9 May 2018

Finally, a rural strategy that may make a difference

Education Rural TheHill

Doctors have welcomed the government’s $550 million plan to boost rural health and GP training, despite controversy over a cash splash for a new medical school “network”.

The strategy, revealed in the 2018-19 budget, focuses on building a “pipeline” to allow doctors and other health practitioners to complete their training in regional centres.

“The $550 million Stronger Rural Health Strategy will … put 3000 more highly qualified doctors and more than 3000 nurses and hundreds more allied health professionals into the regions over the next 10 years,” Rural Health Minister Senator Bridget McKenzie said.

“The strategy will offer greater opportunities for Australian doctors through targeted teaching, training and retention initiatives.”

Among concrete measures, the plan includes a four-fold increase in GP placements for junior doctors – from the current 240 rotations to more than 1000 per year – and an extra 100 training spots to be quarantined for rural generalist GPs from 2021, on top of the 300 already earmarked.

It also promises financial incentives to encourage rural and remote practice, as well as new support for international medical graduates working rurally to gain their GP qualifications.

Dr Adam Coltzau, president of the Rural Doctors Association of Australia, said the strategy would make “a real difference” to the rural health workforce.

“This is the rural health Budget that RDAA has been waiting for” Dr Coltzau said.  “There are not just one or two initiatives here – this is a multi-pronged approach to supporting improved medical workforce distribution to rural and remote Australia.”

Dr Coltzau said the RDAA was “satisfied” that the government had made enough commitments for post-graduate junior doctor training and it could now support the additional rural medical school programs announced in the budget.

“We thank the government for listening to our call to only progress a rural medical school announcement if there was also investment in, and a commitment to, increasing rural junior doctor positions,” he said.

ACRRM President Associate Professor Ruth Stewart said she welcomed funding that would help the rural college in its work to upskill and credential the many non-VR international medical graduates across Australia who are interested in practising in rural and remote areas.

Senator McKenzie and Health Minister Greg Hunt had provided assurances that the work of new National Rural Health Commissioner Paul Worley would be well resourced, she told The Medical Republic.

A/Prof Stewart also said she was “relieved” that a proposed Murray Darling medical school would not go ahead as planned by Charles Sturt and La Trobe universities.

Instead, the two universities will join existing rural clinical schools in forming the Murray Darling Medical Schools Network across campuses in NSW and Victoria.

The network will consist of Charles Sturt University/Western Sydney University (Orange), Monash University (Bendigo, Mildura), University of NSW (Wagga Wagga), University of Melbourne/La Trobe University (Wodonga, Shepparton, Bendigo) and University of Sydney (Dubbo).

The commonwealth will invest $95.4 million in the new network.

AMA President Dr Michael Gannon praised the government for rejecting the proposal for a stand-alone Murray Darling Medical School.

The proposal had been championed by senior National Party figures including former rural health minister Fiona Nash, who now has a strategic adviser position at Charles Sturt.

Dr Gannon said the network was a better approach, building on existing infrastructure to create end-to-end medical school programs.

But the government had taken the “unnecessary step” of compensating medical schools with additional full-fee paying places for foreign students.

“This will not address community need, and instead simply waste precious resources,” Dr Gannon said.

The Australian Medical Students Association said the go-ahead for the Charles Sturt-Western Sydney joint school, based in the NSW central west city of Orange, was baffling.

“Orange already hosts a rural clinical school (operated by the University of Sydney) that is highly successful in creating graduates who return to Orange for intern year, AMSA president Alex Farrell said.

“Last year Orange had eight times the number of applicants for internship positions than available spots. Rural interest at a student level is not an issue in this area.”

Universities that lose commonwealth-supported places to the new school would be allowed to supplement their revenue by recruiting up to 60 international students for full-fee places, AMSA said.

This amounted to “buying off” universities in order to build another unnecessary school.

“This school will not address the maldistribution of doctors in the country, it will only worsen the internship bottleneck and leave more graduates without a job on graduation,” AMSA said.