Government incentives aren’t fixing GP shortages in regional areas, an inquiry has heard.
Government incentives are not resolving the GP shortage in regional areas, while local councils are “picking up the slack”, a parliamentary inquiry heard on Thursday.
Department of Health, Disability and Ageing (DoHDA) representatives faced questioning over why some council areas received significant funding while others were left with little.
The Standing Committee on Regional Development, Infrastructure and Transport inquiry into local government funding and fiscal sustainability in Canberra heard there was “massive overlap” of service delivery, particularly in local government.
NSW Nationals MP and committee deputy chair Alison Penfold asked DoHDA representatives how the department used regional data to ensures that the level of PHN services were meeting the needs of the area.
“I’ll get straight to the point. I’ve been calling for an urgent care clinic in Taree,” she told the hearing.
“The data that’s presented shows the situation in that community, and I’m still astounded as to why the area hasn’t been allocated one.
“My concern is it’s either the decision isn’t being done, and therefore the advice isn’t being provided, or that it’s a decision made outside of the Department.
“Can you give me some assessment of how you’re looking at primary healthcare needs, looking at the data, and making sure that the offer that the government’s got on the table is being is getting into the communities that need it?”
DoHDA primary care division secretary Jo Da Rocha said the primary healthcare funding that went to local governments went through primary healthcare networks.
“They are independent organisations, not for profit, and they do … population health assessments and need with their funding,” she said.
“There is not a lot of funding that they do provide to local government. They do it where they’ve been approached, and they think that they have flexible enough funds to support the provision of additional support through commissioning of grants.
“They make independent decisions, independent of government, and so they do that through their contract arrangements, and we get funding advice from them on what they’ve commissioned afterwards.
“It’s completely independent of us, but I do know that through the funding that the Commonwealth provides to PHNs, they do do quite thorough assessments of need,and certainly listen to the range of providers in their area to assess what support they might be able to [provide].”
In response, Ms Penfold said:
“That doesn’t answer my question. I understand the PHN doesn’t make the decision – they are allocated the funding in relation to urgent care clinics.
“This is an issue that the local councils have to deal with in this particular area, given the state of our public hospital and the broader community that … Taree services, where there is a lack of GPs and people have to travel significant distances to locate one.
“I appreciate your answer, but that doesn’t get to the question that I’ve asked.”
Ms Da Rocha said local councils were not funded for urgent care clinics.
“There is an assessment that is absolutely done and we’d like to provide more and more urgent care clinics.
“There is a limited pool of funding, and there is a decision of government as to where those urgent care clinics [go].”
Ms Penfold asked how DoHDA was assessing areas to ensure funding was fairly distributed.
“If two regions have like … outcomes in terms of … lack of GPs, all those metrics, but one has got a heap of government-funded resources and another has barely any … what advice are you providing? How do you respond to that situation?
“As I understand it, it is making sure that we’ve got universal access to healthcare, and … we’ve heard evidence here … councils are picking up the slack, and we’ve also got regions and areas that have got a significant amount of resources, perhaps over supported.
“How are we trying to make sure that we’re getting the resources to the areas where the people [need them] the most? Are you looking at the data in this way?”
Ms Da Rocha said general practices were independent private businesses and were funded by claiming rebates through the medical benefit scheme.
“The support through the MBS, where people are claiming for bulk billing support … there is bulk billing incentives … that go up by the modified Monash model.”
Ms Penfold said:
“We know from the Rural Health Alliance that yes, there’s a lot of incentives, and they go up … the most at MM7, but that is not resolving the GP shortages in the regions.”
DoHDA first assistant secretary Greg Pugh said of the total Commonwealth Home Support Program (CHSP) funding, around 5.63% went to local councils.
“That’s just shy of $200 million per year GST exclusive on an annual basis,” Mr Pugh said.
“To your question, councils are long-standing CHSP providers. They are also Support at Home providers.
“We’re very well aware that … there’s a decision that the CHSP will not roll into Support at Home before 1 July 2027.
“We are doing our best to make sure that people have some certainty around what those ongoing funding arrangements look like, but that is ultimately a decision for government, which we anticipate should be soon.”
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Independent Victorian MP and committee member Dr Helen Haines said there was “massive overlap when it comes to service delivery on the ground”, particularly in local government.
“We’re hearing consistently from local governments about the increased role they’re playing in in the health space,” Dr Haines told the hearing.
“Is that consistent with the data that you have?
“Have you seen a change over time in how much local government are actually doing service delivery when it comes to healthcare and, in particular, aged care?”
First assistant secretary of DoHDA’s market and stewardship division, aging and aged care group, Luke Mansfield, said the “vast majority” of the aggregate expenditure went to aged care.
“For example, in 25-26, $247.9 million was for aged care specific grants, primarily through the Commonwealth Home Support Program, and in addition to that, there’s $58.6 million in residential aged care subsidies,” Mr Mansfield said.
That did not include funding for home care packages in 2024-25, which was an additional 148.3 million, he said.
