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Speaker 1: We've talked about it a bit, and that is the

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Speaker 1: number of doctors available for people to go and see.

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Speaker 1: And you try making an appointment today, you're waiting the

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Speaker 1: best part of a week to try and get in

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Speaker 1: to see your GP because he or she is flat

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Speaker 1: out and that does not look like it's going to

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Speaker 1: become better anytime soon. Doctor Nicole Higgins's President Royal Australian

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Speaker 1: College of GPS and joins me now in a col Good.

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Speaker 2: Morning, Good morning, Matthew.

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Speaker 1: So your workforce report is out now or the Department

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Speaker 1: of Health and Aged Cares GP workforce report, i should say,

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Speaker 1: released this week showing there's a huge shortfall here in

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Speaker 1: South Australia, the equivalent of three hundred and seventy six

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Speaker 1: full time gps. Where are we going to find them?

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Speaker 2: Well, this is the challenge, isn't it. So we're looking

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Speaker 2: at GP supply and demand. But I think it's also

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Speaker 2: really important to flag this isn't just about general practice.

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Speaker 2: This is the whole health workforce and nurse workforces is

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Speaker 2: in a lot of a lot of difficulty. And the

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Speaker 2: thing is we're all getting you know, we're getting older

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Speaker 2: and more complicated with more illness so there's going to

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Speaker 2: be more demands on the system.

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Speaker 1: Doctors are getting older too. Is there a cutoff date

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Speaker 1: for doctors practicing. I don't imagine there would be if

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Speaker 1: they want to keep going. Yeah.

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Speaker 2: So this is actually something that's come up on Medical

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Speaker 2: Board and some of your listeners may have heard it

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Speaker 2: and talking about from the age of seventy doctors going

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Speaker 2: through you know, through health checks. I think what we

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Speaker 2: need to do is really think about competency and not

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Speaker 2: just a number and make sure that you know, that's

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Speaker 2: what we're looking at. And these are the doctors, especially

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Speaker 2: in our rural and regional areas, who we know that

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Speaker 2: our late career doctors are the ones that tend to

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Speaker 2: work for most hours, so that too may have a

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Speaker 2: big infut you know, impact on workforce.

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Speaker 1: Okay, so doctors over seventy need to be has to

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Speaker 1: do they for their competency?

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Speaker 2: No, So one of the things Medical boarders raised is

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Speaker 2: should doctors over seventy be tested? Okay, I like to

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Speaker 2: make sure that they're still safe to practice, And what

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Speaker 2: we're saying, well, actually, maybe we should just make sure

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Speaker 2: that it's not just about safety. You know, we need

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Speaker 2: to protect patient safety, but let's just not have you know,

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Speaker 2: a blunt instrument with a number, let's assess their competency.

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Speaker 1: Okay, all right, that's that's interesting because you don't want

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Speaker 1: them to retire if they don't want to.

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Speaker 2: Yeah, And there's a lot of richness that you know,

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Speaker 2: our career gps bring and they're often involved in roles

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Speaker 2: such as teaching and supervision as well, and really you know,

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Speaker 2: at the backbone of a lot of our workforce.

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Speaker 1: Yeah, yeah, absolutely, So how do we go about addressing

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Speaker 1: the shortage overall? Is it up to the government, the

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Speaker 1: federal government the fund training places? Is that the starting point?

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Speaker 2: So the last ten years, we haven't increased the numbers

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Speaker 2: of the Commonwealth place for medical students. So we need

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Speaker 2: to be growing our own and making sure that general

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Speaker 2: practice is an attractive career. But you know, it's been

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Speaker 2: our internationally medical quals eyed doctors have really done the

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Speaker 2: heavy lifting in all of this, especially in our rural

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Speaker 2: and regional areas. They are the ones in this supply

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Speaker 2: and demand study who have been working the most number

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Speaker 2: of hours, and they also represent more than fifty percent

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Speaker 2: of our rural and regional areas.

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Speaker 1: And doctors are only a part of it, albeit a

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Speaker 1: very important part of course. But you can put on

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Speaker 1: doctors and meet the challenges around that, but you need

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Speaker 1: then a whole heap of other people to assist in

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Speaker 1: the whole sort of workflow of that, and you need

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Speaker 1: more pharmacists to dispense the prescriptions that doctors are writing.

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Speaker 1: You need more staff within the GP clinic, including nursing

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Speaker 1: stuff and all the rest that goes with it. So

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Speaker 1: putting doctors on is just one component, but that's all

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Speaker 1: it is.

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Speaker 2: Ultimately it is then as the whole team. And when

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Speaker 2: we've got a healthcare workforce facing significant shortage and we're

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Speaker 2: importing many from other countries, the NHS in the UK

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Speaker 2: is falling over their health system at the moment, so

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Speaker 2: we are getting a lot of doctors, nurses and pharmacists

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Speaker 2: from the UK, but we also really need to look at,

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Speaker 2: you know, how we work and how do we work

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Speaker 2: differently to make sure that we meet the demand of

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Speaker 2: the health care needs of our patients, which is changing.

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Speaker 1: What are waiting times like around the country and certainly

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Speaker 1: here in South Australia just from personal experience, you try

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Speaker 1: to book a GP, it takes you four days probably

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Speaker 1: to get in to see them if not longer.

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Speaker 2: So what the evidence, yes, but what the evidence shows

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Speaker 2: is that you know you can get there are practices.

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Speaker 2: You know, there are appointments available on the day and

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Speaker 2: that's part of the accreditation. But we know that they

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Speaker 2: get leveled quickly and it's really varies around the countryside.

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Speaker 2: But what we also need to be doing is general

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Speaker 2: practices is thinking, okay, how can we go that they

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Speaker 2: bit more flexible, look at the models of care to

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Speaker 2: make sure that you know, we have access to patients

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Speaker 2: and also ensure that those who need you see the

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Speaker 2: doctor the most do and get rid of the red

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Speaker 2: tape that you know, really there's a lot of paperwork

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Speaker 2: that gets done that takes away from seeing patients face

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Speaker 2: to face.

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Speaker 1: Yeah, a GP clinics lost to doctors wanting to be

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Speaker 1: in the hospital system because of better better hours, better conditions,

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Speaker 1: may be better pay maybe or is it the other

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Speaker 1: way around of people leaving the hospital system for those

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Speaker 1: reasons to get into GEP. I mean, if I think

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Speaker 1: if it was that you wouldn't have the problem you have.

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Speaker 2: I guess, yeah, So there is not a pay parity

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Speaker 2: between being a doctor in the community. Is a gpay

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Speaker 2: orpital doctors. So we spend the first eight years of

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Speaker 2: our training all in common, irrespective if you're a cardiologist

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Speaker 2: or a GP or a psychiatrist, and then after that

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Speaker 2: time we branch off into our specialty training hospital. You know,

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Speaker 2: non GP training is really attracted in the hospitals because

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Speaker 2: they pay a lot more. And the thing is to

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Speaker 2: get our junior doctors out of the hospital. They take

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Speaker 2: a really big page drop to come and work as GPS.

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Speaker 2: That being said, you know, there are some green shoots

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Speaker 2: that we've got an increase in number of young doctors

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Speaker 2: wanting to become GPS. That's gone up around six seven percent,

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Speaker 2: and that's also reflected in our rural areas, so that

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Speaker 2: you know there is some good news as well.

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Speaker 1: That's positive. But then on top of that, to help

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Speaker 1: that disparity grow even further is the fact the Medicare

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Speaker 1: levy bulk billing issue and so doctor's course to do

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Speaker 1: that to try and keep up so funday.

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Speaker 2: Of general practice. You know, it's dropped from around seven

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Speaker 2: percent to five point seven percent of the healthcare budget.

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Speaker 2: And we know, you know, if you see a GP,

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Speaker 2: people live happier, longer, healthier, So we want to flip

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Speaker 2: the system and calling on a government to you know,

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Speaker 2: put ten percent of the healthcare budget in the general practice,

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Speaker 2: which is what they've now called on for in the UK.

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Speaker 2: And if we keep people in the look after them

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Speaker 2: in the community, we keep people out of hospitals, we

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Speaker 2: keep people away from you know, those ramping ambulances.

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Speaker 1: Well that's exactly it. And if the GP system worked well,

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Speaker 1: then people wouldn't be turning up in eds and causing

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Speaker 1: all the issues in hospitals. So the funding on one

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Speaker 1: hand helps. At the other end, it.

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Speaker 2: Does so funding drives outcomes. So if we fund general practice,

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Speaker 2: then we're not going to have the problem at the

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Speaker 2: end of the line, which is people queuing up in

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Speaker 2: the hospitals and emergency department.

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Speaker 1: Absolutely right, Nicole, thank you for your time, pleasure.

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Speaker 2: Thank you doctor

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Speaker 1: Nicole Higgins there who is President Royal Australian College of GP.