Western Victoria’s GP shortage is putting growing pressure on residents, clinics and doctors, with upper house member for Western Victoria Dr Sarah Mansfield warning the region’s health will suffer if the decline in primary care continues.
A snapshot: A report from Victoria’s Rural Workforce Agency analysing the state’s current healthcare workforce found significant shortages across GP roles, with the highest unmet need identified in Colac, Corangamite, Glenelg, Southern Grampians and Warrnambool.
Warrnambool’s shortfall was equivalent to more than one full-time GP’s workload, with the report adding this was contributing to the city’s reliance on short-term medical staff to maintain basic coverage.
Most regional centres in western Victoria currently have one to two bulk billing clinics out of a total of three or four practices. Warrnambool, however, has 11 clinics and only two offer bulk billing.
“We've heard reports that there are clinics in Warrnambool not taking any new patients at the moment, which is mind blowing,” Greens member for Western Victoria Dr Sarah Mansfield told the Brolga.
Systemic issue: Mansfield, who is also a practising GP, told the Brolga the shortage was a long-standing problem stemming from a range of causes, including a lack of key worker housing, access to childcare and limitations in the current Medicare rebate business model most practices use.
“Systems that charge each person for a consultation are increasingly becoming unsustainable, it's even more so in rural and regional areas,” she explained. “The costs of setting up a business and paying all the other staff that you need to work at that service, none of them can generate income.”
“There's a bit of a vicious cycle because as fewer and fewer GPs work in these areas, more and more pressure gets put on the ones who are remaining, and there's a real risk they burn out.”
Real-life consequences: Mansfield said this cycle left impacts beyond patients struggling to get appointments, with poor access to preventative care leading to worse health outcomes.
“South west Victoria has the highest rate of heart disease across Victoria,” she said.
“If you then think about what the big contributors are to heart disease, they're things like high blood pressure, high cholesterol. They're the sorts of things that are bread and butter general practice issues.”
What can be done? Victoria is one of the last states in the country to offer government-funded community health centres.
Mansfield believes these organisations could provide relief by allowing the state to employ GPs on a salary, rather than relying on fees to continue operating. She said this could also allow for more bulk billing, which was also creating a barrier for patients seeking care.
“If you’re choosing between putting food on the table or going and getting a preventative thing done that doesn’t feel like it needs to be done right now, of course you’re going to put it off,” she said.
“The doctors are salaried, so it takes that pressure off having to bill people to cover those costs. So you don't have people having to pay out of pocket, you prevent some of these chronic diseases that end up costing all of us more through needing to go to hospital.”
“In the long run it's a much more sustainable model, especially outside areas where you don't have as many GPs or other health professionals.”