those diagnosis codes that would very much fall within the remit of primary care,” he said.

“This was our top diagnosis code for a lot of our rural hospitals— Baralaba, Biloela, Emerald, Blackwater, Mount Morgan, Woorabinda and Springsure,” he said.

“In Biloela, for example, last year, when they had approximately 7,000 presentations per year, up to 30 per cent of these presentations were within that diagnosis code: scheduled follow-up exam, 458; administration of medication, 260, or four per cent; dressings, 200, or three per cent; blood collection, 195; UTI, 105; and ankle sprain, 98.19,” he said.

When people go to hospital for a condition that could be treated by a GP it costs Medicare $500 per visit compared to the $39.10 Medicare pays a GP the inquiry was told.

Originally published as Qld hospitals under pressure as medical students abuse scheme