Date published: 
20 April 2021
Media type: 
Transcript
Audience: 
General public

PAUL WEST:

It’s that time of the week where we catch up with federal politics, and today you've been hearing reactions to the news that the only GP clinic in Bombala will close at the end of next week. And it's not just Bombala residents, but those of neighbouring communities like Delegate, Cathcart and Tumut and other outlying areas that will now face hours of extra travel, assuming that they can find a GP who will take them in Cooma or Bega. It's an issue that's been brought to the attention of the Federal Minister for Regional Health, Regional Communications and Local Government. That's Nationals MP Mark Coulton. He joins me on the phone this morning. Minister Coulton, thanks so much for your time.

MARK COULTON:

Morning Paul.

PAUL WEST:

Minister, what's your response to the situation happening in Bombala at the moment?

MARK COULTON:

Look, it is always concerning when these things happen. Sadly, it’s not completely uncommon around the country when GPs do decide to leave. But I have been assured that the Local Health District and the PHN are working together and the Rural Doctors Network, which is funded by the Government is in there as well, working with the local community to try and make sure that we do have some succession in place when the GPs do decide to leave.

PAUL WEST:

What plans are there at the federal level to address that nationwide issue of difficulty in retaining regional doctors?

MARK COULTON:

Look, Paul, the real challenge is that the things that we do in the short-term don’t exacerbate the problem and one of the problems at the moment is a lot of communities across Australia are being serviced by locums and quite often, have quite a high fee for coming in and working temporarily, and that's unacceptable, really, in the long term. Part of the efficiency of rural medicine is when the relationship is built over a long period of time between the GP and an individual or a family. And so, we're going right back. We're training students now in the regions with the Murray Darling Medical School. A couple of months ago, I announced 400 places with the Australian College of Rural and Remote Medicine in what we call the generalist pathway. One of the reasons we've had a bit of a problem encouraging GPs to the bush is quite often that you need a broader range of skills. You know, it's dealing with general medicine during the day and then a carload of teenagers has an accident on Friday night, you need to have that broader skill set to be able to deal with that. So the generalist pathway will do that.

So at the moment, I think the longer term things that we're doing will have an effect, but we've also got to work with the state governments at the moment to fill in the gaps that we've got because we are training more GPs. And under our rural health training program, we've had an extra 7-800 GPs going to the bush but there’s still a tricky time during transition. You know, when one GP wants to retire, getting someone else to come in, that's quite often a difficult time for a town.

PAUL WEST:

Minister, is there any incentivisation for doctors to relocate to the regions and set up practice?

MARK COULTON:

Yeah, sure. So in most places [indistinct] we call the practice incentive payment and that can be as much as $125,000 and workforce incentive payments that go to individual doctors as well as a rural bulk billing incentive that goes to doctors as well. And so, it is financial to a degree but it's also that for too long, Paul, rural medicine has been seen as second prize, so to speak, and a lot of our students have been encouraged in the larger cities to stay in the hospitals and to specialise. What we're trying to do now is change the dynamic. We've funded some trials across- not that far from where you are – in the Riverina and in Western New South Wales where we are working on a team approach, where the State and Commonwealth governments are working together, and some of that money that's being funded into locums now has been channeled back into providing a better workforce- a workplace environment for people that do actually commit. Because at the moment, there's an incentive not to commit to an area and we’ve got to turn that around. We're funding research programs so that medical professionals that go to the bush can undertake research. I live in a little town of 1200 people and we've had our doctors, they’re husband and wife, for 33 years. And so we're somewhat spoiled in those communities, but I know in a couple of years when they decide to leave, it's going to be a big challenge to get someone to replace them. I think we will but it's always a bit of a difficult time for any community.

PAUL WEST:

What further incentivisation do you think could be offered to address this issue? Because it seems that the current levels aren't enough to encourage doctors out into the bush.

MARK COULTON:

I think a lot of it also is providing a positive career move- like what we’re doing with the trial sites is creating a team environment. It's the idea of – particularly a junior doctor – going into an area where they feel that there's strong professional support. We also have a generalist pathway for allied health and nursing, so that those having support of practice nurses, physiotherapists, and people like that in that area but giving them a broader skill set once again, because if you're in a regional town, you can't specialise in certain areas. You've got to have a broader range of skills to deal with what comes your way. So it's not- I don't think, Paul, that there is one particular silver bullet and sometimes the silver bullets can actually be quite dangerous. So we are looking at a very broad approach to delivering long-term solutions. Directly for Bombala. I know that there’s people on the ground there at the moment, both from the health district, the PHN, and the Rural Doctors Network on the ground. They're doing what they can to try and attract people into fill that gap.

PAUL WEST:

I'm speaking with Mark Coulton, the Federal Minister for Regional Health, Regional Communications and Local Government on ABC South East Breakfast this morning. Minister, it seems like a complex issue with the overlap of roles with the federal and state governments. How are you cooperating with New South Wales Health? We spoke with Minister Bronnie Taylor yesterday.

MARK COULTON:

Yes. So I've had- we've hosted two round tables with Brad Hazzard and myself, and Bronnie’s been at those. And where we are- and in a smaller community, it just doesn't make sense that the state government have the responsibility of keeping the hospital or the MPS or whatever is in that town staffed, and then the GPs are sort of struggling up the other end of the street. And so there's a- I think for the first time, there's a real desire, particularly in New South Wales, where we can actually make sure that we've got a better co-operation so that the hospital is covered, but quite often putting a locum into a hospital is not a full-time job in the smaller town and there's plenty of capacity for that person to be working in a GP practice as well. And so we've seen that work well in some sites. I know that we can do more of that co-operation, making sure we look at the resources we've got in the community and making sure that they're working together rather than silos.

PAUL WEST:

The Federal Government's vaccine rollout has lent heavily on GP services to administer the vaccine within communities. How is that affecting under service to communities and their accessibility to the COVID-19 vaccine?

MARK COULTON:

Look, I've actually visited quite a few GP clinics and Aboriginal Medical Services in different towns. I'm actually finding quite different in the regional areas, but that relationship that people do have with their GP. The GPs tend to be, I guess, encouraging their more vulnerable patients to come in and I've seen that generally the country towns, there's a desire to have the vaccine. People understand that we've been very fortunate up until now, but they are more vulnerable than the cities. So it's been slow, but that’s largely in the early stages because of supply challenges. But I think as the supply improves, the rollout in country areas is going to be a little bit more accepted than in the city. That's certainly what I'm hearing at the moment.

PAUL WEST:

Well Mark Coulton, thank you so much for taking the time to speak with us on ABC South East Breakfast this morning. You're the Federal Minister for Regional Communications and Local Government, both significant areas of interest for this region. So hopefully we can get back to you another Tuesday to chat further on some other issues.

MARK COULTON:

Anytime. Always a pleasure. Thank you.

PAUL WEST:

I appreciate it. Mark Coulton, thank you very much for joining us on ABC South East Breakfast. That was the Federal Minister for Regional Health Regional Communications and Local Government.