Medi­cos seize the mo­ment

The Weekend Australian - Travel - - Health -

in­de­pen­dent ‘‘ tiers’’, with the first to recog­nise iso­la­tion, and the other to recog­nise the doc­tor’s pro­ce­dural skills in dis­ci­plines such as anaes­thet­ics, emer­gency ser­vices or ob­stet­rics, and those who pro­vide ‘‘ mean­ing­ful on-call ser­vices’’ to the lo­cal hospi­tal.

In both cases, a doc­tor prac­tis­ing in the rural area des­ig­nated as RRMA 3 would re­ceive a quar­terly pay­ment equiv­a­lent to 7.5 per cent of his or her en­tire Medi­care billings in that pe­riod for each of the tiers in which they met the cri­te­ria. The load­ings would rise from an ex­tra 7.5 per cent in RRMA 3, to 10 per cent in RRMA 4, and 20 per cent in RRMA 5. Fol­low­ing the pat­tern of ex­ist­ing fed­eral in­cen­tive schemes, the load­ing would dip for RRMA 6 to 12.5 per cent, then up again for the most re­mote ar­eas — RRMA 7.

RDAA pres­i­dent doc­tor Peter Ris­ch­bi­eth said al­though the sum in­volved was sig­nif­i­cant, he claimed it was not ex­ces­sive in the con­text of the cri­sis that rural health ser­vices faced.

‘‘ The cur­rent in­cen­tives have only man­aged to get one in 20 med­i­cal grad­u­ates to prac­tice in RRMAs 4 to 7 in the last 10 years,’’ Ris­ch­bi­eth said.

‘‘ In years gone by, 46 per cent of med­i­cal grad­u­ates used to ap­ply for gen­eral prac­tice train­ing — cur­rently the rate is only 23 per cent, and that’s just gen­eral prac­tice over­all, not the rural stream.

‘‘ We need more GPs do­ing more pri­mary health care (in rural Aus­tralia) — if we have more pri­mary health care, we can stop some of the heavy ex­penses in hospi­tal care.’’

In­de­pen­dent sta­tis­tics show the sit­u­a­tion with re­gards to doc­tors in rural ar­eas is get­ting worse, not bet­ter.

The Aus­tralian In­sti­tute of Health and Wel­fare found that in outer re­gional ar­eas, the num­ber of doc­tors has fallen from 147 to 143 full-time-equiv­a­lents per 100,000 pop­u­la­tion, and from 152 to 133 in re­mote ar­eas. In ar­eas clas­si­fied as very re­mote, the rate has fallen from 138 to 95.

The re­sult has been a vi­cious cir­cle, where the fewer doc­tors left in rural ar­eas are each left with less sup­port and a more oner­ous on­call ros­ter — in turn en­cour­ag­ing more to quit and head back to the cities.

Ris­ch­bi­eth says that in Queens­land, some med­i­cal su­per­in­ten­dants are now on-call for up to 21 days in a row — far more than the one in five he says would be re­garded as ac­cept­able.

The of­fices of both Fed­eral Health Min­is­ter Tony Ab­bott and Op­po­si­tion Health spokes­woman Ni­cola Roxon said var­i­ous lobby group pro­pos­als had been re­ceived, and both hinted there would be more pol­icy an­nounce­ments by both sides be­fore polling day.

A spokes­woman for Fed­eral Health Min­is­ter Tony Ab­bott said the min­is­ter ‘‘ al­ways wel­comes con­tri­bu­tions from the AMA and other stake­holder groups, and takes their con­cerns se­ri­ously’’.

‘‘ We are al­ways in­ter­ested in their sug­ges­tions to make Aus­tralia’s health sys­tem bet­ter,’’ she said.

‘‘ We will be mak­ing an­nounce­ments through­out the cam­paign about strength­en­ing Aus­tralia’s health sys­tem.’’

Ris­ch­bi­eth says both par­ties are ‘‘ ob­vi­ously keep­ing their cards close to their chests at the mo­ment’’ but is hope­ful some of the pol­icy will make it into the pre-elec­tion man­i­festos.

Capolin­gua says now is a ‘‘ par­tic­u­larly good op­por­tu­nity for the Coali­tion and La­bor to show us where they are go­ing to go — what plans they have in store. That’s re­ally what we need to see, and an­a­lyse.’’

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