2019 and DWS – what can we expect? Alecto Australia

Significant changes possible

For many GPs and practice owners the annual DWS changes are very significant – and hard to predict! However, given their importance we try to stay on top of news and developments that impact the DWS changes.

What are the current issues at play? Medicare reports that service volumes and benefits paid have increased by 4.9-5.5% between the 2016/2017 and 2017/2018 period, and similar in years before. And by all accounts, the government is determined to stop the increase in future years. [1]

At the same time, policy makers have signaled that they believe Medicare spending can be controlled by the number of GPs, and the proportion of those that are overseas-trained – as they believe OTDs generally bill higher Medicare than locally trained. While this is not an opinion we share (as there is no evidence to support it), we believe this belief will be the foundation of their plans for DWS in the future.

The government has also released basic details about the Stronger Rural Health Strategy, and the Department of Home Affairs Skilled Migration Program, both of which will have significant impact on rural areas. However, most of our readers are in metropolitan areas, so we are focusing on the changes in these areas.

At this stage 19AB has confirmed the changes are not final yet (and the details haven’t been provided), but should be public by the end of the first quarter.

Here are our predictions:

As always, any of our predictions may be subject to change as the federal election campaign ‘hots up’. The Department of Health has also advised that they are still finalising the recommendations for the Minister.

DWS linked to visas

Visas for GPs will be linked to DWS. Unless GPs are working in a DWS, they may not be able to access a 482 visa. For many GPs moving to Australia from places like the UK, this won’t impact if they accept a permanent position in a practice in a DWS area. But for those planning to work as a locum (or on a 6 month locum provider number) or use a teaching exemption – they are unlikely to qualify for a visa.

Reduced DWS areas in some metropolitan areas

We believe the DWS map will change significantly.

Sydney and Melbourne will most likely lose substantial areas of DWS (the few that are left), and it will be difficult for OTDs to get provider numbers in these cities.
Brisbane (including Gold Coast) will also experience a significant reduction.
Perth, Adelaide and Canberra might see a reduction in DWS locations, but not to the same degree as Sydney, Melbourne and Brisbane. All of these cities are currently have much lower ratios of GP for their populations, than the major cities – so we would hope that this is factored into their decisions.

Increased influence of government funded recruitment

The government funded workforce agencies (Rural Health West, Rural Doctors Network, RWAV etc) will play a bigger role in any decisions to recruit from overseas they will have to apply some level of approval. So there will be further paperwork in the overseas recruitment process.

Immigration and Department of Health will jointly determine DWS policy

Information sourced by Alecto from the Department of Health clearly states that the Department is working together with the Department of Home Affairs to determine the formula for DWS. This supports other information that the visas will be linked to DWS.

The Modified Monash Model map will be fundamental

New DWS boundaries will be based on the Modified Monash Model (MMM) which will replace the RRMA and ASGC and other geographic models.

The announcement will be delayed

They are due in February based on the latest communication between Alecto and the Department, this is likely to be delay until at least March.

It’s important to note that under the current policy GPs that already have a provider number for a DWS location will not be affected, even if their area loses DWS status. We predict that the biggest implications will be for the practice owners that are in outer-metro, or low-mid socio-economic areas that may lose DWS which will make it harder to recruit.

Want to keep up to date with DWS changes, register your details at https://www.alectoaustralia.com/dws-map-changes-2018/

If you have further information about upcoming DWS changes it would be great to hear from you – please contact monique.giron@alecto.com.au

Sources used in this article:
[1] Millions of dollars to be saved through fewer doctor scripts

[2] Foreign doctors blow out medicare

[3] Stronger rural health strategy overseas trained doctors in areas of doctor shortage