At a bilateral meeting in Cootamundra last month, the Commonwealth and NSW government discussed opportunities for strengthened coordination in workforce planning.
At a meeting just days after rural generalism got official recognition, the NSW state government reaffirmed its commitment to making the specialty more attractive in the country’s most populous state.
The Bilateral Regional Health Forum was held in Cootamundra on 25 September and was co-chaired by NSW Health Minister Ryan Park and Assistant Minister for Rural and Regional Health Emma McBride.
According to a communique from the event, which was published last week, both NSW Health and the Department of Health, Disability and Ageing discussed ways to engage local communities in areas where primary care was difficult to access or unavailable.
“There was recognition of the value of rural generalists, and consideration given to how NSW Health and the DHDA can work together to make rural generalist roles more attractive and competitive compared to other medical specialties,” the communique said.
“The forum discussed opportunities for strengthened coordination in workforce planning to maximise the uptake of funded training positions and secure a sustainable rural generalist workforce.”
Rural Doctors Association of NSW president Dr Rachel Christmas, a rural generalist herself, told The Medical Republic that NSW was currently “sitting between a couple of systems and trying to work out which is the best way to go”.
“There’s probably not a one size fits all [solution] here, because really we want to encourage GPs to be continuing to practice in their community, working as GPs,” she said.
“We know that good primary care reduces hospital admissions and creates better outcomes overall.
“So we really want a system which encourages GPs to stay within general practice, but also use their skills in the hospital system.
“Hopefully, the recognition of RGs and being able to create scopes of practice and frameworks within which those skills are recognised and appropriately remunerated means that we’ll be able to have different models where we can provide those services in communities.”
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Without RG recognition, she said, it had been difficult to establish career paths for rural generalist registrars who might be training on a single employer model.
“We’ve got a lot of investment in rural generalism from a training perspective and in identifying those junior doctors who want to train up with extra skills to hopefully apply those skills in a rural or regional area,” Dr Christmas said.
“But then, once they finish their training, where do they go and how do they work?
“This is where the RG recognition, industrially, is really important, because we’ll now work towards having job descriptions recognised within NSW Health, so they’re not escaping off to places like Queensland, which is what’s been happening.
“We’ve been losing our trainees once they graduate to places like Queensland, where they have a structure in place, they get paid and they have a job description where they can use their skills appropriately.
“And that’s where New South Wales has been lagging.”
ACRRM president Dr Rod Martin, who is based in the Northern Tablelands region of NSW, told TMR that a recurring issue in rural generalism had been convincing state health services to accept their qualifications.
“States can [be] almost unrealistically risk averse and believe that a qualified rural generalist [should be] … putting a patient in an ambulance and sending them to the regional centre, where a less qualified junior doctor or registrar will be performing the same procedure, often with less supervision,” he said.
“Rural generalists in the settings that NSW [Health] wants them to go to, need to be working to their full scope, without unnecessary and unrealistic clinical governance or oversight and excess input.”
