Inspector, Funding, Respect for Rural Gps

Emeritus Professor Max Kamien, an honorary senior research fellow in general practice at the University of Western Australia, and Dr W Ian Cameron, chief executive of the NSW Rural Doctors Network, liken working in rural medicine to endlessly pushing a boulder up a mountain.

"We do not need any more questionnaire-based surveys of rural intention or one-off reviews that only add to the weight of (the) rock," the doctors said.

"We do need a method to enable us to take a continuing and holistic overview of what is actually happening at the grass roots level in providing rural and remote communities with appropriate and safe health care.

"One possible process could be an independent Office of the Inspector of Rural Health Care."

The rural health inspector would monitor workforce and problems with coordination and red tape, and propose policy and mediation for individuals, government-funded organisations, and sectional groups, said Prof Kamien and Dr Cameron.

As well, rural areas should be able to access a pool of primary medical care funding to effect prioritisation and provision of local health needs, they said.

"Increased respect from bureaucrats towards those working at the coalface will go a long way towards keeping them there," Prof Kamien and Dr Cameron added.

Incentive programs to recruit and retain rural GPs should take into account the conditions necessary to run and sustain a viable rural medical practice, they said.

"They also need to be matched with programs that reflect the environment of today's doctors - a work environment that is attractive to the increasing number of women in medicine and general practice, that encourages a healthy lifestyle for doctors, and that educates communities to be more aware of doctors' needs, as we educate doctors to be aware of patients' needs," Prof Kamien and Dr Cameron said.

The editorial can be viewed in full at www.mja.com

The Medical Journal of Australia is a publication of the Australian Medical Association.