“Everything the government is talking about is in primary care, prevention and yet there’s not enough primary care training places in an ageing population and an increased morbid disease,
Because of years of lack of investment in general practice, there’s been considerable increase in the gap between specialist and GP remuneration, so that has to be a possible negative factor for some of the better and cleverer students.”
Australian Medical Association medical workforce committee chair Tony Bartone said the increase in specialists was needed, but the number of general practitioners remained too low especially in rural and remote areas
“Australia has long struggled to entice and retain medical workers to rural and remote regions.
The remote and rural regions of Australia have been under serviced by medical professionals,
There is a nation-wide undersupply of Indigenous doctors, and a great need in many areas like the Northern Territory, where Indigenous people make up almost a third of the population and have a higher burden of disease.”
The president of the Australian Medical Association’s NT branch, Robert Parker, said it was an ongoing challenge. SEE Previous article
The medical workforce has become skewed to specialist doctors while the number of general practitioners has barely changed in 10 years, in a trend that threatens to undermine the federal government’s push for better primary care.
The Australian Institute of Health and Welfare reported on Wednesday that the rate of general practitioners has remained steady around 114 per 100,000 people, while the number while the number of registered medical practitioners overall has increased by 3.4 per cent a year.
SEE AIHW Press Release AIHW Press release
Health Workforce Australia, whose mission it was to manage the demand and supply of doctors, warned four years ago that Australia faced a massive shortfall of doctors by 2025, when a large number of them were due to retire.
But while there would be an undersupply of specialists in obstetrics and gynaecology, ophthalmology, anatomical pathology, psychiatry, diagnostics radiology and radiation oncology, there would be an oversupply of cardiologists, gastroenterologists and hepatologists and surgeons.
Prime Minister Malcolm Turnbull opened on Wednesday the first trial site for its “health care homes” program, which aims to co-ordinate the care and prevent the hospitalisation of people with chronic disease.
Australian Medical Association medical workforce committee chair Tony Bartone said the increase in specialists was needed, but the number of general practitioners remained too low especially in rural and remote areas.
There were currently 1600 training positions in general practice, which was about 100 short of what was needed.
“It’s got to come into your thinking when you could earn two or three times as much by being a specialist as in general practice.”
The colleges and the federal government would need to address the maldistribution of specialists by funding more training places in the regions and specialties where they were needed, he said.
Hornsby GP Elizabeth Marles, who is an advisor to the federal government on medical training, said if there were not enough GPs, health problems would be pushed into the sphere of specialists.
“It’s a significant problem in terms of health economics because we know that internationally the evidence is that the stronger the primary care workforce the better your health outcomes and the more cost effective it is,” Dr Marles said.
A spokesman for the Department of Health said GP numbers had increased substantially over time, from 16,601 full time equivalent positions in 2007-08 to 22,005 in 2014-15.
This was supported by an increase in the general practice training program from 600 in 2008 to 1500 in 2015.
“The Department closely monitors workforce supply trends over time, working with medical colleges, employers, states and territories and key stakeholders,” he said.
Rural Doctors press Release
The Rural Doctors Association of Australia (RDAA) has warned that the latest medical workforce data for Australia has shown a decline in the number of full-time equivalent (FTE) general practitioners in Remote, Very Remote and Outer Regional areas, and should be an alarm bell to governments and policy-makers that more must be done to entice and retain these doctors in the bush.
The latest data is included in the Medical Practitioner Workforce 2015 report
by the Australian Institute of Health and Welfare.
“RDAA is very concerned that in areas classified as Outer Regional and Remote/Very Remote, the number of General Practitioners (Full Time Equivalent) has decreased per 100,000 head of population in the previous 12 months”
RDAA Vice President, Dr John Hall, said.
“In Remote/Very Remote areas, the number of GPs (Full Time Equivalent) per 100,000 has decreased from 137 (in 2014) to 135.5 (in 2015). In Outer Regional areas, it has decreased from 116.8 (in 2014) to 116.3 (in 2015).
“This should be a real alarm bell for governments and policy-makers, and it reflects the urgent need for the role of National Rural Health Commissioner to be implemented sooner rather than later, in order to drive forward measures that will help reverse this decline.
“Policy-makers and governments need to understand that people in Remote/Very Remote and Outer Regional areas are often forced to travel vast distances to access a GP for even a basic appointment.
“Even the smallest reduction in GP numbers has a significant impact in these communities, where there is a higher prevalence of chronic disease and poorer health outcomes than for those living in the major cities or large regional centres.
“RDAA is also very concerned that while General Practitioner numbers per 100,000 population have improved in the Major Cities and RA2 (Inner Regional) classification areas, this may not be telling the complete story.
“While the Inner Regional classification includes some rural locations, it also includes very large regional centres such as Cairns, Townsville, Rockhampton and Mackay — if these centres are where the growth in GP numbers is occurring, as we suspect it is, then GP growth is clearly not meeting the needs of rural communities.
“This discrepancy in data underlines the fact that the Modified Monash Model classification system should be considered for this type of data collection and analysis going forward, rather than the outdated ASGC-RA classification system which the Government has already replaced for some medical workforce program purposes.
“The AIHW report has again underlined the fact that doctors working in Outer Regional, Remote and Very Remote communities continue to work longer hours than their city counterparts.
“In the Major Cities and Inner Regional classification areas, medical practitioners in the past 12 months have slightly reduced their average working hours, while the average hours for medical practitioners working in Outer Regional and Remote/Very Remote locations have remained the same.
“Rural Generalist doctors are able to provide a wide range of advanced medical and clinical services which integrate closely with rural general practices, and they can work closely with distant specialists to oversee the care of patients living in rural and remote communities.
“RDAA has welcomed the Federal Government’s election commitment that establishing a National Rural Generalist Framework will be a priority for the National Rural Health Commissioner when that position is itself established.
“We look forward to working with the Government to make both a reality.”