Extension of GP relocation incentive a sensible move

Dr Haikerwal said all Australians are facing GP shortages but access is more difficult in rural and outer-urban areas.

"Extending the relocation incentive should encourage more GPs to work in outer-metropolitan areas," Dr Haikerwal said.

"The incentive program is working following changes proposed by the AMA.

"When the Government's "Outer Metropolitan Doctors Initiative" was announced in 2001, the AMA argued that the measures, as they were proposed, would not be enough to attract doctors to outer urban areas.

"Originally, the Government 'carrot' was access to the higher Vocationally Registered (VR) Medicare rebates for inner-metropolitan non-VR doctors who agreed to move. That was all that was on offer.

"The doctors would have to fund the cost of moving their practice - losing their existing patient base, renting or buying new premises in the defined areas, paying set up costs, and working to establish a new practice.

"The AMA told the Government that GPs would need more support and funding and less red tape if they were to be encouraged to make the career and lifestyle decision to move to the outer-metropolitan areas.

"Following the AMA's intense lobbying, the Government introduced the relocation grants in early 2003 and tried to quickly entice as many takers as possible by saying the incentives would run out on 30 June - a 'carrot' with a very early use-by date.

"We assumed this quick uptake strategy was introduced because somebody had discovered early this year that none of the $80 million over three years allocated to this program in the 2002-2003 Budget had been spent.

"So the extension of time for access to the grant is logical and welcome on two fronts. Outer-metropolitan communities may get more GPs and the Health Department can more confidently acquit the $80 million with Treasury.

"The incentive program in its current form is good policy badly administered.

"It must be noted that a parallel measure - whereby specialist trainees, already overworked in the hospitals, would be allowed to 'moonlight' in outer metropolitan general practices - has disappeared without trace.

"This measure was opposed from day one by the AMA on the grounds of lack of supervision and unsafe working hours. The specialist Colleges also opposed this measure.

"A major failing is the lack of opportunity for pre-vocational doctors with an interest in general practice to undertake terms of supervised practice in these outer metropolitan areas. This is only currently available in rural and remote areas where the supervision is more difficult.

"If this initiative was expanded and improved, it would serve the dual need of providing doctors to outer-metropolitan areas of need, while giving young doctors the opportunity to experience general practice before making their vocational training choice - possibly into general practice if the experience was a positive one.

"A further difficulty is the lack of clarity in designating which areas are deemed as outer-metropolitan.

"At the moment we have the ridiculous situation where a practice on one side of a street can be classified 'in' the defined area for the incentive while a practice on the other side of the street is 'out'.

"A proposal to introduce compulsory GP training terms in outer-metropolitan areas was also opposed by the AMA.

"This proposal makes GP training even less attractive. This has become clear with a consistent drop in the number of applicants since announcement of the measure.

"There is no net additional educational benefit and there will be a drain on training infrastructure resources away from well-established high quality training practices.

"This particular initiative is limping along without the support of most GP representative and training organisations," Dr Haikerwal said.

CONTACT: John Flannery (02) 6270 5477 / (0419) 494 761

Judith Tokley (02) 6270 5471 / (0408) 824 306