Dr Kerryn Phelps, AMA President with Malcolm Elliot, Radio 2UE

Over in the eastern suburbs the ratio of doctors to the population is three times higher than in the west where the incidence of disease is significantly higher. Afterhours care is also a big concern in western Sydney with very few medical facilities being available after dark. On line to talk about this issue is Dr Kerryn Phelps, President of the Australian Medical Association.

PHELPS: Good morning, Malcolm.

ELLIOT: Nice to have you with us.

PHELPS: Thank you.

ELLIOT: About the western suburbs. There were still a few responses during the week from people. Are they that bad off as far as doctor's service is concerned?

PHELPS: Things are pretty tough. I was in the Campbelltown way talking to a group of GPs a couple of weeks ago and they're doing it tough out there. They're finding it very, very difficult to continue bulk billing, for example and where they have high numbers of people who are retired, unemployed, facing financial difficulties - it really plays on the doctors' conscience and goodwill.

ELLIOT: Would that deter doctors from going to those areas, Kerryn, because they feel that if they can only bulk bill then they don't want to be there?

PHELPS: Yes, it certainly does and, in fact, the rural areas that I've been visiting over the last year or so, certainly the case is that the doctors who are working in the rural areas are saying 'Look, we just can't practice here and bulk bill'. It just doesn't work because the Medicare rebate for general practice is just pathetic and it's even not enough for them to maintain a viable practice while they're trying to earn a living.

They've got to pay for staff and they've got to pay for their rooms and their equipment and computers and all of the other costs that go with running a practice. So, we really do need to get a commitment from both of the major parties for this election as to what they are going to do about particularly the Medicare rebates for disadvantaged people.

ELLIOT: I came off a cruiseship two years ago in Townsville, I had bad conjunctivitis, I could not get into a doctor. I must have went to 10 doctors between four and six PM who all said to me, 'We are full, we cannot see you'. I never had that ever happen to me before in my entire life. Now, I've been told by friends of mine that have moved to Queensland, they have been trying to find a doctor in the Robina area of the Gold Coast and, they keep getting told, the doctors' list is full, we can take no more patients.

PHELPS: I'm hearing that all over the place as well. It's not just in the rural areas, it's in these urban areas of need like the western suburbs, areas around the Central Coast.

I was down on the South Coast just about two weeks ago - a similar problem. Down in Bendigo this week, I heard from the doctors that their lists are closed because they are short of GPs. So the situation is becoming quite difficult.

ELLIOT: That's horrific if we are looking down the barrel of this happening in Sydney. It's bad enough in Townsville and Surfers Paradise or whatever, that we go to a doctor when we move into a new area, to be told the doctors' list is full.

PHELPS: I know, it's difficult but doctors can only work so many hours in a day and they can't do justice to the patients who are already on their list if they are not able to fit them in, so it's equally difficult if you've been seeing a doctor for 10 or 20 years and they say, you ring up and you're sick on the day and they say 'Look, we can't see you for a couple of days' - that's also a difficult situation.

So, you know, these doctors are having to make a difficult choice and many of them are finding it difficult to get assistance and locums and partners to come into their practices to help out with the workload, too.

ELLIOT: I have an arrangement with my doctor. I only get sick on Wednesdays and Fridays.

PHELPS: That's fair enough. You can make that sort of arrangement. It will work for some.

Ends