The nine Central West towns facing a doctor crisis

The Bogan Shire Medical Centre, in Nyngan, is without a fulltime doctor after the council decided not to renew the contract earlier this month.
The Bogan Shire Medical Centre, in Nyngan, is without a fulltime doctor after the council decided not to renew the contract earlier this month.

Nine Central West towns have a doctor-patient ratio significantly below the national average, according to the NSW Rural Doctors Network (RDN).

The Network’s vacancies register has revealed 19 GP vacancies in 12 towns across the Central West, with 13 of those vacancies – in Bathurst (two vacancies), Condobolin (two), Cowra, Forbes, Parkes (three), Walgett, Wellington, West Wyalong and Young – given District of Work Shortage (DWS) status.

DWS status applies to towns where the doctor to population ratio is significantly below the national average.

There are also less hard-to-fill vacancies in Dubbo (three), Orange (two) and Gulargambone.

RDN chief executive officer Richard Colbran said in towns with a vacancy, the remaining GPs covered the population “as best they can”.

But in towns with only a small number of GPs in the first place, there were significant impacts for patients as well as for the hospitals and Multi-Purpose Services (MPSs).

“In small towns of say three to four GPs, a vacancy typically sees more GP-like presentations at ED, longer waiting lists to see a GP in their rooms, difficulty getting in to see a preferred doctor, and greater problems getting an emergency appointment at the GP surgery,” Mr Colbran said.

Sometimes in a town like Tumut where at present they have only one GP obstetrician, it may mean pregnant women may have to travel to other towns to give birth.

Richard Colbran

There were a variety of factors contributing to the shortage, he said.

“Obstacles or barriers to recruitment may include: the remoteness of the location; the small size of a town; the general practice circumstances to which the recruitment is being made; the wide range of skills that many locations require (including ED skills); whether the vacancy is for a proceduralist doctor (of which there is only a small cohort),” Mr Colbran said.

“While NSW experiences a maldistribution of health professionals and shortages in rural and remote areas, there have been some valuable inroads to addressing the issue through a range of strategies.”

A range of incentive programs is provided by the Australian government as well as at state level, he said, while the RDN offers grants and subsidies and administers the Five-Year Overseas Trained Doctors Scheme which funnels overseas trained doctors into more remote towns.

The network has also supported the placement of seven permanent doctors to the Central West in the last three months, and supports non-fellowed doctors in rural locations such as the Far West through the Rural Locum Relief Program.

“Establishment of the new Australian government rural training hubs will be a source of support in providing junior doctors with the professional development and support required.

Ensuring early rural exposure for medical students is a key strategy in encouraging later rural practice.

Richard Colbran

“The University of Sydney runs a School of Rural Health in Dubbo and Orange and a Departments of Rural Health in Broken Hill. The University of Sydney will establish rural training hubs in Broken Hill, Dubbo and Lismore, while another training hub has recently opened in Bourke.”

In December 2016, the federal government announced the Departments of Health and Education and Training would jointly assess the number and distribution of medical schools, medical school places and training in Australia.

The assessment has been undertaken, taking account of workforce modelling and data, two decades of workforce distribution policies, the expansion of higher education places and the government’s priorities to address the maldistribution of medical professionals across regional, rural and remote Australia.

Assistant Health Minister Dr David Gillespie said the assessment process had also received advice from the National Medical Training Advisory Network and received 37 submissions from key medical education stakeholders.

He said the the establishment of an Integrated Rural Training Pipeline would be key in solving the doctor shortage in rural and remote areas.

The government is committed to ensuring communities in all regions have access to high quality health care, including the Central West, and is tackling the issue of the maldistribution of the medical workforce on a range of fronts.

Dr David Gillespie

“This includes the establishment of the Integrated Rural Training Pipeline for Medicine Medicine which will deliver more certified doctor training spots for interns, residents and registrars in regional centres, so that rurally-minded doctors can complete more of their training (including their second medical college degree) in a rural or regional area.”