Everyone’s worried about the GP workforce. West-of-Sydney PHNs are joining forces to address it.
Three primary health networks in Sydney’s west have come together to tackle the looming GP workforce shortage.
Western Sydney PHN (WentWest), South Western Sydney PHN and Nepean Blue Mountains PHN (Wentworth Health) are developing a five-year plan to increase the number of GPs in an area where the population is projected to rise by a third over the next decade.
The PHNs said the Greater Western Sydney Primary Care Workforce Strategy was brought about to address an ageing GP workforce, retention and recruitment challenges, and an “inequitable” distribution of health practitioners across the area.
The South Western Sydney (94%), Western Sydney (93%) and Nepean Blue Mountain (91%) GPs have the highest bulk-billing rate in the country (in the first quarter of 2025/26).
As older GPs retire, will new recruits carry on the bulk-billing tradition? And does it make it harder to recruit them to these areas?
It has been noted that these high rates are linked to the high areas of disadvantage encompassed by these PHNs.
“There is going to be a clear socio-economic gradient about the access to the co-payments, because GPs are really responsive to the needs of their patients in their community, and in areas where patients can’t afford co-payments, then that’s where GPs do provide most bulk billing,” Dr Tim Senior, chair of RACGP Specific Interests Poverty and Health, told News GP earlier this year.
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The South West Sydney PHN’s most populous local government areas are disadvantaged compared to the national average, according to IRSAD scores compiled from the latest ABS census data.
There are 1.08 million people living in the area covered by South Western Sydney PHN, a population growing at 11.86%.
Its 6190 square kilometres includes more densely populated LGAs like Liverpool (IRSAD score 968, compared to the national average of 1000, population 233,446), Fairfield (IRSAD 885, population 208,475), and Canterbury Bankstown (IRSAD 966, population 371,006), with a much smaller number of people in its better-off, semi-rural towns like Bowral in the southern highlands. Just over half (51%) of the residents covered by this PHN speak a language other than English at home.
Among the Western Sydney PHN area, it’s 45%. This PHN covers a population of 1.07 million people, growing at 13%, and living in an area just over 766km. Western Sydney LGAs are a mix of just above and below the national average, but within them contain cities like Blacktown (IRSAD score of 965, population 50,961), Auburn (score of 908, population 39,333), Guildford (895, population 24,091) and Mt Druitt (910, pop 16,986).
Of the three neighbouring PHNs, Nepean Blue Mountains stands apart demographically.
It has the fewest number of people (just under 400,000, growing at only 7.55%), living in two quite different locales – the city and some suburbs of Penrith, a growing cosmopolitan centre with a large teaching hospital, and then spread out across the remainder of the 9000 square kilometres of small towns, bush and farmland.
The urban areas of Penrith, St Mary’s and St Clair, taking up a small corner on the edge of the PHN map, are all relatively disadvantaged (IRSAD scores of 939, 906 and 976 respectively). The Blue Mountains LGA, population 78,121, has an IRSAD score of 1042 and Hawkesbury LGA, population 67,207 has a score of 1008. Lithgow (mainly rural, on the other side of the mountains) has an IRSAD of 912, and a population of only 20,842.
Only 13.9% speak a language other than English at home in the Nepean Blue Mountains PHN catchment, according to a recent CALD needs assessment (with the majority of those in Penrith).
HSD asked the PHNs how the partnership would work with such different demographics and needs, and how they would achieve their goal of addressing inequity in the way that health practitioners are distributed.
Speaking on behalf of all three PHNs, NBMPHN CEO Lizz Reay said:
“There are parts of greater western Sydney that have a lower GP to population ratio than other areas such as the eastern suburbs and Northern Beaches.
“There are areas of high socioeconomic disadvantage in parts of the Blacktown, Cumberland LGAs in Western Sydney, Fairfield, Bankstown and Liverpool LGAs in South Western Sydney, and in the Blue Mountains, Hawksbury, Penrith and Lithgow LGAs in Nepean Blue Mountains, where general practices struggle to be financially viable and therefore access to GPs is difficult.
“While the government has recently implemented changes to further incentivise bulk billing, these are very new and we are yet to see what impact these changes will have,” she said.
“There are also issues with how some outer metropolitan areas are currently classified under the Modified Monash Model (MMM), which allows GPs and practices in certain areas to take advantage of current government incentives.
“For example, the upper Blue Mountains and suburbs such as Katoomba, are classified as MMM1, which is the same as the Sydney CBD even though they are almost two hours away from the city.
“This issue also affects areas such as Schofields and other suburbs in the Blacktown LGA and in South Western Sydney the classification model impacts adversely on practices in Fairfield and Campbelltown in particular, where reclassification would help bolster GP attraction and retention.
“Attracting GPs to these areas is challenging, where there is no additional incentive to practice in these locations,” said Ms Reay.
“Greater Western Sydney is one of Australia’s most dynamic and fastest growing regions, the health needs and service access issues affecting our communities are similar. So, it made sense for our three PHNs to collaborate on developing a strategy to address these issues, rather than working in isolation.
“Developing this strategy is one way we hope to positively influence the future health workforce in Greater Western Sydney.
“PHNs are doing things now, every day, to help build sustainable workforces in our regions. We offer free training and support to primary care professionals and assistance with workforce recruitment. We work closely with the colleges RACGP and ACRRM, providing data that helps inform GP registrar placements and we support new GP registrars when placed in our regions.
“We work closely with health professionals spanning general practice, allied health, residential aged care and community pharmacy, in collaboration with the respective local health districts. We advocate for local needs to the Department of Health, Disability and Ageing, and have been successful in getting particular suburbs Distribution Priority Area status to assist in recruiting overseas trained GPs into particular areas of need.
“There are many other examples of what we are doing locally and what is exciting about working together on this strategy is that we can learn from each other, across boundaries from our diverse stakeholders about what is working, and what more can be done through a strategic region-wide approach.
“The combined strategy is still in development, but it will outline, among other key recommendations, how we can increase the workforce by better supporting training pathways for health professionals and ensuring health professionals are working to the top of their scope.
“While the strategy is still under development, extensive stakeholder engagement and data analysis is key to understand what needs to shift to attract and also retain GPs to live and work in greater western Sydney, and we will work together on solutions to support the specific needs of our diverse communities.”
