More clarity sought over rural GP pathway

A lack of certainty around the generalist training pathway is causing problems for students and trainees trying to plan their futures

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Both sides of federal politics have used the biggest event on rural GPs’ calendar to dangle high-stakes promises to back health services in the bush and rural-oriented medical training.

Meanwhile, senior doctors at the Rural Medicine Australia conference in Darwin signalled their intent to speak out against inequitable rural health policies in the run-up to the coming election.

They said doctors should “push back” at state-driven health service cuts and demanded more clarity about the promised National Rural Generalist Training Pathway, being developed under the guidance of National Rural Health Commissioner Professor Paul Worley.

The federal minister responsible for rural health, Senator Bridget McKenzie, told RMA delegates the Coalition government accepted the need to attract and train more rural generalist doctors and to support those already working in rural and regional Australia.

“We know that Australians living out in the regions tend to have shorter lives, higher levels of disease and injury, and poorer access to health services compared with those in the cities,” she said.

“For me and you, that is not acceptable,” Senator McKenzie said, addressing delegates by video link.

“As someone who was born and bred in rural Victoria, I will tirelessly work to deliver better health services across Australia and a rural health workforce.

“The Nationals and myself … will always support this career path with more support for regional study training and advancement.”

Making a personal appearance in Darwin, Labor’s health spokesperson Catherine King said investment in rural health was a question of fairness.

“When we’re talking about rural health and rural health needs, and what we need to do as we focus on the details about workforce, it’s really about inequality,” she told conference delegates.

As a likely candidate for health minister if Labor takes government at the coming election, Ms King said she would focus on the rural challenge.

“It is the depth of inequality in health outcomes and in provision and access to health services, and how we make that vision of universal access a reality across our communities, that we are all challenged with.

“And that is something I, hopefully in a different capacity next year, depending on the outcome of the general election, is something that I want to turn my head to, well and truly.”

For the first time, Labor included support for the Rural Generalist Training Pathway in its draft national policy platform, released last Friday.

Ms King also urged doctors to complain about a loss of funding for preventive healthcare.

“While we are working on some policies at the moment, I really want to encourage all of you to speak as loudly and clearly as you can, to really makes sure prevention stays or gets back on the agenda,” she said, adding she expected the election to be called in March-May of 2019.

The current government had axed programs for preventive health “with very little political pain”, she added.

Dr Adam Coltzau, president of the Rural Doctors Association of Australia, said country GPs must resist moves to shut down rural hospitals and restrict rural generalists’ practice because of arbitrary quotas for procedures.

“We need to push back and own the space of rural medicine,” the southwestern Queensland GP said.

ACRRM President Dr Ewen McPhee told The Medical Republic that a lack of certainty around the rural generalist training pathway, which has been under a consultation and planning process for a year, was causing problems for students and trainees trying to plan their futures and for regional training organisations.

He suspected roadblocks were being erected in some jurisdictions by senior specialists and administrators who “for some reason” did not see the value in rural generalism.

“Whether they feel threatened, whether they fail to appreciate the issues in rural and remote Australia, whether they simply don’t believe it’s necessary that rural people should have the same level of access and equity close to home as in metro areas … who would know?” Dr McPhee said.

“We’ve got to call them on it and we’ve got to push back, because we know generalism is the future.  Continued sub-specialisation just increases costs to the health system and doesn’t improve health outcomes.”