The long-term quality of country health services is under threat from Federal Government funding, two of South Australia’s most senior country GPs say.
The doctors said the Prevocational General Practice Placements Program (PGPPP), which was scrapped in last year’s budget, helped solve a chronic shortage of doctors in country Australia.
Rural Doctors Training taskforce vice president Doctor Richard MacKinnon said the PGPPP was vital in getting doctors out into rural areas.
“Fifteen years ago we were suffering a shortage of doctors in the country,” he said.
“There were around 300 of them working in rural SA and we relied on overseas doctors to prop the system up.
“Now there are more than 500 and one of the keys to that change has been the PGPPP.”
Dr MacKinnon argued the success of the program hinged on exposing doctors in their intern year to country medicine, before they made a concrete decision on their future.
“If you look at the type of medicine in the major [metropolitan] teaching hospitals, it’s probably about 5 per cent of what medicine is about,” Dr MacKinnon said.
“This gave them an opportunity to see what primary health care was like in a rural setting, and yet they could still experience hospital-type medicine and emergency medicine.”
Dr Holly Deer was a PGPPP country intern who now partners Dr MacKinnon in their busy Crystal Brook practice, two hours north of Adelaide.
She said spending time in a rural area helped clarify the direction she wanted to take in her medical career.
“It sold general practice for me,” Dr Deer explained.
“I thought that I’d probably go into rural general practice, but was not completely sold on what I wanted to do when I became an intern.”
Program served its purpose: Fiona Nash
In a statement to the ABC, Federal Assistant Health Minister Fiona Nash argued that the Government was committed to rural health and the PGPPP had cured the disease it was designed to.
“The Federal Coalition Government has redirected the PGPPP funding to create 300 more GP training positions a year from 2015 onwards,” the statement said.
“At least 50 per cent of GP training must take place in regional and rural locations.”
While Dr MacKinnon agreed the program was expensive, he believed it could have continued if the Federal Government consulted with doctors about ways it could be made more cost effective.
Rural GP training specialist Dr Tim Kelly was involved in the early trials of what eventually became the PGPPP.
He said scrapping the program could affect not just the number of country doctors, but the quality of medical services in the long-term.
“This program was hugely successful in attracting the right people to do rural general practice,” Dr Kelly said.
“The question [now] is will we have the right people who want to be there, or will we have people coming out who can’t get a job anywhere else.”
Drs MacKinnon and Deer said the short-term consequences were already apparent with Crystal Brook’s last intern leaving in December.
They said their workload had jumped, both at the clinic and next door in the Crystal Brook Community Hospital.
“We might joke a little about interns being dog’s bodies,” Dr MacKinnon said.
“But they are very important. Those big teaching hospitals would not run without interns in there doing all those sorts of jobs. It’s the same out here.”