Doc­tors fear su­per-clin­ics detri­men­tal to the bush

The Weekend Australian - Travel - - Health - Clara Pi­rani Med­i­cal re­porter

LA­BOR’S plan to spend $220 mil­lion to es­tab­lish GP su­per-clin­ics could at­tract doc­tors away from rural towns that al­ready lack med­i­cal ser­vices. Health groups com­mend the plan for recog­nis­ing the need to pro­vide multi-dis­ci­plinary and pre­ven­ta­tive health care, but many be­lieve La­bor has pro­vided no in­cen­tive for GPs and spe­cial­ists to work in rural ar­eas.

The pro­vi­sion of pri­mary health­care in­fra­struc­ture, such as doc­tors’ surg­eries, is a sig­nif­i­cant prob­lem in rural Aus­tralia given the cost in­volved in de­vel­op­ing this in­fra­struc­ture and the im­mense fi­nan­cial risks in­volved,’’ the Rural Doc­tors As­so­ci­a­tion of Aus­tralia’s im­me­di­ate past pres­i­dent, Ross Maxwell said.

How­ever, La­bor’s ini­tia­tive to de­velop GP su­per-clin­ics will only ad­dress a small num­ber of projects na­tion­ally, and many smaller rural and re­mote cen­tres will miss out. Th­ese com­mu­ni­ties also des­per­ately need as­sur­ance that their im­me­di­ate and long-term health needs will be met by new in­vest­ment in much-needed pri­mary health­care in­fra­struc­ture.’’

Maxwell said rural and re­mote com­mu­ni­ties need a com­mit­ment from gov­ern­ment that a rea­son­able and sus­tain­able level of ser­vices will be pro­vided.

If rural health ser­vices are to sur­vive, im­proved ini­tia­tives and in­cen­tives to get and keep more doc­tors and health pro­fes­sion­als in the bush must be put in place along­side any in­fra­struc­ture sup­port ini­tia­tives.

The knife-edge eco­nomics of rural prac­tice must be ad­dressed and ap­pro­pri­ate in­cen­tives and fi­nan­cial sup­port put in place to at­tract and re­tain many more rural doc­tors, as at least 1000 ad­di­tional doc­tors are re­quired in rural ar­eas im­me­di­ately just to en­sure ba­sic med­i­cal care in the bush.’’

How­ever, La­bor claims the su­per-clin­ics will be lo­cated in ar­eas where there is cur­rently poor ac­cess to ser­vices, in par­tic­u­lar doc­tor short­ages and sub­se­quent un­der­util­i­sa­tion of Medi­care ser­vices, in­clud­ing low safety-net ben­e­fits.’’

The clin­ics would be es­tab­lished in ar­eas where it is be­lieved they would re­duce pres­sure on lo­cal pub­lic hos­pi­tals, in ar­eas with high lev­els of chronic dis­ease, and among pop­u­la­tions with a large num­ber of chil­dren or el­derly. Th­ese cri­te­ria mean the clin­ics are most likely to be lo­cated in re­gional towns and outer metropoli­tan ar­eas,’’ La­bor’s New Di­rec­tions for Aus­tralia’s Health doc­u­ment states.

The $220 mil­lion su­per-clinic fund will run for four years and in­clude in­cen­tive pay­ments to en­cour­age a mix of health pro­fes­sion­als to work to­gether at the same clinic. The type of

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