Wide swaths of regional and rural Australia are experiencing acute shortages of general practitioners (GPs), leaving frontline health care in what experts have described as a “dangerous state”.
An unprecedented drop in the supply of doctors has left many cities and regional centers across the country without a single doctor. It is not unusual for one doctor to serve the needs of thousands of people.
That’s forcing people to seek help from emergency rooms at regional hospitals, already overburdened 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 GP Network in the country’s most populous state said: “The reality is there is not a town in rural NSW that is not at risk of being in able to maintain viable primary care at this time. 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 bushfires, GPs have never felt a time when the system was in such a dangerous state. They are exhausted.”
Kolbran said at least 600 rural GPs who also work as doctors in local hospitals have left their positions in the past 10 years. There are now fewer than 200 GPs working in rural NSW, with authorities worried that number could drop to less than 100 within the decade.
Dubbo, in central New Wales, recently closed three of its twelve general practices. Dr Ai-Vee Chua, a local GP, told SMH: “I’ve been working in rural NSW for over 20 years and the shortages we’re seeing now are the worst they’ve ever been, especially with the growing population.”
Dr Chua said patients were forced to go to emergency departments because they “had no other option”.
In Queensland, Kingaroy in the south-east of the state, there is such a severe shortage of GPs that waiting lists for local doctors are 8 weeks. There are only seven medical clinics for the city of over ten thousand, 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 will see demand for GP services increase. increase by 38 percent by 2032.
The study reports that on current trends, the supply of GPs will decline by 15 per cent in cities and by 4 per cent overall, leading to a shortage of 11,392 GPs in 2032. This would equate to 1 in 3 of the workforce of general practitioners.
The lack of essential health 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 demanding urgent action on the staffing crisis and describing the situation as dangerous and unprecedented.
Rural health in Australia has been under-resourced for decades, subject to funding cuts by both Liberal and Labor state and federal governments. For years, patients with acute severe illnesses had to be airlifted to city hospitals for emergency care. Those suffering from chronic illnesses must travel to the city 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. This inquiry launched in September 2020 following a series of preventable deaths in rural and regional hospitals which highlighted the catastrophic state of health services in these areas.
The conditions highlighted in the report have been superseded, both in terms of the shortage of GPs and the additional and intolerable workload of those who remain. However, more recent findings from this presentation reveal the deepening crisis ahead of GP shortages in rural NSW. Wellington NSW currently has a population of 10,000 and yet only one doctor practices in the local hospital. In the next 5-10 years, at least 43 small communities in the state are at risk of losing general practitioner services altogether.
President of the Royal Australian College of General Practitioners for South Australia and the Northern Territory Dr Zakaira Baig said NewsGP earlier this year that labor shortages were “becoming an Australia-wide problem”. Baig said attracting young doctors and medical students to general practice remains the biggest challenge as they have lost interest in pursuing careers in the field.
“There are multiple reasons for this,” Baig said. Among them are “the large disparity in remuneration of the GP and other specialists; while GPs are recognized as specialists, GPs are not paid the same. Young doctors often have relationships, there are no job opportunities for their partners if they go to the countryside… so they don’t want to go to the countryside unless there are special incentives. [There are also] limited training opportunities for children of rural GPs. Many move to cities for this reason when their children grow up.
Many doctors choose to work in areas that are already well served by general practitioners to avoid professional isolation and expected overwork.
A study by the Australian Institute of Health and Welfare, published just before the pandemic began in late 2019, revealed that “on average, Australians living in rural and remote areas have shorter lives, higher rates of disease and injuries and poorer access to and use of health services compared to people living in urban areas’.
The report concludes that poorer health outcomes in rural and remote areas may be due to a range of factors, including differences in lifestyle and levels of educational and employment disadvantage, but also limited access to health services. services.
Funding for primary care has not increased for eight years. Patient discounts for GP services have been frozen since 2014 by the Abbott coalition government after the Gillard Labor government introduced them as a “temporary” budget measure in 2013.
The result is that GPs are being forced to charge patients ‘gap fees’ to make up for the funding cuts, putting the crisis on the backs of the working class. With the rapidly rising cost of living due to inflation, many people have to forego health care because they cannot afford the costs with dire consequences for the health and well-being of ordinary people. This means that without treatment, preventable medical conditions progress and become chronic or life-threatening.
Albania’s new Labor government promised during the election campaign to inject very limited funds into health care. But within weeks of forming government, Labor has instead nominated health as one of the key areas for spending cuts, as the national debt built up by handouts to big business over the past two years is paid off by further destruction of basic services.
There is no solution to the health care crisis that is being exacerbated on many fronts, by big business governments or the capitalist system. It is up to the working class to fight for an alternative.
The Socialist Equality Party is calling on workers to form rank-and-file committees, independent of corporate unions, in health workplaces across the country, as well as in regional, rural and urban areas.
These committees should be established to unite all health workers in a common struggle for decent staff pay and conditions and high-quality, free public health care for all. This posits the need for an alternative, socialist perspective aimed at reorganizing society to meet social needs rather than the profits of big business and banks.