Rural

By Dr David RivettI spent a recent Friday afternoon assisting our President as we jointly addressed the Senate Committee enquiring into rural medical workforce shortages.

The AMA had put forward an excellent paper to the committee outlining the many facets of change needed to solve the worsening workforce crisis in rural Australia.

My personal situation is pretty typical, with my own practice needing at least another three doctors, and relying on older doctors like myself - who should be reducing their hours - to instead crank up their throughput to maintain a very basic standard of care. Patients are let down badly by inadequate access to timely care in such circumstances, and agreement on a national solution is of the utmost urgency. If I cannot attract doctors to a locale as pleasant as Batemans Bay, I can but wonder how towns west of the divide are going to do so.

Any solution needs State and Federal governments working together, and committing serious funds. Both levels of government need to agree on a robust national solution and get started on it immediately, as it will take years to flow through, even if we bring in nationwide rurally-orientated generalist courses for substantial numbers of post-graduates now, backed up with real fiscal incentives to go bush for five years at a minimum.

Australia should not be relying on international medical graduates to keep rural care alive, and instead should be training enough of our own students to enable provision of adequate core numbers at all rural and regional locations. By adequate core numbers I mean enough to provide for an attractive work-life balance, with on-call no more rigorous than one in every three nights.

The rural rescue package agreed by the AMA and Rural Doctors Association of Australia (RDAA) needs to be part of any solution, and the Australian Standard Geographical Classification system consigned to the bin. A national blueprint detailing what numbers of differing medical professionals, with what skill sets, are needed where, is a key foundation to underpin any workforce planning for a sound solution. Conscription of international medical graduates and medical students is not acceptable.

Hopefully this Senate Committee will deliver robust recommendations to government which can be enacted through the Council of Australian Governments.

Back to the personally controlled electronic health record (PCEHR), and the budget announcement that participation would be essential to continue to gain the IT component of Practice Incentives Program (PIP) payments.

This really was a major disaster for GPs. All GP groups must work in unison to overturn this imposition of a huge workload for no remuneration. I trust the Royal Australian College of General Practitioners will now see the folly of their decision to embrace an unfunded PCEHR, apologize to members for their lack of sense and fight furiously with the AMA, the RDAA, and the Australian College of Rural and Remote Medicine to reverse the situation.

However, just as a solution to the rural workforce crisis is almost a dream, so too is the thought that the RACGP chiefs will have the grace to admit they have got it badly wrong.