Doorstop following local roundtable with the rural health workforce, Cummins SA.

QUESTION:

Mark, recent figures from RACGP suggest there’s a decline in doctors electing for GP training and choosing specialties instead. Do more incentives need to be in place to fill more GP training roles?

MARK COULTON:

That’s exactly right. So, you know, what we’ve seen here in the bush is a symptom of a larger problem. And that is as we speak this year, there’s 30 per cent vacancy in funded training places for GPs across Australia.

We need to lift the value of general practice as a discipline.

We’re also training generalists, which is proving to be very popular with students coming through. So, doctors that have that broader range of skills, a GP with an emergency skill, obstetric skill, that would be of use when you’re working more remotely by yourself. And so, we’re looking at a whole range of issues going right back to the training through the students, working with the colleges, right through workforce issues and incentives, putting more students from country areas into training.

This month, the first students from the Murray Darling Medical School are being enrolled, and there was a massive amount of interest in that.

That will roll out over the next couple of years.

Yesterday, I met with Minister Stephen Wade from the South Australian Government about the issues here. And we’ve had a discussion about working more closely across. So, you know, we have a similar issue we’ve got to solve.

The State Government’s got the issue of keeping the hospitals staffed and open. The Federal Government’s responsible for the pipeline of GPs coming through.

In a small community, it makes sense that we look at the resources we’ve got and make the best use of them, because what we’ve seen in some communities is that the health- the State Government’s paying large money to locums to [indistinct] a hospital, but it’s not really a fully utilised job.

And then the GP at the other end of the street might be struggling because they’re overrun with patients.

And so, we are looking ways at making better use of the resources.

We’ve got two problems. We’ve got the long term one, and Rowan (Ramsey MP) mentioned that longer pipeline.

And I’m very confident that what we’re putting in place will make a big difference.

But the short term one is what happens in the next year or so. And so, that’s when we’re going to have to come up with some innovative models of care, so that going to work in a regional area is seen as an advantage to your career, not as a career killing move.

That goes right back to the culture of the rural pathway where straight away the mindset is going rural somehow is second best. And so, we’ve got to create- because it’s not second best.

The skills you require in a town like Cummins and the rewards of being the GP to service a community that knows you, respect you, loves you and relies on you are immense.

But we’ve really got to get that message back to the junior doctors and the students to look at this as a genuine pathway of a career.

QUESTION:

Would you consider, I guess, with the Government workforce incentive payments, would you consider increasing them for doctors here? I believe they get a lump sum per year? There’s talk of maybe doubling it or perhaps do some tax?

MARK COULTON:

Certainly, I’m more in favor of the carrot approach than the stick approach.

I think forcing doctors out here would be short term at best. There is quite significant payments that come out of practise incentive payments (PIP) and workforce incentive payments (WIP).

So there’s quite an array of federal payments that would come into a community like this.

But, you know, one of the issues we’re discussing at the moment and I discussed it in here today, was maybe a graduated MBS remuneration for remoteness so that if you live in a city, you get a rebate of X amount. But if you live in a modified Monash (model) six or seven town, you get a larger amount, because at the moment we’re expecting doctors to service the towns of the highest level of health need, and they’re the towns that had the lower propensity to actually pay for it.

And so a GP would go to a more affluent suburb where there’s a higher level of care, but also a greater ability to pay where they can co-charge $100, $120 for a consultation.

Whereas in a town like this, people would not be able to pay that amount. And so it’s a double edged sword that we’re dealing with.

We’re aware of the situation.

I live in a small town very similar to this one in New South Wales. I know very much the issues that these communities are facing.

Rowan (Ramsey MP) has been incredibly articulate in explaining to our colleagues in Canberra exactly the issues that he’s dealing with here.

Athe moment, it’s the number one health workforce priority that the Australian government is working to overcome – this workforce shortage in rural areas.

QUESTION:

How reassured were the doctors walking out just then that there will be changes this year?

MARK COULTON:

Look, I’m not one for coming in and telling people what they want to hear.

We had a very frank discussion today about different options, and they were very frank in their assessment of the likelihood of that happening.

But what they did say to me is that they are looking for some action to back up these meetings.

They don’t just want to come to meetings without having an action it.

There is a lot happening. There was members of my health department from Canberra on that call.

Professor Ruth Stewart, the Rural Health Commissioner, was on that call. Her primary job is to overcome workforce issues in regional Australia.

So we are putting a big effort into this. But I’m not going to stand here today and say this is going to be fixed in a short time. It’s a big job.

QUESTION:

Now, Minister run me through, how is the rollout going to go in regional areas?

MARK COULTON:

Okay, so, it will be quite varied how it goes. And so you might’ve noticed there were some hubs announced a couple of weeks ago that did cause a bit of a ripple through the communities.

There was a misunderstanding that they were actually hubs for vaccination. They just the storage hubs.

So the first vaccine, the rollout will be the Pfizer vaccine, that’s the one that’s stored around minus 70.

It’s not quite as tricky as some might think it is. Once it’s thawed back to refrigerated temperature, it has a lifespan of five days.

So from those hubs, it will be distributed out. And the priority will be through the front line health workers.

It will be to aged care workers and residents and disability workers and residents as a priority. So for every million doses we have, that’s half a million people, because once you’ve had your first dose, another one’s put aside so that you can have that second one in a timely way. It’s been passed by the TGA.

The AstraZeneca vaccine is in the final stages of that. It will be actually produced in Australia.

So we will have larger volumes of that coming through. Different cohorts of Australians will be vaccinated over a period of time.

In regional areas like this, we’ve now gone to expressions of interest for the local GP’s, and pharmacists to administer the vaccine.

The health districts and Aboriginal controlled medical centres will be involved.

In some areas, the larger towns that have got GP-led respiratory clinics that the Commonwealth funded, they’ll be doing that.

Because we’ve got to actually give 50 million needles to 25 million people, it will be basically all hands on deck and we’ll be looking for support wherever we can so that people will be able to get them in their local communities.

There was a bit of a misconception that you might have to travel to Port Lincoln or somewhere like that from here and there’ll be opportunities here.

I’m just asking people to be patient.

We are working through the finer details now with the state governments, with the local health districts.

When the time comes for the people across regional South Australia to have those shots, that will be very clear what the process is, where the locations are and what they’re required to do.

So just asking for the patience until that’s finalised. And then there’ll be a lot of publicity assets attached to that.

QUESTION:

Will the Royal Flying Doctor be able to distribute these vaccines?

MARK COULTON:

Well, in some cases, I’m sure, and so in some of the more remote Aboriginal communities or remote communities full stop, there will be flying squads come in.

During the pandemic, we actually went to them (the RFDS) for retrieval. We actually funded the flying doctor an extra $57 million to have their ability to actually retrieve people.

Thankfully, regional Australia, particularly remote Australia, has been COVID-free, thankfully. Because of some of our most vulnerable communities. But yeah, we’ll be using all the resources that we can.