The ‘pipeline’ of GPs who will be available to work in after hours services is being ‘blocked’ and we are likely to see serious workforce shortages in the after hours period if government policies don’t change.
From Perth to Port Melbourne and from the Gold Coast to Golden Grove (SA), practices are struggling to find a suitable workforce for the after hours space. A series of policy bungles, combined with tighter registration processes, means that provision of after-hours services is more difficult than ever. Some of the current ‘blockages’ include:
- The lack of supervised practice in hospitals due to the ‘tsunami of graduates’
- More stringent supervision guidelines for supervision in General Practice – including restrictions which mean that each supervisor can only care for one supervisee
- After hours item numbers which commence at 8pm rather than 5pm (the real end of the working day for most GPs)
- PESCI blockages which mean that many doctors need months to participate an ineffective assessment process that mostly benefits the PESCI providers
- Less AMDS services as a result of new accreditation guidelines that are forcing many providers out of the marketplace
- Increased numbers of doctors who require a 19AA exemption and do not qualify for any of the 3GA programs – getting PR is much quicker than getting FRACGP in the current policy environment.
New protections for Australian trained doctors have also been put in place which means that the system is designed to support the doctors who are the least likely to want to work after hours. This means that there is pressure to ensure that an OTD working in an AMDS service also needs to demonstrate that he/she is working a significant proportion of the time working in the daytime – an impossible requirement for a doctor requiring a 19AA exemption.
These policy bungles mean that neither GPs or GP clinic owners are being incentivized to work after hours. In fact, all the policy-making energy is being poured into dealing with a small number (less than 10) who have abused the MBS item numbers for AMDS services.
We applaud clinics around the country who continue to find creative solutions to try to provide after hours services, but as a sector we need to be talking to local federal politicians to demonstrate that a series of current policies will contribute to ongoing issues that can only be resolved if there is the political resolve to find a solution.