The Australian Institute of Health and Welfare has today released another valuable report on the number of doctors working in various capacities and in various parts of Australia. For this it is to be thanked. The fact that this latest information still does not give a clear understanding of comparative doctor availability across the country is due to factors beyond the Institute’s control.
It is good to have a count of ‘general practitioners’ rather than of ‘primary care practitioners’, but the fact that the report’s estimates have had to be made without numbers from Queensland and Western Australia is, in this day and age, quite extraordinary. The reason is that medical registration in those States “did not close until after the national registration deadline of 30 September 2010”. So much for the notion of Australia as a single nation and for the pace of harmonisation.
Nor can the Institute be held responsible for what many will see as the fatal flaws of the regional analysis of employed medical practitioners. One of the Report’s headlines is that the supply of doctors as a whole (GPs plus others) in Outer regional areas improved between 2006 and 2010. And in 2010 there were almost the same numbers of GPs (Full Time Equivalent) per 100,000 people in Inner regional (108), Outer regional (103) areas and Major cities (105).
These headline numbers obscure three facts. First, the FTE number in the regional areas is boosted by the fact that GPs in those areas are working longer hours: an average of 38, 40 and 44 hours per week in Major cities, Inner and Outer regional areas respectively.
Secondly, as one moves from Major cities to regional and then remote areas, the nature of a GP’s work changes with the changing practice landscape. This is most obvious in terms of the amount of time the doctor needs to spend travelling to see patients in different areas and settings (eg moving between the surgery, the hospital and the aged care facility – something city GPs rarely do). So the same number of full-time equivalent doctors ‘on the ground’ does not equate to the same number ‘seeing patients’.
Thirdly, some of those in the know will scoff at any analyses using the Inner and Outer regional classification (the dreaded ASGC-RA) because of its anomalies. The Outer regional class, ASGC-RA3, includes both Urana, town population 800, and Townsville, population 180,000.
In the interests of the people of rural and remote areas, it is to be hoped that the reported improvements in the supply of doctors and GPs are being shared by the Uranas of Australia as well as the Townsvilles.
It will need a clearer and simpler system of reporting the facts to know whether this is so.
Gordon Gregory - Executive Director: 02 6285 4660