This page has answers to frequently asked questions.

Q1.  Why is there a shortage of GPs in Australia?

Answer:  There are a number of international and national factors that have resulted in the shortage of doctors and other health professionals.

Internationally the demand for doctors in developed and developing countries has outstripped supply. This is particularly evident in rural areas away from major population centres.

Research has shown that shortages persist despite the fact that the Australian health workforce has been growing at nearly double the rate of the population. The Productivity Commission notes that “reductions in average hours in response to such factors as workforce ageing and greater feminisation of some professions have partly offset this increase in numbers.” Medical shortages also remain despite an increasing reliance on overseas trained doctors, who now make up 25% of that workforce compared with 19% a decade ago.

In years past people were accepting of illness and disease as part of the normal human condition. Now, due to increasing medical knowledge and technological breakthroughs, people in the developed countries have come to believe that illness is generally preventable and treatable. This has served to fuel the community’s expectation about the level of access to services and the demand for costly investigations and treatments.

The ageing of populations in the developed countries has further fuelled the demand for health services and as a response wealthier countries have looked to recruit from poorer countries.

The Productivity Commission’s Report - Australia’s Health Workforce (2006) states that the spending on the over 65s is currently around four times more per person than on those under 65. With the ageing of the “baby-boomer” generation we can fully expect that the demands placed on our health system and health professionals will increase rapidly over the next 10 years. It is noteworthy that many retirees are moving to rural and coastal communities. These communities will come under particular pressure as the existing medical infrastructure attempts to deal with the resultant patient load.

Areas of special need such as rural health, mental health, aged care, disability services, and palliative care, will suffer significant difficulties in the face of growing demand. 

Q2. What is the GP workforce outlook for Tasmania?

Answer:  Workforce data suggests that we currently have 50 GP vacancies in Tasmania. The GP workforce model predicts that if our GPs retire at age 65 then in 2011 we will need an additional 38 full-time GPs to meet growth in demand since 2006.  This means that we will have a total shortfall of 88 GPs in 2011.  The model predicts that the shortfall will grow to about 150 by 2016.

Q3. What will GP workforce shortages mean for Tasmania?

Answer:  The shortages may carry a range of implications:

• Access to GP services will not keep pace with the growth in demand caused by population ageing
• Those with deficient access may present at public hospitals seeking GP- level services
• GP shortages may compromise the continuity of care of those living with chronic disease
• Service constraints in the general practice sector may have compounding effects in the acute hospital sector.
• GP shortages in rural areas will bring the viability of some District Hospitals into question.

Q4. What are the solutions to GP workforce shortages?

Answer:   A degree of controversy arises when people discuss possible solutions.

Recent strategies:

• Medical student intakes have increased
• There has been a focus on the recruitment of doctors from overseas
• Incentives have been offered to encourage doctors to work in areas that are under-serviced
• Elements of medical training have been ruralised to encourage graduates to practise in rural areas after graduation
• GP training has been restructured - capacity has been increased and regionalised training providers have been established

Future strategies are being discussed at the national level:

• Development of a new ancillary health workforce to help offset doctor and nurse shortages- eg. VET- trained Medical Assistants, Nurse Practitioners, University- trained Physician Assistants
• Embrace new ways of service provision - to ensure the right provider, with the right skill level, is available to the right patient at the right time, to ensure safe, consistent, appropriate, timely and cost effective care.  This strategy is predicated on the notion that the current system is inherently inefficient.
• Move to a primary health centric model of a care that incorporates a holistic community-based approach (with associated values) that deliver improved population health outcomes for all. This strategy is predicated on the notion that our current system is illness-focussed and not wellness- promoting.
• Revision of our funding mechanisms to facilitate the move to the new health workforce and reformed models of service provision. This strategy is predicated on the belief that the Medicare system enshrines health inequalities that sees rural people experience poorer health.
•  Remodel clinical infrastructure, where necessary, to support contemporary multidisciplinary care and engender the flexibility needed to accommodate a new health workforce and reformed models of care. This will enable the desired productivity improvements to be realised. GP Super Clinics may have a role here.
• Revise health system management arrangements to ensure single-point accountability and engender the flexibility to meet local circumstances.
• Enact strategies to systematically moderate burgeoning patient demand and associated community expectations.
   

 Q5. Who is responsible for fixing the problem?

Answer:  GPs usually work as private operators.  As a consequence Governments can't tell doctors where to work. The last decade has seen Governments at all levels offer lucrative incentives in an effort to recruit and retain GPs for under-doctored areas. These policy initiatives have enjoyed a measure of success. However, there is a growing consensus that financial inducements will not in themselves be enough to meet rural health workforce needs. 

The absence of an essential human service such as medical care constitutes a social risk for all. As individuals, families, and communities we all share in some of the responsibility for alleviating demand on struggling healthcare providers. Rural communities will understandably look to governments, politicians, community leaders, and health service providers to assume the leadership role. It is becoming increasingly clear that meaningful partnerships must be forged between rural communities, public institutions and health experts if the challenge of the future is to be met.

Please click here to view a process whereby at-risk communities can play an active role in improving the sustainability of rural health services.

Please click here to submit other questions for inclusion on this page.

Please click here to view the "What's Up Doc" publication.  This document, while directed at local government, includes a range of insights for elected members wanting to understand the complexities surrounding rural health.

 Please click here to view the presentation delivered at the Tasmanian GP Workforce Summit in December 2007.