A parliamentary review of the state’s rural health sector, like the NSW review before it, found a primary care system in shambles.
Rural doctors in Tasmania may well get a shot at working under new and innovative employment models, as the state takes stock of its ailing healthcare system.
Earlier this week, the Tasmanian legislative council subcommittee tasked with investigating the state of rural health on the island tabled its final report.
It found that Tasmanians were more likely than any of their state or territory peers to have three or more chronic conditions, especially if they lived in a rural area.
Without “specific action”, the report warned, the health outcomes for rural and regional Tasmanians are likely to get worse.
While it acknowledged that each community requires a tailored approach, the committee recommended that, where appropriate, the Tasmanian Health Service should adopt a single-employer model for hospital, rural generalist and GP services.
Dr Dan Halliday, newly minted ACRRM president, told The Medical Republic that the report captured the community issues within rural and remote Australia that had spurred doctors to create ACRRM in the first place.
“It recognises the barriers between transference of a major regional or metropolitan model of care into a remote context,” he said.
“That’s something that ACRRM has been fighting for recognition of for some time – breaking down and addressing issues of geographical narcissism and ensuring that rural communities get contextually appropriate care.”
Rural Doctors Association of Tasmania president Dr Ben Dodds said that while the report didn’t necessarily present much new information, it did consolidate and formalise what doctors on the ground experience.
“It’s really hard to measure how many heart attacks or strokes were prevented, and it’s really hard to measure how many people didn’t present to the emergency department because they got affordable [primary care],” he told TMR.
The Tasmanian report, he said, made this link apparent – the government has finally acknowledged that, if it doesn’t act to fix primary care, the hospital system will suffer.
RDAT is particularly interested in helping Tasmania retain its rural generalists by offering fair conditions, remuneration and salary packages.
“We train excellent rural generalists that say ‘hey, you know what looks good? Coastal NSW’,” Dr Dodds said.
Other recommendations in the report include advocating at the federal level for increased MBS rebates and seeking support for multidisciplinary teams in primary care.
“There are obviously recommendations in in that report that look at the full scope of practice for GPs, but also our allied health professionals,” Dr Dodds said.
“We’re [interested in] actually building that broad, multidisciplinary team, because doctors can’t do it alone in these rural communities.
“It’s certainly a team sport, when it comes to delivering modern healthcare.”
ACRRM’s Dr Halliday also supported increased funding for multidisciplinary team-based care.
The operative phrase there is “team”; ACRRM does not support siloed models that duplicate and fragment care.
Perhaps unsurprisingly, the report includes a submission from the Pharmacy Guild of Australia’s Tasmanian chapter, which argues for increasing pharmacist scope of practice to include prescribing medicines.
Those fearing an independent community pharmacist-based solution, however, can most likely breathe out – the recommendations section specifies delivering multi-disciplinary models of care that support collaborative arrangements.
There is no specific mention in the recommendations supporting a siloed pharmacist-led prescribing model à la north Queensland.
