This time we cannot blame the Coronavirus. This time it is a combination of bad planning and the inability to recognise important trends. In any case, the results are likely to be detrimental to Australian communities.
As we wrap up 2020, we reflect on the changes in workforce supply and what that is likely to mean in 2021 and beyond:
Deliberate planning to reduce GP numbers:
- Visa restrictions for GPs introduced March 2019 and maintained even though doctors and nurses are on the priority list (PMSOL) designed to help us recover from the impact of the Coronavirus
- Reductions to DPA/DWS map to exclude outer metro and many regional centres that are struggling to find enough doctors
- New Specialist pathway through the RACGP which we estimate has reduced the intake of new Specialists from approximately 400 a year to less than 10 in the first 12 months of the program
- Specialist PEP program participants banned from using 19AB exemptions such as Spousal, After Hours or DPA replacement exemptions
- Refusal by AHPRA to allow GPs to do ID checks with Australian authorities overseas, resulting in GPs waiting 14-16 weeks without pay to gain provider numbers
- Barriers to entry for non-VR GPs through the new Standard PEP program and disbanding of a significant number of 19AA/3GA programs
Reduction in GP numbers by other factors:
- Significant cohort of graduating medical students and registrars have been unable to complete their training. As a result, the usual inflows of GPs will not occur in 2021
- Reduction in applications for GP training programs (AGPT) by up to 30% in some regions
- Decreasing popularity of GP profession in spite of multi-million-dollar campaigns by the RACGP
- Ageing of the GP population with up to 30% expected to significantly reduce their working hours in the next ten years
- Travel restrictions due to the pandemic
While 2020 has taught me that it is impossible to anticipate or predict the future, I am worried for Australian communities that may find it difficult to access GP care in the coming years.
I am not worried about the wealthy inner suburbs where many Australian GPs want to live and work. They will always have a ready supply of medical professionals and they are likely to have the healthcare they need.
But I am worried about the outer metropolitan suburbs where bulk billing practices rely heavily on overseas doctors. I worry for the families in the areas that have the highest rates of chronic illness and are the most likely to poor health outcomes.
Do I worry too much? Will there be a plan that will change the trajectory of GP workforce planning in Australia? Maybe you have some thoughts you would like to share? And maybe at the end of next year or the year after, we will have more answers to my questions. And maybe I will be proven wrong – and that would definitely be a good thing.
Commentary by Martina Stanley