A shire in rural WA made headlines for spending close to 10% of its annual budget on securing a GP. But that’s only half the story.
The West Australian shire of Gnowangerup is shelling out an “outrageous” sum to keep its GP clinic running, but the town’s new doctor says it was a bargain.
Gnowangerup, population 1200, is about four hours from Perth, three hours from Bunbury, two hours from Ravensthorpe and 90 minutes from Albany.
Which is to say: it’s somewhat isolated.
The town’s previous GP gave his notice in April.
As reported by the ABC, the $275,000 a year that the solo-doctor practice was receiving from the council – part of which covered housing – had to be upped to $350,000 under a new agreement with regional chain Livingston Medical.
The new sum reportedly reflects about 8.5% of the shire’s annual budget and was labelled “outrageous” by National Rural Health Alliance president Susie Tegen.
“We are hoping that the feedback rural, remote and regional Australia has given the government will impact the strategies that they will implement over the coming year,” Ms Tegen said.
“We need a National Rural Health Strategy. It has to be a compact between the federal and state governments.”
GP and practice owner Dr Michael Livingston, who is one of Gnowangerup’s three new doctors, called for more investment in rural general practice from all levels of government.
“We had to replace all the IT hardware, replace all the clinical software, the whole lot,” he told The Medical Republic.
“People seem to forget that when we walk into one of these practices, we are up for the set-up costs, but no financial assistance.”
While some members of the public had read the $350,000 figure and assumed it was a “cakewalk”, he said, the clinic had spent upwards of $50,000 on the refit alone.
“We had to get a doctor here from South Australia, so we had to pay his relocation costs as well,” Dr Livingston said.
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“And if we use a recruitment agency … [it adds] another $18,000 to $22,000 on top.”
It adds up to around $70,000 outlaid before any patients even walk through the door.
“It is not quite the cakewalk it would appear to be,” Dr Livingstone said.
“Then you’re left of sorting it all out, so to speak – what’s the clinical care been like, what’s the prescribing been like?
“There are a lot of headaches, and I’ve spent my own time for the past five or six weeks trying to sort that out, which means staying away from my family and living at the caravan park.”
For those who baulk at the $350,000 figure, he said, it’s worth doing the maths on what it costs not to have a local GP.
“Let’s flip this on its head – if we didn’t get this money, the town would have no doctor,” Dr Livingston said.
“They would have to rely on a locum, who could cost between $2500 and $3000 a day, so then they’re down $1 million a year.
“Then another 100k above that … on the building and then they’d have to pay staff on top, so their costs would be nearly sixfold if we weren’t there.”
By the Scottish-born GP’s calculations, he’s also saving the state government around $1.2 million in flying doctor service retrieval costs.
Both the NHRA’s Ms Tegen and Dr Livingston pointed to Tasmania as an example of a state that puts funding toward general practice.
Under the island state’s GP guarantee policy, regional practices can receive grants of up to $250,000 per year.
