Extreme GP drought hitting Northern Territory

The government has pledged to double the rural primary care workforce and convened in Alice Springs to turn the workforce crisis around.

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Amid research showing an 80% drop in NT’s GP training enrolments since 2016, the government has promised to increase doctors in regional areas by hundreds over the coming years.

The study, published this week in the Australian Journal of Rural Health, analysed over 100 articles to summarise GP training program enrolment data in the NT and nationally.

While enrolment nationally declined by 10% between 2017 and 2022, enrolments in the NT were down over 80% since their peak in 2016, with only 14 vocational GP training spots filled for 2023.

The study, run by the Menzies School of Health Research – which is launching a locally-led medical training program in the NT this year in collaboration with CDU – interviewed more than 50 medical professionals to deliver high priority strategies to address the GP crisis.

According to the interviewees, the number one priority was increasing opportunity for newly registered doctors to gain experience in general practice.

Five other actionable solutions were identified;

• Medical school stage: Ensuring adequate infrastructure to accommodate and support extended learning in primary health care settings.
• Junior doctor training stage: Introducing and investigating additional primary health care training opportunities for junior doctors.
• GP training stage: Offering portable employment benefits, together with high quality, culturally sensitive and flexible personal and professional support.
• General practice: Better remuneration of GPs. 
• Profession perception: Greater promotion of the diverse experiences and expedited GP career opportunities available in the NT.

Professor of Remote and Rural Health Services at Menzies John Wakerman said swift action was paramount.

“The decline of medical graduates entering GP training in the NT has already had an impact on Territorians accessing primary health care and signals a grim outlook for GP supply in rural and remote Australia,” he said.

“To address this, we need to be expanding primary care training opportunities, offering portable employment benefits during vocational training, and supporting GPs to receive high quality, culturally sensitive, professional and personal support.

“Increasing GP training numbers in the Territory will require investment, co-ordination and implementation of a range of strategies by key stakeholder organisations.”

While the entire country is suffering in the face of a looming GP crisis, the issue remains at the forefront for Territorians because of the NT’s remoteness and higher incidence of chronic health conditions, particularly for Indigenous Australians, the study said.

The Albanese government has already pledged $76 million over three years via the John Flynn Prevocational Doctor Program, which commenced this January, aimed to increase rural primary care rotations for hospital-based doctors from 440 in 2022, to 1000 by 2026.

The program will aim to retain junior doctors in rural areas, with priority for areas deemed “high need”, especially those directly servicing Indigenous Australians.

It will also allow doctors to participate up to five years after they graduate and limits rotations for doctors from urban hospitals.

AMA President Professor Steve Robson told TMR the program was a step in the right direction.

“We welcome the government’s efforts to provide more opportunities for prevocational doctors to work in rural areas, particularly in general practice,” Professor Robson said.

“While the program has a new name, the reality is that this builds on earlier programs that were in place, expanding the available number of prevocational training places.

“General practice is well positioned to support this expansion, having had a solid history of providing valuable rural training experiences for doctors over many years.

“In fact, there were around 1000 prevocational GP training places in rural areas each year under the former Prevocational General Practice Training Program before it was dismantled in the first Abbott government budget. 

“What we are now seeing is an effort to restore this capacity and provide a real pipeline into rural practice.”

Yesterday, the Albanese government met with the NT’s health workforce to discuss issues uniquely faced by Territorians, with the aim of working with first nations peoples to co-design plans to attract, recruit and retain a healthcare workforce and improve equity of access to care.

On the agenda for the Primary Health Care Workforce Summit: how to fix a workforce in crisis.

This centred around workforce shortages worsened by the extend of rural and remote areas in the NT, the myriad issues brought on by a partially fly-in-fly-out workforce and the additional training necessary to ensure the provision of culturally appropriate services.

Crucial to the summit was tackling the “well-known and deep inequities facing regional, rural, remote and First Nations communities across the Northern Territory”, said Assistant Minister for Indigenous Health Malarndirri McCarthy, who co-hosted the summit.

“Growing the number of Aboriginal and Torres Strait Islander people working across the health system and designing services in genuine partnership with First Nations communities and organisations are central to long-term improvements.”

Assistant Minister for Health and Aged Care Ged Kearney, who co-hosted the summit alongside Senator McCarthy, promised that the government was “steadfast” in its commitment “to rebuilding primary care”.

“All Australians deserve equitable access to healthcare – and patients in the Northern Territory should be no exception,” she said.