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Grattan Institute report offers poorer quality health care to rural Australians

02 Oct 2013

AMA President, Dr Steve Hambleton, said today that the rural health plan enunciated by Dr Stephen Duckett in the Grattan Institute report, Access all areas: new solutions for GP shortages in rural Australia, could result in rural Australians being consigned to poorer quality health care than the rest of the population.

Dr Duckett’s proposals include having pharmacists take over some of the roles currently performed by GPs.

Dr Hambleton said that rural Australians should have access to the same high quality primary care as the rest of the population.

“When people are sick or injured or want advice about their health, they want to see a GP,” Dr Hambleton said.

“GPs are highly trained and skilled, they provide holistic care for their patients, and are uniquely placed to look after people throughout life, from birth to old age.

“GPs are the cornerstone of primary care for Australians, no matter where they live.

“The key to improving access to primary care for rural Australians is to provide greater support for GPs, not undermine them or have alternative health practitioners take over their specialised role.

“Providing prescriptions and vaccinations are key functions performed or directly supervised by GPs.  It would be unwise to compromise the quality of health care by taking these functions away from general practice.

“The AMA is not opposed to the use of physician assistants who would work strictly under the direction and direct supervision of GPs, but the reality is that there will be no extra training capacity for any new health professional in Australia until at least 2025.

“The priority in medical training must remain with the medical students already in the training pipeline.”

Dr Hambleton said that the AMA has safer and more practical solutions to improve GP access for rural Australians.

In order to attract a medical workforce in adequate numbers and with the right skill mix to meet the primary health care needs of rural Australia, the AMA is calling on the new Government to:

  • provide a dedicated quality training pathway with the right skill mix to ensure GPs are adequately trained to work in rural areas, and by developing and implementing, in consultation with the AMA and specialist colleges, a new funding program to support and encourage more ‘generalist’ training;
  • provide financial incentives to ensure competitive remuneration for rural doctors by implementing the AMA/RDAA Rural Rescue Package (, which would provide further enhancements to rural isolation payments and rural procedural and emergency/on-call loadings;
  • extend the MBS video consultation items to GP consultations for remote Indigenous Australians, aged care residents, people with mobility problems, and rural people who live some distance from GPs. This will considerably improve access to medical care for these groups and improve health outcomes;
  • replace the Australian Standard Geographical Classification (ASGC-RA) and the Districts of Workforce Shortage (DWS) system, which are so inequitable for many rural areas, with a more comprehensive model that provides a more accurate picture of workforce conditions for administering relocation payments, and providing incentive and retention payments; and
  • improve the effectiveness of the Bonded Medical Places Scheme by providing more flexibility for Bonded Medical Graduates to allow them to complete return of service obligations in any rural area, not just a DWS.

Dr Hambleton said that the AMA believes that pharmacists have a very important role to play in rural health – being pharmacists.

“The AMA has been working with the Pharmaceutical Society of Australia (PSA) on a plan that would allow general practices to employ pharmacists to work within the general practice alongside GPs and general practice nurses in a primary care team led by the GP,” Dr Hambleton said.

“This is a much safer and more practical primary health care model to serve the growing needs of rural Australians,” Dr Hambleton said.

Dr Hambleton said that the AMA would be lobbying the Government to provide more GP infrastructure grants for rural general practice on top of those already promised during the election campaign.

“We will also be urging the Government to scrap the former Government’s cap on tax deductions for work-related self-education expenses.

“The cap is bad policy that will have a devastating effect on the rural medical workforce,” Dr Hambleton said.


2 October 2013

CONTACT:        John Flannery                     02 6270 5477 / 0419 494 761

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Published: 02 Oct 2013