Bush docs call for DPA reversal

4 minute read

IMGs were again at the centre of discussions around rural workforce woes at a snap summit in Mildura this week.

Peak rural doctor groups want to hit reset on the rules that govern where overseas trained doctors can work, after a bigger-than-average exodus from remote towns immediately following a loosening of the criteria.

Australia’s ongoing rural workforce issues were on the table again at a summit in Mildura earlier this week, which was attended by Dr Nick Coatsworth and shadow health minister Anne Ruston along with representatives from the RACGP, ACRRM and the Rural Doctors Association of Australia.

Nationals MP Dr Anne Webster, who hosted the summit, reportedly rejected an offer to have a government representative attend the event.

It was open to GPs, pharmacists, practice managers and allied health professionals working in a regional setting.

Two of the major takeaways, according to RDAA president Dr Megan Belot and ACRRM president Dr Dan Halliday, centred on internationally trained doctors.

As part of an election promise, Labor loosened the criteria governing distribution priority areas (DPA) mid last year. Internationally trained doctors can’t attract Medicare rebates for their patients unless they go to work in a DPA location for a period of time.

Labor’s change, which came into effect in July 2022, granted DPA status to some Modified Monash Model level 1 and all MMM2 areas and above.

This made an incentive that was previously exclusive to rural and remote towns available to regional centres. While this made it easier to recruit doctors to towns, it removed what rural medical advocates say was one of the few advantages they had in recruiting doctors for the most remote practices in Australia.

Roughly 72 doctors moved from an MM3-7 area to an MM2 area in 2022 – that is, escaped from a remote to a regional setting – up from around 40 in previous years.  

While it might appear to be a relatively small number overall, Dr Belot said that each move had the potential to cripple a rural community.

“Just one doctor out of a certain community can really have a massive impact,” she told The Medical Republic.

While the RDAA would like to see stricter DPA rules reintroduced, it also said that it did not fully support the “conscripted” method of the policy.

Right now, Dr Belot said, there were at least 800 clinician vacancies across the different regional and rural Australian workforce agencies.

“That’s actually not including private practices trying to get doctors in different ways,” she said.

Another area of interest was strategies for recruiting more international medical graduates.

“[One idea was to] maybe even to look at the countries that have less red tape in the sense that there are reciprocal rights in their fellowships – for instance, the UK,” Dr Belot said.

“Maybe the workforce agencies should go back over to the UK and try and get doctors, nurses and allied health professionals to come over to Australia, because I think that’s what used to happen.”

The summit also looked at longer-term solutions which needed more funding.

Dr Belot is passionate about getting young people in rural and regional areas interested in health careers as early as high school.

“Where I work in Kerrang, I’ve got kids there that kind of look at me like I’m dumb when I say, ‘well, why don’t you want to come and be a doctor, come and be a nurse, or a physio, or a speech pathologist, or a psychologist,” she said.

“They’re kind of like, ‘well no, Megan, I’m not going to get the score to get into that’, so I think that there needs to be a lot of work done there.”

Dr Halliday said there had also been a productive discussion around how multidisciplinary teams can be used to align with the needs of different communities.

“I think it should be recognised that these [ideas] aren’t necessarily new,” he told TMR.

“But that they have been mentioned for some time and are being reinforced as opportunities to take advantage of.”

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