I'd like to thank and congratulate Access Economics and Roger Kilham for producing this report. It arose out of concerns that I have that the modelling on general practice workforce was grossly inadequate and misleading and, in fact, the report that has been today, launched and was delivered to the AMA in recent weeks, certainly confirms the fact that our concerns are quite real. Rather than there being the alleged surplus of general practitioners in Australia there is, in fact, a demonstrable under-supply of general practitioner services. And unless there is a change to government policy and to the training of GPs and to the general practice workforce, then we will see a growing under-supply of general practitioners.
It's not only in country areas, as we have become accustomed to hearing, but it is also in the suburbs of our cities. This is a matter of great concern because, in the future, patients will have difficulty receiving the general practice care that they need and they are already experiencing that difficulty now. It is not time to panic but it is certainly time for a change to government policy that reflects the need in the community that is currently being unmet. I think you've all seen a copy of the report - you've had a chance to look at it - please ask me any questions.
QUESTION: What changes to government policy need to be made do you think?
PHELPS: The government needs to work with the state governments and with the medical profession to find solutions to this problem. We need to look at a number of different types of responses. One of them will be to look at general practice remuneration, to make it more attractive for general practitioners to stay within medical practice - if they're currently working part-time to work full-time - to attract junior doctors into general practice as a specialty.
We need to look at training numbers. We've certainly seen provider number restrictions on Australian-trained graduates which was predicated on an alleged oversupply. We now know that that oversupply is not true and that the restrictions should be now reviewed so that we are training sufficient Australian graduates in the specialty of general practice to meet the need into the future.
QUESTION: If it's not a crisis yet, when do you think that will be?
PHELPS: It's coming close. I think, unless government policy changes, there's going to be an increasing under-supply of general practitioner services. I suppose it depends on how you define a crisis. At the moment there is a serious shortage in large tracts of Australia.
For example, one in five Australians live in an area of severe shortage and that is of course having an impact on that one in five Australians. It's one in eight in the urban areas and it's at a level of almost a half in our more rural and remove areas. So, for some communities, there is unquestionably a crisis. If it's impossible to see a GP for several months for basic check-ups, preventive health care or even for acute care, then that's a crisis.
If it's impossible to see a GP in your town without travelling a half a day each way to the nearest town where you have a GP, then that's a crisis for those people. And I think that we need to look at where there are areas of need and to make it more attractive for doctors to go there and to stay there.
QUESTION: You spoke about how ……
KILHAM: Oh that's what they're saying, because of the feminisation, because of the change in patterns, the average number of hours that you extract from a GP in their working life is lower than before. And therefore you really need to have, you know…
QUESTION: Have you got figures on that - what that was five years ago or how many years ago?
KILHAM: No. No what we've done is we've done projections for the future. We've tried to look at how the changing age and gender structures of the workforce will affect the hours that can be produced in the future.
PHELPS: These are questions that actually haven't been asked before, in terms of surveying doctors working at the coalface and asking them what they're doing, what their plans are for the future. For the first time we now have reliable evidence - and health policy should always be based on evidence - we now have the evidence that will inform future health policy and workforce planning.
Thank you all.