Vast areas of regional and rural Australia are seeing a severe shortage of general practitioners (GPs), leaving frontline health care in what has been described by experts as a “dangerous state”.
An unprecedented decline in the supply of doctors has left many cities and regional centers across the country without any GPs. It is not unusual for one doctor to meet the needs of thousands of people.
That’s forcing people to seek care from emergency departments at regional hospitals that are already overstretched by years of funding cuts, exacerbated by the COVID-19 pandemic and now the flu.
Speaking of Sydney Morning Herald (SMH), Richard Colbran of the New South Wales (NSW) Rural GPs Network in the country’s most populous state said: “The reality is that there is not a town in rural NSW that is not at risk of not being able to stay sustainable primary care now. For every GP leaving the workforce there will need to be three to replace them to keep up with demand. After COVID-19, floods and fires, GPs have never felt a time when the system is in such a dangerous state. They are exhausted.”
Colbran said at least 600 rural GP proceduralists, who also work as doctors in local hospitals, have left their positions in the past 10 years. There are now fewer than 200 GP proceduralists working in rural NSW, with authorities concerned that number could dwindle to less than 100 within the decade.
Dubbo, in central NSW, has recently seen the closure of three of its twelve general practices. Dr Ai-Vee Chua, a local GP told SMH “I’ve worked in rural NSW for over 20 years and the shortages we’re seeing now are the worst they’ve ever been, especially with the population growing.”
Dr Chua said patients were being forced to go to emergency departments because “they have no other choice”.
In Queensland, Kingaroy in the south-east of the state is seeing a GP shortage so severe that waiting lists for local GPs are 8 weeks. There are only seven medical clinics for the city of over ten thousand people, and the practices are not accepting new patients.
A recent report published this year by Deloitte Access Economics, titled “General Practitioner Workforce Report 2022”, found that the crisis will only progress as an aging and growing population sees demands for services of general practitioners to increase by 38 percent by 2032.
The study reported that on current trends, the supply of GPs would decrease by 15 per cent in cities and 4 per cent overall, resulting in a shortage of 11,392 GPs in 2032. This would equate to 1 in 3 the GP workforce.
Lack of basic health care services puts patients and staff at extreme risk. Earlier this year at Yass Hospital in south central NSW, such a shortage of doctors left a paramedic and a registered nurse running the hospital. Twenty-four clinical staff associated with the hospital then wrote an open letter calling for urgent action on the staffing crisis and describing the situation as dangerous and unprecedented.
Rural health care in Australia has been under-resourced for decades, subject to funding cuts under both the Liberal and Labor state and federal governments. For years, patients with severe acute illnesses have needed to be sent to city hospitals for emergency care. Those suffering from chronic illnesses must travel to cities or large regional centers for optimal care.
The resulting anger in rural communities was evident in submissions to the NSW State Parliamentary Inquiry into regional, rural and remote health care. This inquiry, established in September 2020, follows a series of preventable deaths in rural and regional hospitals, which have highlighted the catastrophic state of health services in these areas.
The conditions highlighted in the report have been replaced both in terms of the lack of GPs and the increased and intolerable workload of those who remain. However, the latest findings from this submission reveal a deepening future GP shortage crisis in rural NSW. Currently, Wellington NSW has a population of 10,000 and yet only one doctor practices in its local hospital. Over the next 5-10 years, at least 43 small communities in the state are at risk of losing GP services.
South Australia and Northern Territory President of the Royal Australian College of General Practitioners Dr Zakaira Baig said NewsGP Earlier this year, labor shortages were “becoming an issue across Australia”. Baig said attracting young doctors and medical students to general practice remains the biggest challenge as they have lost interest in pursuing a career in the field.
“There are many reasons for this,” Baig said. These include “the huge disparity in the remuneration of GPs and other specialists; while GPs are recognized as specialists, GPs are not paid the same rate. Young doctors are often in relationships, there are no job opportunities for their partners if they go to the countryside… so they are not inclined to go to the countryside unless there are special incentives. [There are also] limited schooling opportunities for children of rural GPs. Many leave the cities for this reason when their children grow up.”
Many doctors choose to work in areas already well served by existing doctors to avoid professional isolation and the expected excessive workload.
A study by the Australian Institute of Health and Welfare, published shortly before the start of the pandemic in late 2019, found that “on average, Australians living in rural and remote areas have shorter lives, higher rates of illness and injury and poorer access to and use of health services, compared to people living in metropolitan areas”.
The report concluded that poorer health outcomes in rural and remote areas may be due to a number of factors, including changes in lifestyle and a level of disadvantage in relation to education and employment opportunities, however this included also limited access to health services.
Funding for primary care has not increased in eight years. Patient discounts for GP services have been frozen since 2014 by the Abbott Coalition government, after the Gillard Labor government introduced it as a “temporary” budget measure in 2013.
The result is that GPs have been forced to charge patients “gap payments” to compensate for funding cuts, shifting the crisis onto the backs of the working class. With the cost of living rising rapidly due to inflation, many people have to forgo health care because they cannot afford the cost with serious consequences for the health and well-being of ordinary people. It means without treatment, preventable medical conditions progress to chronic or life-threatening.
The new Albanian Labor government, during the election campaign, promised to inject very limited funds into health. But within weeks of forming government, Labor has instead named health care as one of the main areas for spending cuts, as the national debt, built up through handouts to big business over the past two years, is paid off in ruin. further essential services.
There is no solution to the health crisis, which is being deepened on many fronts, by governments, big businesses or the capitalist system. It is up to the working class to fight for an alternative.
The Socialist Equality Party is calling for workers to form high-level committees, independent of corporate unions, in health workplaces across the country, in regional, rural and urban areas.
These committees should be established to unite all health workers in a common struggle, for adequate wages and conditions for staff and for high quality and free public health care for all. This raises the need for an alternative, socialist perspective aimed at reorganizing society to meet social needs, not the profits of big business and banks.