Dr Kerryn Phelps, AMA President and Professor Bob Birrell, Monash University, ABC Radio 'AM'

A severe shortage of locally-trained doctors is forcing hospitals increasingly to rely on foreign medicos, many of whom, a new study has found, have failed the most basic Australian medical qualification.

The findings are key in a new report released today by researchers from Monash and Melbourne Universities and they blame successive Federal Governments for continually slicing away at doctor numbers in a bid to keep the lid on public health costs.

From Melbourne Michelle Fonseca reports.

FONSECA: In public hospitals throughout Australia, the researchers say the wards are full of overseas-trained doctors who have either failed their qualification exams or are still studying for them. Professor Bob Birrell from the Centre for Population and Urban Research at Monash University prepared the report.

BIRRELL: Doctors from overseas are not supposed to practise until they've passed these minimum standards but in practice there are hundreds of doctors operating in the front line of medicine in Australia who have not completed their accreditation with the Australian Medical Council.

FONSECA: The doctors are mainly from Asia and the Middle East, regions Professor Birrell says don't provide medical graduates the same level of skills and knowledge as medical schools and hospitals here.

In order to practise in Australia, technically the doctors must complete Medical Council exams before beginning an internship. But Professor Birrell says, because there's such an acute shortage of local doctors, those trained overseas are being put to work, even though they're unaccredited. And he says the Commonwealth must take the blame for allowing such a situation to occur.

BIRRELL: Successive Federal Governments have pursued this policy of cutting back on the rate of growth of doctors because of a concern about the costs of Medicare. For the last few years, there's been a limit on general practitioners imposed by a 450 quota for the training program, the post-graduate training program. This means that, unless you complete that program, you're not allowed to bill on the Medicare system.

Now to give your listeners an idea of what this means: Before the implementation of that rule, in the mid-nineties, something like 700 doctors were setting up as GPs annually. Now it can't be any more than 450.

FONSECA: Professor Birrell also takes aim at the Australian Medical Association which he says has been more concerned about securing pay rises for doctors than addressing the skills shortage. But AMA federal president, Kerryn Phelps, says the blame lies squarely with the Commonwealth which she says now needs to focus on getting more doctors into the system.

PHELPS: We don't want to open up the floodgates, as it were, and have unlimited numbers of doctors being trained because we just don't have the resources to do that and it wouldn't be appropriate to lower the bar in any way.

But it appears that the bar is being lowered at least in the respect of some of the overseas-trained doctors who are being allowed to work without having sat for the Australian Medical Council exams in order to solve this manpower crisis. So I think we need to look very carefully at the numbers of doctors that are being trained and plan very carefully but using the right statistics.

FONSECA: The researchers agree it's time for the Federal Government to make some big decisions about public health policy. They say the Government must either embrace large numbers of overseas-trained doctors and supervise them properly, or increase health funding to get more locally trained doctors into hospitals, as the AMA is calling for.

Professor Bob Birrell.

BIRRELL: That's going to have to be accompanied by rules which ensure that they serve where they're needed.

Doctors, in effect, are public servants in Australia. They are trained at our expense in the medical schools. All - almost all their income comes from Government, but unlike teachers and nurses, they don't have to serve where the Government would want them to serve. They can serve where they would like to serve. So that's part of the problem as well.

FONSECA: A spokesman for the Health Minister, Kay Patterson, says she won't comment on the report until she's read it.

COMPERE: Michelle Fonseca reporting from Melbourne.

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