The states and Commonwealth must work together to fund rural GP locums, according to Far West LHD’s boss.
Employing a collaborative funding model to recruit GPs to work both in rural hospitals and in local communities, with costs shared across Commonwealth and state funding streams, could be a way of overcoming GP workforce shortages in rural and regional NSW, according to Far West LHD CEO Brad Astill.
Presenting before the NSW Special Commission into Healthcare Funding, Mr Astill said shifting current funding arrangements to provide LHDs greater support to offer both hospital and community-based services would allow rural LHDs to deliver primary care services much more efficiently given current workforce constraints.
“The challenge in some of these small communities is that a GP practice based entirely just on MBS billings is not sustainable. That’s why we’ve seen the situation [unfold] that we have in a lot of small rural communities,” Mr Astill said.
“It does beg the question whether you [could] cobble together an arrangement where the [GP] spends some time [delivering] hospital services, which may well be paid for out of LHD or state funds, and some time delivering GP-type services funded through the Commonwealth and potentially some other services, which might be funded by the ACCHO revenue. You could construct a medical service that could work in that environment.
“Given that many of the services in that context would be primary care services, it’s not unreasonable to have an expectation that there might be some Medicare dollars attached to that as well, to establish that.”
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Having previously tried to implement such a model while attempting to recruit a new GP to fill gaps in the Wentworth region, Mr Astill said even the district’s “very rough” cost analysis, done on the back of an envelope, had been enough to show that doing so under the district’s current funding arrangements would be “crippling”.
“Our discussions were primarily with Coomealla Health Aboriginal Corporation [CHAC],” Mr Astill said.
“We were working with a locum agency who tries wherever possible to get a roster of potentially three or four GPs who would work about a week [each] so that there’s some consistency. That was the model that we had in place here for a while, but the costs of bringing those people to town were crippling.”
