Emergency summit hears rural health system in state of collapse

The regions are suffering from increasing practice closures, a doctor exodus and bulk billing collapse resulting in patients delaying care and health conditions worsening.

More towns will be left with no or inadequate general practitioner services if the federal government does not stop an exodus of GPs leaving remote, rural and regional areas.

The warning comes as health care leaders met in Canberra today for an unprecedented emergency summit after a new report found general practice in Australia was at “breaking point”.

Royal Australian College of General Practitioners rural chair Dr Michael Clements said the regions were suffering from increasing practice closures, patients struggling to access GPs and bulk billing continuing to collapse because Medicare indexation was not keeping pace with inflation – resulting in patients delaying care and health conditions worsening.

He said an increasing number of rural towns were now without a GP, had an insufficient number of GPs to service the local population or no bulk billing service.

“Some of the hardest to-fill roles have traditionally been in remote Indigenous communities and smaller towns that are not on the tourist drive. But we are seeing more and more practice closures and increasingly bigger towns fall into this shortage trap,” he said.

The situation took a further nosedive in August after 10 GP clinics owned by the Tristar Medical Group ceased to operate, including clinics at Avoca, Ararat, Dandenong and Grovedale in Victoria.

Dr Clements’ warning comes after the RACGP’s Health of the Nation 2022 report, released last month, showed almost half of all GPs surveyed were finding it currently financially unsustainable for them to continue working as a GP.

The situation was worse in the regions where GP workforces were older and nearing retirement and a lack of young doctors were moving to the bush.

Meanwhile, former Australian Medical Association president Dr Mukesh Haikerwal said last week appointment shortages would also worsen with a “great resignation” among GPs leaving clinical roles after three years manning the frontline of a pandemic.

The search for replacements is set to hit the bush hardest as rural doctors have been targeted for recruitment to large regional and city locations particularly after Labor’s change to the medical workforce policy came into effect after this year’s federal election.

The change scrapped the requirement that overseas trained doctors must first practice in a rural setting before moving to large regional centres and outer metropolitan areas.

Dr Clements said this policy “only moved more doctors out of rural and remote areas.”

He said the “natural consequence” of fewer doctors is that remote and rural patients were not seeing GPs and having chronic diseases progress as they were presenting at later stages of diseases, and often too late.

“What we need to see is new money, new investment, and new incentives so people want to go rural again. At the moment the Medicare rebate is the same in the middle of Sydney as it is Broken Hill, so there is a problem there,” he said.

“The government is not doing enough to draw people out to the harder to fill areas.

“Right now people are having poorer health outcomes because the government has underfunded primary care.

“The question is whether this is a situation they are happy to allow to continue to happen and decline, where there are have’s and have nots of health, or are they going to make a real investment and actually reverse that with new money?”

The General Practice Crisis Summit brings together leaders from the general practice sector, consumer groups, government, and academia.

The seven-point plan for discussion deals with the financial sustainability and viability of general practices in the country and again making general practice a desired career pathway for the young doctors.

AMA president Professor Steve Robson said “we need at least half of all Australia’s young medical graduates to join general practice in this country”.

The situation is worsened as the surge in the number of people moving to regional and rural Australia is placing further stress on an already strained rural health system.

Dr Clements said the $750 million of government funding flagged for primary healthcare over the next four years is “a drop in the ocean”.

Originally published as Emergency summit hears rural health system in state of collapse