Crisis meeting in Armidale to find solutions to GP shortage

Doctors, nurses, politicians, and concerned locals packed into the Armidale Bowling Club on Wednesday night for The Future of Primary Health Care forum to address the chronic GP shortage, that hit crisis point following the recent loss of 13 doctors.

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New England Visions 2030 founder Maria Hitchcock OAM organised the forum, with Dr John Nevin leading a majority vote via a show of hands on five recommendations they are expected to present to the NSW and federal governments.

The three recommendations passed included increasing the Medicare Schedule fee, establishing an independent body to oversee fees set for the Medicare Schedule and introducing the Murrumbidgee plan.

The two recommendations voted down included establishing a locally-based pool of locums to fill short-term positions in the regions, and allocating doctors to areas across Australia based on population size and need.

Ms Hitchcock, who also started the health petition to split the New England Health District, said the next step would be to set up a bigger lobby group "because there is strength in numbers and collaboration is key".

"This health issue is a hot issue at the moment and we're trying to do what we can," Ms Hitchcock said.

About eight general practitioners retired or relocated from practices in Armidale to February 3, with another five registrars expected to leave by month's end, leaving thousands of people without a GP.

Tamworth-based GP and CEO of Australian Medical Association's Council of Rural Doctors, Dr Ian Kamerman, said it was good to hear feedback from locals about how the lack of GPs was impacting them.

"This is one of the signs of the failure to ensure we've got a significant medical workforce problem throughout rural Australia," Dr Kamerman said.

Dr Kamerman also said communities need to ensure health professionals are welcomed and incentives provided such as relocation and subsidised housing.

"I don't know what the quality or availability of housing is like in Armidale, but in Tamworth we've got significant problems housing our GP registrars."

"They can't find an actual house to move into, so what message does that send?"

Former Armidale mayor (2012-2013) Jim Maher spoke about being among thousands on the search for another GP, after doctors Puxty and Bohlsen sold the West Armidale Clinic to not-for-profit group Rural And Remote Medical Services RARMS.

"In my time we never had a crisis like this, Armidale had no trouble attracting GPs," Mr Maher said.

RARMS has since introduced nurse-assisted telehealth at the West Armidale Clinic, because they were not able to recruit any replacement doctors.

Armidale-based GP Dr Martin Danke spoke candidly about the urgent "deep-seated structural reforms" needed on the political level to entice doctors to the region.

"We need not one or two people relocating from the large urban centres, we need five, 10...15 doctors," Dr Danke said.

Dr Danke arrived from Germany to settle with his Armidale-based wife about 20 years ago, when he started working as a GP in the New England region.

"International graduates, like myself, are not ideal. It is always the second-best solution," Dr Danke said.

"We also want general practitioners to not only speak the lingo but also know what people mean.

"They might hear what patients say if they have good English, but do they really know what they mean when they talk about domestic violence, end-of-life palliative care, and so forth.

"So, we also need people who are really comfortable in the culture and with the language."

Retired GP Nigel Pain said he doesn't think bulk-billing has a future because Medicare has not kept up with cost-of-living, leaving many "cranky" and "upset" GPs teaching graduates.

"I'm not sure they will be the best people to encourage new graduates to go to general practice," Dr Pain said.

"If it is not being paid properly and taught by people who aren't very happy, then I don't think that will be a very good outcome."

Chair of the New England Division of General Practice NEDGP, Dr Vicki Howell, led the forum with a six-point plan before answering questions from the audience.

"We heard from some members of the community with very powerful messages tonight," Dr Howell said.

"People have really picked up on the theme that we need to create a new model for primary care provision."

The six-point plan supported the first recommendation about the need to roll-out the Single Employer Model, which was first successfully trialled in Murrumbidgee, and would see trainee doctors employed seamlessly across both private clinics and state-run hospitals.

"We desperately need that model here in NSW, but it will take an act of parliament to make that happen," Dr Howell said.

The federal government announced the Single Employer Model would be rolled-out across Tasmania, in a controversial move that had NSW Minister for Regional Health Bronnie Taylor proposing a scaled-up plan for the state where it originated.

Dr Howell said they would also call on the Hunter New England Health District to increase staff numbers in Armidale Hospital, and demand the Royal Australian College of General Practitioners (RACGP) lift caps on the number of trainee doctors allowed to work in private practices under supervision.

"We are turning away registrars because we aren't allowed to employ them under the current caps set," Dr Howell said.

"These doctors could be recruited from April and commence practice in town from August."

There also needs to be a fully state-funded after-hours clinic staffed by general practitioners in Armidale, Dr Howell said.

The final two dot-points on the list included reinstating the Distribution Priority Area DPA, so that overseas-trained doctors would first do their time in rural regions, and allocating funding for more nurses in general practices.

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