The Northern Territory has traditionally struggled to attract registrars, but some hope an investment in training will turn its luck around.
The Northern Territory will host its first single employer model trial for rural generalist registrars from June, a move that ACRRM hopes will help the jurisdiction attract fresh faces.
Federal health minister Mark Butler announced the trial, which is funded through to December 2028, on Wednesday.
There’s space for up to 24 full time equivalent rural generalists in training to join the scheme. All registrars will officially be employees of the Northern Territory government as they rotate across hospital and community-based placements.
This allows them to keep accruing annual leave, sick leave and parental leave like a regular hospital-based trainee and also guarantees their income throughout training.
All registrars will be based out of Katherine Hospital, rotating out to three regional Aboriginal Community Controlled Health Organisations and one private general practice.
“Attracting doctors to our regions is critical to ensuring all Territorians can access timely, high-quality care, no matter where they live,” Northern Territory health minister Steve Edgington said.
“Making it more attractive for doctors to come and stay in Katherine is important to ensuring better health services for the people of Katherine and restoring our unique Territory lifestyle.”
ACRRM president Dr Rod Martin told The Medical Republic that the top end had been a “tougher” location to attract registrars to this year.
“Despite the fact that they’ve had a couple of floods and the threat of fuel [shortages], [the Katherine region has] done pretty well to remain resilient,” Dr Martin said.
“The Territory certainly is one of those tough locations.”
Single employer models are particularly relevant for rural generalist trainees, who often do their advanced skills training in a hospital-based specialty like anaesthetics or obstetrics.
“This trial in the Territory will be a pretty good opportunity to be able to see what influences the delivery of a SEM model has on attracting trainees – and maybe, somewhere in the future other doctors – into that system where the expectation is that rural generalists will typically provide hospital and primary care services,” Dr Martin said.
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“[Rural generalism] lends itself very much to having an all-in-one funding and conditions pot that certainly is built for registrars, but increasingly people can use in their first two or three years post fellowship to see how things settle down.”
There are currently federally backed SEM trials operating in rural and regional New South Wales, Queensland, South Australia, Tasmania and Victoria.
RACGP Northern Territory chair Dr Samuel Heard said the Medicare bulk billing model “simply does not stack up” outside metropolitan areas.
“We are seeing the real-world consequences of this. Nhulunbuy in East Arnhem Land has just lost its private general practice, Tennant Creek has lost its last private GP clinic, and Katherine is struggling to keep a single private practice operating,” he said.
“When private general practice disappears, the liveability of these towns suffers. People lose continuity of care, pressure shifts to already stretched hospitals, and communities become less attractive places to live and work.”
While welcoming the SEM announcement, the RACGP also called for sustained and long-term action – more supervisors, more training posts and more practices – to fix workforce shortages in the top end.
