The Lib/Nats have proposed a raft of workforce incentives for rural doctors. Curiously, none of them involve increasing Medicare rebates.
Both GP colleges have cautiously welcomed the Coalition’s rural health pitch, which features $146 million in funding to expand successful training programs and provide further workforce incentives for the rural health workforce.
Nationals leader Barnaby Joyce and current Minister for Rural Health Dr David Gillespie pledged the funds toward the coalition’s Stronger Rural Health Strategy while in Shepparton, Victoria yesterday.
The bulk of the promised bounty – some $87 million – would go toward “workforce incentives”.
It’s not quite clear what this means on a granular level, with the Nationals just saying the money will “provide further targeted support to rural generalists with additional education and skills to work in the regions, and to support the engagement of nurses, nurse practitioners and allied health professionals as part of local multidisciplinary care teams”.
Rural Doctors Association of Australia president Dr Megan Belot said the promise of increased funding under a reform of the Workforce Incentive Program would improve quality care in rural and remote communities.
“This is a model developed by RDAA in collaboration with the first Commissioner for Rural Health Professor Paul Worley and other Peak General Practice bodies, which will see doctors working in rural and remote areas (MMM 3-7) receive increased loadings to their remuneration that recognises the provision of quality general practice and the extended scope of service that many of these doctors provide,” Dr Belot said.
“It will be a strong improvement and retention payment for the senior doctors in these communities, and also a significant uplift in remuneration packages to attract highly skilled and motivated rural GPs and rural generalists to the areas that need them.”
More specific measures that would be funded using the $146 million include expanding key programs like the Murrumbidgee single-employer model, the Innovative Models of Collaborative Care program and increasing the John Flynn Prevocational Doctor Program to more than 1000 placements per year by 2026.
Under current funding arrangements, the John Flynn program is set to support 800 rotations per year by 2025, or 200 FTE.
The Murrumbidgee rural generalist training pathway, meanwhile, supports GP registrars by making them an employee of NSW Health but allowing them to train in a mixture of regional hospital and primary care settings.
General Practice Registrars Australia President Dr Antony Bolton said that while GPRA recognises the value of expanding the trial, it looked forward to a full evaluation before any decision is made.
“At this stage it is unclear if hospital networks are best placed to manage placements in primary care,” he said.
There’s also $9 million earmarked for additional training posts for GPs and rural generalists who want to undertake advanced skills training in fields like obstetrics, paediatrics and mental health.
The final component covered in the funding announcement is the preservation of DPA status for a further year, for any catchments which managed to obtain it over the exceptional circumstances review process.
While most of these policies and promises are drawn directly from the pre-budget and election submissions of organisations like ACRRM, the RACGP and the RDAA, there is one glaring omission: increased Medicare patient rebates.
“The announcements … zero in on the ‘push’ factors designed to lure more future doctors into rural and regional general practice through universities and training,” RACGP Rural Chair Dr Michael Clements said.
“That is welcome; however, we also need to attract and retain GPs through appropriate investment in general practice for GPs later in their career.”
Dr Clements also said that the college believes rural GPs should have access to MBS items that they hold advanced skills in.
ACRRM president Dr Sarah Chalmers called the announcement a “strong start”.
“Evidence shows that doctors who have positive experiences studying, training and working in rural communities are more likely to stay in those regions,” she said.
“We also know that flexible, collaborative approaches which recognise the value of the rural generalist model of practice, provide clear career pathways and opportunities for training and skills development at all career stages, and develop a critical mass of healthcare professionals to provide holistic care and share the workload.”
Labor has not yet announced any rural health measures, apart from a proposal to lower the bar for DPA status, so that outer metro areas experiencing workforce shortages could attract overseas-trained doctors.
