Monday, March 17, 2008

Dear Mr.Rudd ....

15 February, 2008

Dear Mr. Rudd,

I wish to bring to your notice the problem concerning the impending closure of a yet another general medical practice in your electorate.

It was reported recently in the South-East Advertiser (local newspaper) that another general practice, namely Logan Road General Practice, 329 Logan Road, Stones Corner, Brisbane, is likely to close in the near future as they are unable to employ suitable doctors to join the practice.

This is not the first medical practice in this area to be closed in recent times. Greenslopes Family Practice is in the process of closing and recently at least three medical practices that I know of, in the close vicinity of Stones Corner, have closed. All experienced the same problem – inability to employ overseas trained doctors (OTDs).

This is not because there are no doctors interested in joining them. It is due to the federal government’s policy with regard to overseas trained doctors. The area serviced by the Logan Road General Practice and the other medical centres that have closed is not classed as a ‘district of workforce shortage’ (DWS), therefore overseas trained doctors cannot be employed as they are not eligible for provider numbers for work in this region.

This is a region of high density population which includes a significant number of aged people, a migrant population, and pockets of people of low socio-economic background, as well as the young families that are moving into the area. I know that the Logan Road General Practice serves the community well as they work with interpreters and other support groups.

There is a public hospital in this area (The Princess Alexandra Hospital) that may be able to service some of the people’s medical needs, but this would be an added burden to the already stretched public hospital system.

So this inner city, high density area is not classed as a DWS. In light of the fact that several medical practices have already closed and others are about to close, and the fact that most existing medical centres in the area have closed their books to new patients, where will people go for medical care?

Will the Princess Alexandra Hospital and the Mater public services and existing GP services in the area be able to service the needs of this population? I think not. Already the hospitals are overburdened and existing medical services have closed their books. I was told by a local chemist that some people have had to go as far afield as Springwood to find a doctor who would be able to attend to them.

The closure of these medical centres therefore pushes local people further afield to find medical care. This is not a viable, let alone easy, option for elderly or chronically ill people.

This region may appear to have a good doctor to population ratio. A check of the Yellow Pages however, indicates that many of the doctors listed for this area are specialists or GPs specialising in particular areas, e.g. mole clinics, weight loss clinics, etc. This, together with the fact that many clinics have closed their books to new patients would indicate that this is not so.

As it is well acknowledged that primary health care is the cheapest overall approach to health care, it seems to me that it is in the interests of the community, the hospital system and the economy, to help sustain GP medical centres such as Logan Road General Practice.

In a good GP clinic, as opposed to the proposed ‘super clinics’, patients with chronic illnesses, age related illnesses and certain psychiatric conditions, are monitored and treated. This often means that people are treated before they reach the stage of hospitalisation. This requires time, building a relationship between patient and doctor and enough doctors to make this primary care viable.

I do not know the criteria for determining whether a region is a ‘district of workforce shortage’, however, perhaps the criteria need to be reviewed in the light of demographic conditions that would indicate potential medical needs of people in the region.

The situation in regard to medical care that this area is facing is dire. It would seem to me that there are two aspects to a solution: the short term and the long term.

The long term solution is being attended to by government through increased medical places at university.

In the short term is it possible to:

  • ease the placement requirements for certain overseas trained doctors? For example, if an overseas trained doctor comes to Australia with her spouse who is on transfer, because of federal policy, she is unable to take work in a local area so that she can remain with her family. Her skills are lost to the profession, the community, and the economy.
  • make access to re-skilling easier for doctors who have left the workforce for various reasons and who may be induced to return? This would include help with medical indemnity and cost of re-skilling.
  • give support and incentives to doctors who would prefer to work part time?
  • make bulk billing more attractive for GPs? (In this electorate the bulk billing rate is 10% below the national average.)

The most recent edition of the South-East Advertiser the federal health minister, Ms. Nicola Roxon is quoted as playing down the concerns about health services in this region and ‘said because the area was classified as “inner metropolitan”, it was not entitled to employ OTDs to work conventional hours’. This is unrealistic as it does not take into account zoning laws and people’s actual needs. Should we plan to visit our GP at 10.00 p.m. or midnight?

So, in the light of general practice closures, the inability of many existing medical centres to take on new patients, and a high density of population, I ask for a review of the criteria for the placement of OTDs so that existing practices are able to continue to serve the community.

Should this review not be possible, give the patients of these clinics directions as to where they will be able to receive their primary health care within a reasonable distance of their residence.

Finally, Mr. Rudd, I offer you my heartfelt congratulations on your election victory.

Yours faithfully,

Dr. Barbara Reynolds-Hutchinson, Ph.D.

7 Rowland Street,
Coorparoo Qld. 4151

Cc:

The Hon Nicola Roxon MP,
Minister for Health and Ageing.

Senator the Hon. Jan McLucas,
Parliamentary Secretary to the Minister for Health and Ageing.

The Hon. Anna Bligh,
Member for South Brisbane

The Hon Stephen Robertson,
Minister for Health,

The Hon. Gary Fenlon,
Member for Greenslopes

AMA Federal Secretariat

AMAQ

RACGP College House

National Seniors

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