The German Press.

The article in Die Welt has been translated by a colleague. This is how the German Press understand the situation in Australia as regards the GP shortage and the employment of international medical graduates.

Flying Doctors in Australia face an Emergency.

On this fifth continent, the scarcity of country doctors necessitates the Royal Flying Doctors to take over. But the RDFS are now facing great shortages in manpower.

They land with their propeller driven aircraft among grazing kangaroos. They fly into Aboriginal camps to pull teeth, and they save stranded tourists who have accidents with their camper-van. They are the physicians of the Royal Flying Doctor Service (RDFS). They are the most prestigious relief organisation in Australia, and this has brought them global fame. Yet in this year in which they celebrate their 80th birthday, the organisation finds itself in an acute state of distress despite incoming donations and continued government grants.

The new generation of the medical profession are missing in taking up the challenge of servicing the inland, leaving the present staff stretched to the limits of their capacity. They must cover ever larger areas with less and less personnel. The crisis has become so acute that the flying doctors can only maintain this enterprise with the assistance of foreign help. “The demand for our services becomes ever greater” said Roger Petheram, the manager of the regional RFDS based in Dubbo, – a town in the interior of the Australian east coast State, NSW - with a population of 40,000. A place where it rains rarely, and where the wind-dried tufts of grass blow into the aircraft hangers.

From here, several times a week, rescue teams are deployed into the Outback. To meet further emergencies, a second airplane and an additional surgeon is needed to ensure a smooth service. But the response has been sluggish. “We have been looking for a qualified physician since the middle of July – so far the interest has been low” says Ingo Stormer, a German anaesthetist. Scarcely two years out from Cologne, he now holds a senior rank with the RDFS at the Dubbo base. His emergency colleagues are doctors from Holland and Zimbabwe.

The reality is that without foreign trained doctors, a large part of the Australian health system would have long broken down, with 43% of all medical practitioners in the vast rural areas of the continent having gained their qualifications abroad. These fill the gaps due to the fact that Australian trained doctors are unwilling to dedicate their skills to the Outback, but rather prefer to establish their careers in the larger coastal cities. Presently, the RDAA has announced an urgent need for approximately 1600 more doctors, with at least a dozen needed to maintain the work of the Flying Doctor Service.

Additionally, more qualified nurses are used to take up the slack. “Positions that should be taken up by those medically qualified,” states Gordon Gregory, the chairman of the National Rural Health Alliance. And the situation becomes graver with many elderly and established country doctors now seeking retirement, leaving their practices, and not being replaced by others within their profession.

“Unfortunately, younger Australian doctors have abandoned the bush – and have no desire to take on the hard work so much evident in the country-practices,” says Janet Clarkson, a female doctor practicing in Brisbane.

Even migrant doctors are unwilling to go into country practise as they must commit themselves up to ten years service in the Bush. And things will get worse due to past negative experiences where under-qualified overseas doctors have brought their profession into disrepute with medical fraud, atrocious surgery leading to mutilation and even death of patients, and other disreputable and unethical practises. To counter this, authorities are intensifying the already complex guidelines for immigrants that wish to work in welfare occupations.

From July 1st 2008, stricter language tests and stricter rules will be in place before foreign medical qualifications are officially recognised. Tracey Green, who is responsible for medical personnel within the Royal Flying Doctor Service in Queensland believes that such hurdles will make it more difficult for German doctors to immigrate. Rather, a greater recruitment for qualified physicians is underway concentrating on England, Canada, and New Zealand. “That is unfortunate,” Green says, “as we genuinely admire the skills of German-trained doctors.” Moreso, if Ingo Stormer is correct, because they may be more willing to accept a job in the Outback.

The flying doctor team has found one promising candidate in Germany. But, even if all the bureaucratic entry hurdles are overcome, it must be recognised that this Australian icon – a non-profit and very famous enterprise – faces serious challenges ahead. Even if the medical situation improves, the RDFS are now desperately seeking pilots to fly their planes.

Translation by Yuri Koszarycz