Workforce doctor shortage reaches critical status

UNITED: Dr David McCreary (locum), Dr Amanda Bethell (GP, OBMC and hospital), Dr Amy Bicknell (Obstetrics & gynaecology Reg, PAH), Dr Bas Kirmani (RFDS), Dr Emilie Ross (surgical intern PAH), Dfr David Little (locum), Dr Louise Williams (GP registrar, OBMC), Dr Terence Chung (GP registrar, OBMC) gather at the Port Augusta Hospital in support of bringing more general practitioners to the region.
UNITED: Dr David McCreary (locum), Dr Amanda Bethell (GP, OBMC and hospital), Dr Amy Bicknell (Obstetrics & gynaecology Reg, PAH), Dr Bas Kirmani (RFDS), Dr Emilie Ross (surgical intern PAH), Dfr David Little (locum), Dr Louise Williams (GP registrar, OBMC), Dr Terence Chung (GP registrar, OBMC) gather at the Port Augusta Hospital in support of bringing more general practitioners to the region.

With only 10 full-time general practitioners (GP) employed in a town populated by over 14,000 people, the doctor shortage in Port Augusta has reached critical status.

Its at best frustrating and many are very stressed, frightened and understandably angry, Dr Amanda Bethell sympathises with residents seeking medical attention.

Timely access to healthcare is seen as a given in Australia. Some people are missing days of their regular medications for chronic diseases if they cant get an appointment.

Others are being admitted unwell to hospital as they havent been able to get into a GP earlier for treatment which may have prevented the admission.

While the shortage of doctors is felt in many rural locations, the $57.2 million expansion of the Port Augusta Prison has only intensified the problem by putting excessive strain on the Port Augusta Hospital.

A parliamentary inquiry into regional health services revealed the increased workload in the hospitals emergency department has further deterred local GPs from filling rosters.

Acting Minister for Health Susan Close said the state government works with key stakeholders, including local governments, and funds the Rural Doctors Workforce Agency to develop incentives to attract doctors to regional areas.

The Minister did not comment on the lack of doctors employed in the Port Augusta Prison before its expansion.

The Royal Australian College of General Practitioners 2017 General Practitioner of the Year, Dr Bethell, has been a strong advocate in putting an end to doctors working 24-hour shifts in country towns.

The 24 hour shifts at the hospital understandably deterred several younger doctors including GP registrars who were otherwise interested over the past few years, Dr Bethell explained.

Whilst Im passionate about hospital work being part of country GPs role, I also think we should support doctors who want to work in the country but dont want to work in the hospital - we need both. But we do need to make sure the hospital has other sources of doctors, as is starting to happen.

For many years Port Augusta was designated as a District of Workforce Shortage (DWS) which helped with the recruitment of doctors to the area, but since that status was revoked the shortage has once again become a significant problem.

A spokesperson for the federal Minister for Rural Health Bridget McKenzie said the Department of Health is currently undertaking the calculations for the February 2018 update to DWS classification.

The Government has also established the Distribution Working Group (DWG) to review the Departments rural health workforce programs, the spokesperson said.

This includes a review of the DWS system to ensure that it is meeting its objectives to improve the distribution of the medical workforce across Australia.

Minister McKenzies spokesperson also said that while the government does not have a direct role in employing health professionals, it does have a number of programs to encourage the recruitment and retention of doctors into rural areas.

This includes the General Practice Rural Incentives Program (GPRIP) which provides a financial incentive for GPs to work in rural areas.

Under the GPRIP, a doctor working in Port Augusta can receive an incentive of up to $18,000 per year, although Dr Bethell said these incentives are simply not enough.

At present we can really only offer much the same employment package as a practice in Burnside - which has (arguably) a less complicated patient load, specialists on-tap, a very expensive public hospital down the road, and wealthy people to pay whatever is asked. And no after-hours work, she said.

The Federal Government needs to find a meaningful way of addressing the maldistribution of GPs there is an over supply in the city and an under supply in rural areas across the country.