State, federal governments must step up on general practice

Transcript: AMA Queensland President, Dr Maria Boulton, Nine Network, Today with Charles Croucher and Sarah Abo, Monday 12 June 2023

Subjects: GP shortages, payroll tax, Hunter Valley bus crash

CHARLES CROUCHER:   As the state's health system struggles to keep up with the booming population just outside of Brisbane, let's bring in AMA Queensland President Dr Maria Boulton. Dr Boulton, good morning to you. Ipswich, Moreton Bay, Logan - they're the areas currently experiencing the worst GP shortages in the country. How has it gotten this bad?

DR MARIA BOULTON:   Good morning, Charles. And we can also add rural and remote Queensland to that list as well. It's gotten this bad due to decades of neglect of Medicare rebates and not keeping up with the cost for patients to access GPs. But also there's been a drop in the number of doctors wanting to train as GPs. When I went to medical university more than 20 years ago, almost 50 per cent of medical students wanted to be a GP. Now that number is only down to 15 per cent, which is going to have strong repercussions in the next five to 10 years.

CHARLES CROUCHER:   We know GPs are so pivotal in our system in so many ways. They prevent us needing specialists because of early intervention. What impact does a shortage of GPs have long term on our health?

DR MARIA BOULTON:   Absolutely. I'm a GP and I love what I do. We're very privileged at my practice to care for four generations of many families. GPs are well known to keep patients healthy and out of hospital. And we're often the first port of call when people have mental health issues. The reality is that we've just been really badly supported, especially through COVID. We weren't considered frontline where in fact we were. And we haven't had the resources to continue to provide the quality services that we want to provide to our patients.

Now we're seeing a lot of states and territories introduce this new interpretation of payroll tax as well, which not only makes GP clinics very unviable, but also makes it much less accessible for patients to see their GP.

CHARLES CROUCHER:   State governments effectively are saying it's up to federal governments to support the GPs, while the states funnel money into hospitals. What's your response and what's the solution? How do we prevent more people leaving general practice?

DR MARIA BOULTON:   It's really frustrating. If you're a patient trying to make an appointment with a GP after hours, you certainly don't care where the funding comes from, whether it's the state or the federal government. But they both have a role to play. The federal government controls the Medicare rebates that you get to see your GP, but the state governments can also provide financial incentives for people to go into GP training. They can also remove this payroll tax.

At the end of the day, yes, the state government controls the hospitals, but if there's not enough GPs, those hospitals will continue to become inundated. And we know that at the moment they're very strained. We're seeing ambulance ramping, we're seeing long lists for elective surgeries. It takes a whole-of-system approach to get us out of this health crisis that we're facing.

CHARLES CROUCHER:   Dr Boulton, I just want to get you on our top story of the day, which is that horrible bus crash in the Hunter Valley. We've seen again the value of your profession and the people that work in your industry, be it paramedics or those that were there at the emergency department. Can you take us through what kind of a toll seeing and being involved in something like this has on people in your profession?

DR MARIA BOULTON:   Our thoughts are with the community. Oh my God, that’s just awful and to wake up to that news following a wedding is just dreadful. Healthcare workers, and particularly healthcare workers in the community are often the first port of call. I used to work in a community called Proserpine and that’s near the highway, and it was very often that we would get called to motor vehicle accidents.

Kudos to the paramedics, they do an amazing job, the first responding doctors, the nurses, the people who do the helicopter and airplane transfers, and the people in emergency departments and the hospitals that look after the community.

This will have an effect, especially when people live and work in the same community and they may know the people that may have passed away, and our thoughts are with all of them.

CHARLES CROUCHER:   Dr Boulton, we appreciate your time this morning.