Doctors call for review of fee structure for visiting medical officers stuck in the 80s

Doctor Phil Correy should know: the GP has worked as a doctor in Glen Innes for 33 years.

He's watched as the old-fashioned visiting medical officer model has been eroded away, replaced by an endless series of locums flown in from metropolitan areas for brief stints, paid far more then him.

He has two doctor daughters, neither of whom is going to work in a rural area.

"The young generation don't really want to go bush and there's no incentive for them to go rural," he said.

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The GP visiting medical officer model - in which a doctor in private practice also provides medical services to the local public hospital - came in for heavy criticism in the upper house rural health inquiry, released this week. Often the job can require doctors to be on call virtually 24 hours a day.

But in terms of remuneration, the dollar amount is still based on the Medicare Benefits Schedule, which is indexed to inflation, but hasn't changed since the 80s. Locum doctors can attract thousands of dollars a day for doing the same job. As a result, he resigned last year.

"What rural communities need are people who live in the area, work in the area, and provide that cradle to grave experience," he said.

The inquiry determined that rural residents endure "significantly poorer health outcomes, greater incidents of chronic disease and greater premature deaths" than their metropolitan counterparts. It found that the state health system operates under a "culture of fear" of speaking out.

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It also recommended a review of the working conditions, contracts and incentives of GPs working as visiting medical officers in public health facilities in rural, regional and remote New South Wales, in order that the model remains viable.

Minister for Regional Health Bronnie Taylor vowed on Thursday to implement many of the inquiry recommendations, giving her "absolute commitment" to work with the federal government to solve doctor shortage problems.

Gunnedah, which is in the Tamworth electorate, was singled out in the inquiry as a case study of a system in crisis.

Local Kate McGrath, who represents the Gunnedah Community Roundtable, told the inquiry her community had scarcely enough doctors to get by.

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She said the community has been "waiting with bated breath" for the results.

"What we're looking at is the result of policy failure over a very long period of time," she said.

"There's so much more incentive to become a specialist in a particular area of medicine rather than a GP. Everything has conspired to make becoming a GP really unattractive."

On Friday, Tamworth MP Kevin Anderson welcomed the rural health inquiry, saying it had "further highlighted issues that our community has been calling to be addressed for some time".

"There are recommendations in the report that would greatly benefit our area in terms of clarifying the relationship between GP services and the public health service and a 10 year workforce review to ensure services in our region are fully staffed," he said,

Like the Minister for Regional Health, Bronnie Taylor, there was no apology for the state of the system after a decade of Nationals in government, from Mr Anderson.

"The report also highlights issues around workplace culture within NSW Health. I am horrified to think that there would be any barrier to shining a light on issues within our health system," Mr Anderson said.

He said he would work with Minister Taylor, Commonwealth Government agencies like the Primary Health Network and the Rural Doctors Network on implementing solutions tailored to the region's needs.

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