Time for action on rural health
BY DR SANDRA HIROWATARI, CHAIR OF THE AMA COUNCIL OF RURAL DOCTORS
Here we go again.
That’s what we hear when another election rolls around. Politics has been ugly in recent times, so people tune out. But we have a duty to our communities, to our patients, and to our fellow rural docs – we have to get the politicians to listen and act on rural health.
Some of our rural and remote communities have received a lot of attention and support in recent times through the tragedies of the drought and the floods in Queensland. We have appreciated the support and the concern, but we don’t just need emergency relief, we need continued and meaningful support year-round.
We saw a glimpse of this with the Stronger Rural Health Strategy announced at the 2018 Budget. It showed that the Government was listening to the AMA on rural health. Support for teaching and training doctors rurally was desperately needed. This will help solve the issue of the critical lack of doctors outside of the cities.
We know that if a medical student spends two to three years training in regional hospitals and general practice, they are four times more likely to choose a rural career.
We know that students who spend one-year training rurally are almost twice as likely to work in the same region. We also know that training doctors from rural and remote areas increases the chances of them returning to practice medicine rurally.
But we want to see more of this. We need our politicians to support more opportunities for students and junior doctors to gain rural experience. We need to increase the targeted intake of medical students from a rural background from 25 per cent of all new enrolments to one-third of all new enrolments. We need the proportion of medical students required to undertake at least one year of clinical training in a rural area to be lifted from 25 per cent to one-third.
We also need more support must be provided to supervisors. This is a critical issue that is continually ignored. The More Doctors for Rural Australia Program (MDRAP) is a perfect example of where this has happened. The MDRAP supports non-vocationally registered doctors to join a pathway to Fellowship in a rural area. What is does not support is the GPs who will have to supervise them. Our rural GPs are already working well beyond their limits and now we are asking them to provide months of direct supervision with no financial support?
We also need support to serve our communities. Everyday we are challenged by infrastructure limitations with internet and phone service, equipment, and physical space. We already have an answer to this: infrastructure grants. Previous infrastructure grant funding delivered real results for rural communities, supporting practices to improve patient access and to teach. The Australian National Audit Office showed that infrastructure funding grants are effective and a good value-for-money investment. It’s time to remind the politicians.
Tell your local candidates: we want a further 425 rural GP infrastructure grants of up to $500,000 each.
This will support rural general practices to improve their infrastructure, expand their services and provide patients with access to nursing and allied health.
We don’t just need more GPs, we need more specialists too. We want the major parties to expand the successful Specialist Training Program to 1,400 places by 2020. Give a higher priority to training places in regional and rural areas, generalist training, and specialties that are undersupplied.
There is so much that we need better policy on: climate change, indigenous health, and the closure of rural maternity services to name just a few. The AMA has asked you what your key issues are in the Rural Health Issues Survey. We have listened and we will make sure that your voice is heard, but that doesn’t mean you can’t get involved.
Rural doctors – you are respected in your communities and you have influence. Speak to the candidates about the pressure you are under, explain to them what is needed at the Federal level and at the local level. Talk to your colleagues and your friends, write to the local newspaper so that your letter makes one of the bi-weekly editions. The greatest strength of the AMA is its members. Let’s all stand together at this election and make sure that our voice is heard.
Published: 11 Apr 2019