General Practitioners Call for Change in Health Funding Status, Incentives to Address Doctor Shortage in WA

At least once a week, Zaliah Campbell goes on an hour-long trip to see her family doctor.

Given the complexities of needs and the need for mental health care, it was not easy to find a doctor near her home in Armadale, southeast of Perth.

Instead, she travels nearly 60 kilometers to the Peel Health Hub in Mandurah to see a specialized group of general practitioners and other health professionals.

“I have borderline personality disorder and it affects how emotions work,” said Ms. Campbell.

Zaliah Campbell with her family doctor.(ABC News: Herlyn Kaur)

“It’s not best to have two children [there], and then try to get them out, work your way through afternoon nap.

The city of Armadale is the fourth fastest growing local government in WA, with an annual growth rate of 3.6 percent – more than three times the state average and more than double the Australian average.

According to the latest data from the Council, poverty, access to services and mental health problems are key issues facing the local community.

Ms. Campbell said the all-round services that the Peel Health Hub provides in the Mandurah community made all the difference to her wellbeing.

“It’s all under one roof. I’m a recreational drug addict, I’ve been clean for three years. I see Palmerston” [rehabilitation service]who is affiliated with Peel Youth Medical Services.

“I can be booked down there for emergency appointments, my doctor calls me if I need an emergency appointment, she finds me time to plan me in.”

General practitioners “fully booked weeks in advance”

Eleanor Britton is Business Development Manager of the Peel Health Hub and helped set up the service in 2018.

She belongs to a group of health professionals fighting against changes to the federal government’s classification system for general practitioners known as the Distribution Primary Area (DPA).

A medium shot of Eleanor Britton standing in front of a sign that says Peel Health Hub.
Eleanor Britton says the government needs to break down the barriers to specialist GPs working in regional areas.(ABC News: Herlyn Kaur)

The Peel area was once classified as a need area but has not been recognized as a primary care shortage area since changing its status to a non-DPA area in 2019.

Similar to Armadale, Ms. Britton said the biggest problem with Mandurah’s growing population is finding enough GPs to keep up with demand.

“We really need one or the other family doctor here and are only a small service, but a really important service.

“We actually serve vulnerable and marginalized parts of the community … so this puts a lot of pressure on us and puts a lot of pressure on the other employees in the building.”

A photo of the outside of the Peel Health Hub.
Peel Health Hub serves marginalized and vulnerable communities.(ABC News: Herlyn Kaur)

Ms. Britton – along with others in the working group formed under the WA Primary Health Alliance – submits an application in which she objects to the non-DPA classification of the Peel region.

“We really feel the pain of this decision and this limitation on us,” she said.

“The general practitioners we need are general practitioners with a special interest in mental health and alcohol and drugs.

She said regardless of DPA status, more needs to be done to attract general practitioners to the area.

“First we have to have a DPA priority status for this region, then we still compete with other regions to attract general practitioners, but I also think we have to promote the region, promote Mandurah as a beautiful place to live.”

Stamm builds on family doctors in high-demand areas

Back in Armadale, several general practitioner offices were forced to close their books to new patients due to overwhelming demand in recent years.

A close up of Harsha Jayatilake in his doctor's office.
Harsha Jayatilake was unable to recruit any more general practitioners.(ABC News: Herlyn Kaur)

Haynes Medical Center owner Harsha Jayatilake said there has been a serious medical shortage since Armadale was classified as a non-DPA two years ago.

In its heyday, the practice had 13 doctors, today there are only seven.

“I’ve advertised all over Seek and the RAC GP website, but the response to my ads and the response from all of these recruiters has been negative,” he said.

The shortage means the practice is about to close to new patients, or possibly permanently.

“We’ll be at a loss at some point, and when that happens we’ll have to seriously consider whether to keep the business going or to come up with something else,” he said.

“Everyone deserves help”

Ms. Campbell’s main concern is the lack of suitable and available GPs near her home in Armadale, as long waits are deterring her from practices in the area.

A photo of Zaliah Campbell with her two children talking to her family doctor.
Ms. Campbell says improving health care in the area would save lives.(ABC News: Herlyn Kaur)

She said better care in the area would help save lives.

“We need more mental health workers, we need more people who sit down and actually care.”

The federal health ministry said its classification system has prioritized areas with significant supply shortages among general practitioners and directed graduates and doctors to rural and remote areas.

It also funds a number of other incentives to encourage primary care practitioner recruitment and retention.

Call for incentives to increase the number of general practitioners

Ramya Raman, WA chairman of the Royal Australian College of GPs and based in Armadale, said the demand for GPs in the area continues to grow.

She said the COVID-19 pandemic had exacerbated the problem.

A woman is smiling at the camera.
Dr. Ramya Raman says Australia needs more general practitioners.(Supplied: Royal Australian College of General Practitioners.)

“The shortage of general practitioners is a persistent problem across Australia and was made worse by the pandemic – and particularly by the travel restrictions and the influx of international medical graduates into Australia,” she said.

“I hear the concerns associated with this [the DPA] and there are instances where it has caused problems that are isolated and RACGP has advocated these communities. “

Dr. Raman said the RACGP supports medical practices who want to challenge their non-DPA status.

“We really need to attract and train more GPs across Australia, especially in the communities where they are most needed – especially in regional and remote Australia.

“The shortage of specialists in general practitioners in rural areas is our top priority and … we have long been calling for further investments to attract doctors to these communities.”

She said there needs to be a lot more incentive in urban areas.

“We recommend increasing the workplace incentive programs with additional payments for those doctors who use additional advanced skills, especially in rural areas, graduated according to their skills, in order to enable access to appropriate specialists [Medicare Benefit Scheme] Elements of having a GP with advanced skills … and initiatives to help GPs learn rural medicine and move into rural communities. “

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