‘Urgent action’ needed on GPs feeling squeeze

Australia is facing a ‘looming shortfall’ of GPs amid increasing demands on the system, the representative body has found.

RACGP president Nicole Higgins. Picture: NCA NewsWire / Martin Ollman

Australia is facing a “looming shortfall” of GPs amid increasing demands on the system, the representative body has found.

The Royal Australian College of General Practitioners annual survey found four out of five practice owners were concerned about their future viability, up from just over half in 2021. Furthermore, just 10 per cent of respondents expressed interest in owning a practice in the future, compared with 26 per cent in 2017.

At the same time, the RACGP’s Health of the Nation report – now in its seventh year – found GPs were, on average, spending more time with patients than they were last year, a reflection of “increasing complexity of patient needs” – including more chronic illness, multiple conditions, and mental health issues – said RACGP president Nicole Higgins.

Dr Higgins said the report showed “urgent action” was needed to boost GP numbers.

“We need to do much more to attract and retain this essential workforce,” she said.

“Being a GP is one of the most rewarding jobs, and those in the profession know it. GPs tell us they love their job, but current circumstances make it feel hard to provide the high-quality care we are trained for.

“GPs are specialists and do the same eight years of medical training as any other specialist, followed by at least three years further training in a general practice. However, GPs are hamstrung at the outset due to discrepancies in conditions and pay between hospitals and private practice.”

The survey of 2048 GPs found almost a third of respondents – 29 per cent – intended to retire in the next five years. It also found an increasing job dissatisfaction rate, with 23 per cent reporting they were “moderately” or “very” dissatisfied with their job, up from 20 per cent the year prior. Seventy-one per cent reported burnout.

GPs in regional and rural areas reported higher levels of job satisfaction than their urban counterparts.

The survey results also reflected a growing trend where fewer GP practices were bulk billing.

The share of GP respondents that bulk-billed all patients dropped to 12 per cent from 24 per cent in 2022. The share that bulk-billed a majority of patients dropped from 40 per cent to 30 per cent.

Just on 44 per cent reported they bulk-billed a minority of patients, up from 28 per cent the year prior.

The Albanese government’s budget earlier this year more than tripled the bulk-billing incentive payment to reverse falling rates. The Australian reported last week that doctors serving patients in the most needy areas of the country said the tripling of the rate did nothing to help their patients.

The RACGP report found this significant drop in the space of one year was consistent across Aboriginal health organisations, solo practices, and group practices. It also found the trend was more evident in metropolitan areas.

Dr Higgins called for three specific measures: introducing an incentive payment in the first six months of community GP training, study leave, and paid parental leave for GPs in training.

“It’s unfathomable that in today’s age GPs in training don’t get paid parental leave, and more so when you consider that more women are becoming GPs each year than men,” she said.

“Addressing these three key barriers would make an immediate difference in getting more GPs training and working in the communities that need them.”

Dr Higgins also drew attention to recent developments that could see some practices subject to payroll tax for the first time.

“One of the biggest threats to practice viability is a new interpretation of payroll tax which has seen practices in some states hit with enormous retrospective tax bills for extra payroll tax on their independent GPs,” Dr Higgins said. “Practices have always paid payroll tax on their employees, but it has never applied to GPs because they work under independent agreements.

“This needs to be addressed urgently; we need a consistent approach to this tax across Australia.”

Federal Health Minister Mark Butler has previously said that while payroll tax arrangements were state government matters, he urged “as you consider your payroll tax arrangements, consider the impact on the backbone of our healthcare system, which is general practice.

“We want to see [federal funding] money stay in general practice and allow them to deliver the care that they desperately wanted to deliver to their patients.”