NACCHO #Healthelection16 : No doctor glut in the bush:Numbers hide rural medical shortage


” Marjad is Mount Isa’s first traditional owner GP as a proud Kalkadoon man. Dr Page’s also has connections to two other Aboriginal tribes – Waanyi and Gangaldida :Mount Isa is in the heart of Kalkadoon country and Dr Page said it was of great benefit to the community to have a Kalkadoon doctor working locally. “My plan was always to help my mob. I’m a very proud Mount Isa local. I love this town like nothing else … I always knew I was going to come back and help my people here.”

VIEW Interview with Dr Marjad Page on NACCHO TV ” Aboriginal Health In Aboriginal Hands

The Rural Doctors Association of Australia (RDAA) has warned that rural and remote Australia still faces a significant shortage of local doctors with the advanced skills needed for rural medical practice, despite coverage of a report by the Australian Population Research Institute in today’s Australian newspaper indicating that Australia has an overall oversupply of doctors.

“We are the first to agree that there is a maldistribution of doctors in Australia, with an oversupply in our large cities and some of our regional centres” RDAA President, Dr Ewen McPhee, said.

“But this is not the case for the hundreds of small rural and remote communities across Australia that desperately need local doctors with the right skills to provide the range of advanced general practice and hospital-based services that those communities require.

“There is not only an overall shortage of doctors in the bush, but more importantly a shortage of those doctors trained in advanced medical skills who can provide both procedural services (like anaesthetics, obstetrics, general surgery and emergency medicine) and non-procedural services (like advanced mental healthcare and Indigenous healthcare) in rural and remote settings, often with very few available supports.

“Historically, rural and remote Australia has had a strong and viable rural medical workforce, with local doctors providing not only general practice care but also medical services at their local hospital.

“But with the older generation of rural doctors now passing retirement age, and still working for the good of their communities — and with other rural communities relying on a dedicated cohort of overseas trained doctors to keep medical services afloat — the urgent challenge is to get in place the Rural Generalist pathways needed to entice more of the next generation of Australian-trained medical graduates into advanced rural medical training, and then get them into rural and remote practice, where they can become the much-needed GPs and hospital doctors in their towns.

“In communities where rural generalism has been embraced and supported, and where the next generation of doctors with advanced medical skills are working, it has resulted in increased services in local hospitals as well as increased numbers of doctors in local general practices — and this can only be good for rural patients.

“It is getting ‘the right doctor, with the right skills, in the right place’ that is the challenge for governments in developing the next generation of doctors for the bush — and it is this challenge that we must get right if we are to ensure rural and remote communities have better access to local doctors with advanced medical skills in the years to come. Pleasingly, there appears to be recognition across the political spectrum of the need to meet this challenge…we now need the dedicated action to back it up.

“A comprehensive, cohesive and agreed National Rural Health Plan — centred on better access to local, high quality, GP led, team-based primary health care and underpinned by realistic levels of funding — would redress inequities in access to healthcare and health outcomes for rural and remote Australians, and get Australian-trained medical graduates to where they are most needed.

“A fundamental component of this plan must be an agreed National Rural Generalist Framework encompassing:

  • mechanisms to promote and sustain rural general practices, including significant investment in physical and technological infrastructure and adequate recompense for the advanced skills, scope and complexity of practice required of rural doctors
  • rural recruitment and retention strategies, and other workforce development measures
  • a National Rural Generalist Training Program to ensure that the next generations of rural doctors are equipped with the necessary education, training and skills to prepare them for rural medical practice.

“We have been very pleased to see The Greens’ support for a National Rural Health Plan, and hope that the Coalition and Labor will also support it.

“We also recognise that ending the Medicare patient rebate indexation freeze is only a part of what is needed in terms of overall health sector reform, but it is important.

“And it is critical that the focus on the rebate’s true role in the health system is not lost.

“The rebate is there to make medical care more affordable for patients. And in the bush, where many patients find it hard to make ends meet, let alone afford healthcare — and where more patients suffer from multiple chronic conditions — maintaining the freeze on the Medicare patient rebate is simply making it even harder for them.”

RDAA’s 2016 Election Platform can be found by clicking here.

‘Right doctors’ for rural and remote Australia are still needed

The Australian College of Rural and Remote Medicine (ACRRM) has responded to reports of an oversupply of General Practitioners, saying that despite increasing numbers, a significant maldistribution of the GP workforce means that many rural and remote communities are still struggling to attract doctors, especially doctors who have the generalist skills and training to be able to meet community needs.

College President, Professor Lucie Walters said new policy settings are needed to address this issue which has emerged over the past few years.

Whereas previously there has been a significant policy focus on increasing overall numbers of GPs, we cannot assume that this will guarantee that rural and remote communities will get the doctors and medical services they need,” she said.

“We now need a far more targeted approach.

This includes initiatives around selecting medical students and junior doctors who have a genuine interest in rural medical practice; providing them with targeted training and support; and then ensuring that they are appropriately recognised and remunerated for providing the often complex range of services that are needed in rural communities.”

Professor Walters said while there are a number of existing incentive and training programs available, more work is needed to redress the ongoing workforce maldistribution.

“ACRRM has called on all political parties to support the rollout of a National Rural Generalist Program which would address many of these issues,” she said.

“This needs to be accompanied by remuneration and incentive models which recognise and reward doctors for providing high-quality, coordinated and collaborative care.”

Professor Walters acknowledged the services of Overseas Training Doctors who are filling service gaps in many rural and remote communities, but said that the long-term solution rested  with ‘growing our own’ doctors.

“We cannot continue to rely on other countries to provide our rural medical workforce,” she said.

“We need to use the increasing numbers of junior doctors and medical students to provide the right doctors’ who have the training, motivation and support to be able to deliver high-quality health care in rural and remote communities.”


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