Going without … Australia’s outback towns are in desperate need of more doctors. Picture: Thinkstock Source: ThinkStock
OUTBACK towns are dying without doctors because a botched Federal Government incentive scheme pays GPs $30,000 to relocate to tourist cities like Cairns and Townsville.
Instead of helping ease the medical crisis in tiny bush towns, the $113 million a year General Practice Rural Incentive scheme is attracting doctors to big regional cities with shopping malls, hospitals and universities.
The Abbott government has so far failed to reform the scheme, despite being urged to do so by a government inquiry and a 2012 Senate inquiry involving Assistant Health Minister Fiona Nash.
However, after being contacted by News Corp Australia, the Minister signalled this week she had asked her department to look at alternatives to the current system.
The main problem is the size of the inventive payment a doctor gets depends on how far they live from a major city, small weight is given to the population of the town.
Hence, the small town of Hay 700 kilometres from Sydney has a population of 2,600 people and just one medical practice but the government’s Rural Relocation Incentive Grant scheme offers doctors who decide to move there the same $30,000 grant given to doctors who want to move to Cairns (population 150,000).
Doctors who continue to practice in Hay for up to five years get an $18,000 incentive payment from the government, the same as in Cairns.
Worse still, the Rural Doctors Association of Australia says if the medical practice in Hay was to relocate just five metres outside the town the subsidy to attract doctors there would double to $60,000, and the five year retention incentive would rise to $27,000.
Deniliquin (population 7,500), 750 kilometres from Sydney attracts a relocation grant of just $15,000 even though it suffers a shortage of doctors and is surrounded by other towns attracting a $30,000 incentive.
“The fact that Deniliquin is now competing directly with Cairns, Townsville, Hobart, Darwin and other major regional centres for much- needed doctors is not helping matters,” the Rural Doctor’s Association says.
“There is a significant amount of waste in this program and we are not getting doctors to towns that need them,” says RDAA president Dr Ian Kamerman.
Too much waste … Rural Doctors Association of Australia president Dr Ian Kamerman has criticised the scheme. Picture: Supplied Source: Supplied
In May 2012 Senator Nash grilled the Health Department during a Senate inquiry on the incentive scheme asking whether it was aware of the concerns it was “illogical and
inappropriate when it comes to the incentive payment?”
A bureaucrat told the committee “anecdotally, the information we are getting from stakeholders is that it is not really working effectively for them.”
A spokeswoman for Assistant Minister for Health Fiona Nash said she was aware of anomalies caused by the Australian Standard Geographical Classification – Remoteness Areas (ASGC-RA) system used to determine the incentive payments.
“This is why she has tasked the Department of Health to investigate alternatives to improve the system. It is important that proposed new models go through rigorous testing,” she said
“The Government will continue to work with stakeholders to ensure we implement a system that better supports communities most in need,” she said.
In 2012—13, 12,771 payments were made under the program with 11,500 doctors and registrars paid annual retention grants and just 55 doctors awarded relocation grants.
Medicare billing data shows that in June 2012, the number of full-time
workload equivalent GPs in the bush had increased by 9.7% since the introduction of the schemes in July 2010. A government inquiry found the major growth in medical retention payments had been in the more desirable inner regional areas and not those classified as remote.
Monash University School of Rural Health research found doctors would only consider relocating to a rural location of 5,000 people or less for an additional 64% of their current salary, well above the government incentive payments.
Monash University Professor John Humprey has modelled an alternative incentive scheme endorsed by the Senate committee and in modified form by a government inquiry.
It would have six categories of grants and recognises that communities with population under 15,000 have a greater need for incentives.
It would take into account not just population size and distance from a major city but also the hours a doctor workers, whether they had to work in a public hospital, whether they did after hours care, found it difficult to take time off, had a choice of schools and jobs for their partner.
NSW Health Minister Jillian Skinner says in the last year almost 300 extra doctors started working in regional and rural NSW and over 400 medical interns commenced work in the bush in 2014.
A new rural generalist training program has been established to provide co-ordinated training for doctors who want to works as rural GPs.
Originally published as Doctors get $30,000 to avoid the bush