Conclusion The change in the supply and distribution of doctors has resulted in fewer requirements for incentives in larger regional centres. In the main, the key characteristics identified as adversely affecting recruitment and retention in rural areas no longer exist in these larger regional centres. Incentives need to be applied where they are more likely to compensate for the negative factors affecting recruitment and retention and support for comprehensive practice. Evidence that rural doctors in smaller rural locations and remote areas are required to possess an advanced skillset including procedural and emergency medicine, and are required to have greater workload flexibility to incorporate call and hospital duties to meet the needs of the community. The majority of this additional workload is identified and is supported through a range of measures in addition to the GPRIP. The Panel noted that a large proportion of doctors currently practising in regional and remote locations are either or completing return-of-service obligations and as such, many do not yet have the necessary skills to meet the needs of their communities. Increased numbers alone are not the solution. Following the Government announcements the understanding of the nature of the medical workforce problem in rural and remote Australia has now effectively moved from a limited concept of geographical maldistribution of workforce with fewer doctors in the country and more in the cities to one that is defined by an improved understanding of community health needs and appropriate service delivery models. A concentration on numbers of doctors, rather than community access to defined services and the training, skill sets and practice structures required to deliver these services has limited or even detracted from attempts to resolve the medical workforce issues. Thus many small rural communities require access to comprehensive primary care, emergency services, hospital care and maternity and procedural services. This in turn implies broadly skilled practitioners and teams operating within a training, referral and visiting service network as a 'system of care’. A head-count of just does not suffice as a measure of this, nor whether ‘GPs’ Medicare-subsidised medical services in the district are less than the national average. The political and public rhetoric has changed to encompass imperatives such as community needs, continuity of care, need for social and health capacity building within communities, appropriate practitioner training and skill sets, vertical and horizontal integrated care and viable models of practice. Implicit in a viable practice model is sustainable delivery of services in rural and remote communities that are comprehensive and continuing across primary care / general practice into extended settings. Inherent in the model must be scope for adequate succession planning and system solutions that go beyond individual commitment, skills and personalities.
Conclusion The change in the supply and distribution of doctors has resulted in fewer requirements for incentives in larger regional centres. In the main, the key characteristics identified as adversely affecting recruitment and retention in rural areas no longer exist in these larger regional centres. Incentives need to be applied where they are more likely to compensate for the negative factors affecting recruitment and retention and support for comprehensive practice. Evidence that rural doctors in smaller rural locations and remote areas are required to possess an advanced skillset including procedural and emergency medicine, and are required to have greater workload flexibility to incorporate and hospital duties to meet the needs of the community. The majority of this additional workload is identified and is supported through a range of measures in addition to the GPRIP. The Panel noted that a large proportion of doctors currently practising in regional and remote locations are either or completing return-of-service obligations and as such, many do not yet have the necessary skills to meet the needs of their communities. Increased numbers alone are not the solution. Following the Government announcements the understanding of the nature of the medical workforce problem in rural and remote Australia has now effectively moved from a limited concept of geographical maldistribution of workforce with fewer doctors in the country and more in the cities to one that is defined by an improved understanding of community health needs and appropriate service delivery models. A concentration on numbers of doctors, rather than community access to defined services and the training, skill sets and practice structures required to deliver these services has limited or even detracted from attempts to resolve the medical workforce issues. Thus many small rural communities require access to comprehensive primary care, emergency services, hospital care and maternity and procedural services. This in turn implies broadly skilled practitioners and teams operating within a training, referral and visiting service network as a 'system of care’. A head-count of ‘GPs’ just does not suffice as a measure of this, nor whether Medicare-subsidised medical services in the district are less than the national average. The political and public rhetoric has changed to encompass imperatives such as community needs, continuity of care, need for social and health capacity building within communities, appropriate practitioner training and skill sets, vertical and horizontal integrated care and viable models of practice. Implicit in a viable practice model is sustainable delivery of services in rural and remote communities that are comprehensive and continuing across primary care / general practice into extended settings. Inherent in the model must be scope for adequate succession planning and system solutions that go beyond individual commitment, skills and personalities. call
Independent%20Expert%20Panel%20Report.docx