Our Meeting with Nicola Roxon.

Representatives of our Need More GPs group were invited to a meeting with Nicola Roxon on Tuesday 9th September. We are still considering our formal response at this time, but in summary, we feel that:

Nicola Roxon knows the horse is sick

She knows the cart needs repairs

However she is focused on building the barn.

Do we need to say that we fear that the GP section of the barn will be empty, unless some urgent interim action is taken?

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

The International Press.

More on the GP workforce shortage:

Our campaign has come to the notice of the German press. It is in the newspaper Die Welt (readership of 690,000), in an article on the rural medical problem and the Royal Flying Doctor Service. The article is HERE.

UK - Trained GPs ready to help us.

It seems that help for our GP workforce shortage problem is waiting in the wings - or could be, if the powers that be would allow it. 

We have received the following email from Mr Ron Crause, Chairman of the Australian Association of Medical Recruitment Agencies (AAMRA).

"I have read your submission to Mr Rudd. We at AAMRA would be most supportive of your initiatives. I thought I would also bring to your attention that the last federal government introduced, under Mr Abbot a program in 2004, called Strengthening Medicare which has been very successful in bringing in over 600 GPs into Australia during this period. This program has not been renewed by the current government even though tenders went out for it in December 2007. Submissions have been made to Ms Roxon to entreat her to continue the program but without any success.  With the current economic downturn in the UK we have the opportunity to get some really good UK trained GP’s and the continuation of this program or anything similar would also help."

So, Mr. Rudd and Ms. Roxon, what is the go here? Is there some really good reason that that this program has not been continued? If there is, please tell it to us - and especially our rural colleagues.

Recruiting GPs from a developed nation such as the UK avoids the ethical dilemma of taking doctors from countries that can ill-afford to train them in the first place, never mind then losing them to wealthier countries.

More Media Interest

The media remains interested in our campaign on the GP workforce shortage and provider number issue, in the wake of the 'response' from Mr. Rudd's office (the link to which is in the previous post).

Steve Austin gave us airtime on ABC radio (612) on Tuesday, at 7.35 after the news.

Adam Cresswell, the Health Editor for The Australian on August 23 also featured our story (for the second time). His article is HERE. His article from July 11 is HERE.

Kevin Rudd's Response.

Well, we did get a response from Mr. Rudd's office.

It is HERE.

A not-very-useful response as it turns out.

It fills up space by repeating our own comments, and fills up more space repeating the same old 'solutions'.
I would like to suggest to the powers that be that the strategies outlined in the letter are
(a) optimistic in the extreme, given that they are based on the hope/wish/expectation that the great increase in medical students will magically result in an increased number of GPs. Two immediate potential sticking points come to mind. (i) a large percentage of the new number of students are from overseas and (ii) there is absolutely no evidence that general practice is going to attract many of them at all. We are leaving the profession in droves. There may be no-one left to run the training program.
(b) even if they have some chance of success, they are long-term strategies, and the situation is urgent.

Also, Mr Rudd - strategies that depend on nurses are great in theory, but - there is a shortage of nurses too!

GP Shortage: The Australian: The Article.

The Australian has picked up the story of our campaign.

It is HERE if you are interested.



P.S to Mr. Rudd: we are eagerly awaiting your response to our meeting.



P.P.S To readers of this blog. If you are concerned, please consider signing our e-Petition to the State Government, which can be done HERE.