AMA submission to Inquiry into provision of general practitioner and related primary health services to outer metropolitan, rural, and regional Australians

The submission calls for broad reform to general practice funding and targeted solutions to workforce issues in outer metropolitan, rural and remote areas.

The key recommendations are:

• The Modified Monash Model must remain as the tool to determine rurality as it is the best system. It should not be the only consideration in determining incentives and the Government should explore the impact of its use in jurisdictions such as Tasmania that face unique workforce pressures.
• Supports and incentives for outer metropolitan general practice should be different from rural incentives.
• The Distribution Priority Area/District of Workforce Shortage model of medical workforce management, including the Health Insurance Act (1973) Section 19AB, is a useful tool but has its limitations due to its blanket nature that does not always reflect local circumstances. Modifications should be made, specifically new categories for practices in areas where the classification has recently shifted, but the model itself should remain.
• Existing rural and remote general practices require support to remain viable. Any new policy or program must not undermine the practice and profitability of existing private practices.
• A single employer model for GP trainees should be introduced nationally, providing GP registrars with comparable remuneration and entitlements to their hospital-based colleagues, to help arrest the steady decline in junior doctors choosing general practice
• General practice requires significant investment and support. Many recommendations in in the AMA’s ‘Delivering Better Care for Patients: The AMA 10-Year Framework for Primary Care Reform’ and the government’s “10 year primary care plan” are required to meet this goal.
• Increases to commonwealth supported places (CSPs) for medical students and intake of international medical graduates (IMGs) will not solve workforce maldistribution and should not be pursued.
• Continue to implement reforms to the Bonded Medical Place Program, with a view to a further review of workforce programs including their impact and evidence base.