The shortage of general practitioners is crippling health care in regional NSW and adding to hospital emergency admissions, according to a local medical practitioner.
The Hastings is feeling the effects of the shortage with many medical centres closing their books to new patients and moving away from unsustainable bulk billing.
In some cases, Hastings residents are waiting three weeks for a GP appointment in Port Macquarie and instead being advised to attend medical centres in Wauchope.
The Grange Family Medical Centre practice owner, Dr Debra King, has worked locally for 15 years and is the North Coast representative on the Royal Australian College of General Practitioners NSW board.
Dr King said training positions aren't being filled and doctors are working longer hours exacerbating the workforce shortage in regional areas.
"In Port Macquarie I think there is only one practice who are taking new patients, all the others are closed and that indicates there is a shortage of general practitioners. I think that is going to get worse over time," she said.
"If a new family moves to the area they won't be able get a general practitioner and the only way for them to get help is to go to the emergency department at the hospital.
"We are at a critical point where we will start seeing doctors burn out next year from working extra hours, there will be those charging a greater gap because business costs have gone up and there will be no general practitioners for new patients in the area.
"This all results in a rise in chronic illness because people won't be attending their doctor regularly and they will attend hospital emergency department instead."
Dr King said their medical centre runs teaching programs to help keep medical students and registrars in regional NSW.
"The major problem is the shortage of general practitioners coming through the training program and it just hits hardest in the country," she said.
"The income of a GP and a specialist is widening, so when students come through the system they are going into special training programs instead.
"That gap has gotten worse over time, business costs are higher and freezing the Medicare rebate for ten years has certainly not helped at all.
"Adding to that, regional doctors are working pretty hard at the moment because we are seeing our normal patients and vaccinating for COVID on top of that.
"General practitioners are getting burnt out with the increased workload. Our workforce doesn't go up, we just work longer hours."
The town where the patients' patience has run out
In the rural village of Barraba in the NSW New England region it can take years to get on the books at the local doctor's surgery.
Neither of the two doctors live in the town and each is on a fortnightly rotation.
At the same time patients wait to be seen, the doctor is stretched to the limit, required to be available to the hospital's emergency department at all times.
Toni Morrissey is an aged care worker, she has to take a 100km round-trip to Manilla, or a two-hour slog to Tamworth, to see a doctor.
"It's terrible really, I moved here seven years ago and the books were closed so we had to go elsewhere to find a doctor," she said.
"We are a town of 2500 people, but how do you close your books to a small town? I can't comprehend that."
The federal government is responsible for funding GP services, while the state tries to find solutions to medical workforce shortages. For the past two years, a 24/7 on-call visiting medical officer has been available at the Barraba Multipurpose Service (MPS).
When a doctor isn't available, Barraba MPS relies on doctors in neighbouring towns or Tamworth hospital ED to provide support over video or the phone to staff, Hunter New England Health (HNEH) Peel Sector acting general manager Kylie Whitford said.
"More than 98 per cent of all Barraba ED patients are treated within their benchmark waiting time," she said.
Resident Greg Forder said calls for help appear to be falling on deaf ears.
"I find the situation totally unsatisfactory, we are 45km from our nearest town at Manilla one way, and then Bingara 60km north," he said.
"I have lung issues and can't go out to the cold to go to the ED at all hours, but not only that, the ED is just that, it should not be an extension of the practice for people to go there for a consult, it's really a catch-22."
Minister says government remains committed
A Parliamentary Inquiry into Health Outcomes, Access to Health and Hospital Services in Rural, Regional and Remote NSW is continuing public hearings and expects to present findings next year.
Minister for Regional Health and member for Lyne, Dr David Gillespie said the federal government is committed to improving access to health services for all Australians regardless of where they live.
"The primary issue of the health workforce is no longer a matter of under-supply but of equitable distribution," he said.
"Over the past decade the rate of increase in GP numbers in Australia has been two and a half times greater than that of the general population with the majority of growth in GPs numbers in major capital cities and metropolitan areas."
Dr Gillespie said the most recent update on July 1 this year showed Port Macquarie is above the benchmark for services access.
Having practiced medicine for 33 years including teaching and training doctors in regional areas I'm keen to ensure we have the right suite of policies and incentives to not only attract, but also retain doctors in the bush.Dr David Gillespie
"This mean there are many other communities with lower access to health services, compared with Port Macquarie, and overseas trained doctors are currently prioritised to those other communities," he said.
"In relation to Wauchope, I have asked my department to review the latest information to ensure recent changes that may have occurred within the community are factored into its current Distribution Priority Area status.
"In relation to the town of Kempsey, it is DPA with one to five per cent below benchmark levels of services access.
"Having practiced medicine for 33 years including teaching and training doctors in regional areas I'm keen to ensure we have the right suite of policies and incentives to not only attract, but also retain doctors in the bush.
"Iunderstand that the situation on the ground can feel or is often unique. That is why it is important to ground truth the situation and enable bespoke solutions to be developed where problems exist."
Dr Gillespie said there is funding for a range of programs to attract and retain GPs in rural communities including financial incentives for doctors and practices.
Practices facing difficulties with recruitment should work with the Commonwealth Funded local Rural Workforce Agency and the NSW Rural Doctors Network.
The 2021-22 Federal Budget is investing an additional $123 million in the rural health workforce to improve access, according to Dr Gillespie.
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