The Australian government’s methods for identifying critical shortages of doctors are unfairly benefiting richer, urban areas and neglecting poorer, rural regions.
The Royal Australian College of General Practitioners has stated that the current system, which decides which areas require more resources, is faulty and is worsening the shortage of general practitioners in rural areas.
Foreign-trained physicians play a vital role in addressing the shortage of general practitioners (GPs) throughout the nation. This is due to the requirement that they work in designated areas of need, known as distribution priority areas, for the first decade of their practice in Australia in order to qualify for Medicare benefits.
The DPA system is currently under review and works by identifying locations lacking an adequate number of GPs. This is determined by analyzing the area’s level of remoteness, the socioeconomic status of its patients, and the amount of Medicare billings. The DPA classification is updated on a yearly basis.
However, rural towns located on the outskirts of cities and regions argue that their status is being overshadowed by their non-rural neighboring areas, which are able to attract more General Practitioners (GPs). This has caused them to not qualify for District of Workforce Shortage (DPA) status and face difficulties in recruiting international doctors, which they have traditionally relied on to fill staffing shortages.
Dr Farza Rastegar is the owner of the only GP clinic in Pearcedale, a town 1.5 hours south-east of Melbourne in the City of Casey local government area, which is classified as metropolitan. However, the town of Pearcedale itself is considered a coastal rural locality, surrounded by farms and horse racing stables.
Rastegar expressed confusion over being classified as metropolitan.
Join Guardian Australia’s mailing list for daily news updates with our free morning and afternoon email newsletters.
However, the nearby region of Mount Eliza, classified by the Australian Bureau of Statistics as having the greatest level of privilege in the Mornington Peninsula, qualified for DPA status. This decision was made despite the fact that Pearcedale has a diverse population including a significant number of disadvantaged individuals, according to Rastegar. The most recent census data shows that the median weekly household income in Mount Eliza is over $500 higher than in Pearcedale.
According to Rastegar, the clinic has been struggling to hire internationally trained doctors to replace the four GPs who left, resulting in a decrease from seven to four doctors at the centre.
Rastegar stated that they are aware of someone who is willing to begin soon. However, they are unable to hire them as they have only recently relocated from the UK and have not yet completed their required 10 years of experience.
She stated that the center will be closed on Fridays starting November 1st due to difficulties in finding sufficient staff.
The community is in a state of panic, with concerns about potential closures in the future.
In May, Pearcedale Medical Centre requested a government review of its DPA status. However, the review determined that the entire catchment area has above-average levels of GP accessibility.
Some general practitioner offices in outskirts regions, including cities on the Sunshine Coast like Buderim, Caloundra, Maroochy, and Noosa, as well as clinics in Wallan, Victoria, have faced problems with their staff due to not being designated as a District of Workforce Shortage (DPA).
Dr. Anita Munoz, the chairperson of the Royal Australian College of General Practitioners in Victoria, stated that the Pearcedale case highlights the shortcomings of the current classification system.
Munoz stated that addressing the shortage of medical professionals in rural and regional areas is a complex issue, with no one solution that can fully solve it.
“Unless we improve our methods of measuring areas of need, we will likely continue to misclassify certain areas and unintentionally create new gaps while neglecting existing ones.”
According to Peta Rutherford, CEO of the Rural Doctors Association, the use of remoteness modelling can be imprecise and is having a notable impact on patients living on the outskirts of major cities or in large regional areas.
Rutherford noted that in a rural town without doctors, one would likely not take a bus to a neighboring suburb, but would have to drive hundreds of kilometers.
According to the RACGP, Senate estimates data from earlier this year showed that the percentage of international doctors relocating from rural and remote regions has risen by over 50% since the implementation of DPA reclassifications.
A 2021 study commissioned by the health department revealed that while most DPA classifications were suitable, the calculation method may unfairly disadvantage outer-metropolitan and regional areas.
The DPA program is currently under review by the department, with an expected completion date of 2024.
The Australian health minister, Mark Butler, informed Guardian Australia that the government provides various programs and incentives to encourage general practitioners to move, in addition to the DPA.