The RACGP has revealed that more than 60 GP practices have closed across Australia since 2019.
Feedback submitted in RACGP member reports showed that the 60 closures, which have primarily occurred in regional areas, were the result of low Medicare rebates and not being able to recruit enough GPs.
In WA, Toodyay most recently lost the Alma Beard Medical Centre in November last year, even with support from the shire council, which provided 10 years’ rental subsidies for the clinic. At the time, CEO of the Wheatbelt Health Network (WHN), Ms Catherine Milliner, said that regional practice was becoming unsustainable.
“Although managing a general practice in the regions is always challenging, this has become even harder as a result of reducing incentives and the increased cost of living and wages with no corresponding increase to the Medicare rebate,” she said.
The story across Australia is the same.
The most recent and relevant investigation, the 2021 Health Sector Report, Trends in the structure and financial health of private medical practices in Australia, by Professor Anthony Scott from the school of Applied Economic and Social Research at the University of Melbourne, showed that despite profits rising by an average of 2.4% a year for GP businesses and 5.3% a year for non-GP specialists between 2005-6 and 2020-21, costs for GPs rose by an average of 2.7% a year and 2% for non-GP specialists over the same period.
Turnover from total fees charged grew by 2.9%. and 3.5% respectively.
“Overall, the growth in costs for GP businesses was higher than for other specialists, and the growth in turnover was lower,” Professor Scott said.
“This gap between costs and turnover has grown over time.”
Given the private business model under which most general practices operate, current data for total WA clinic closures are challenging to ascertain, as the healthcare system only tracks individual doctors, however, GP recruitment specialist Rural Health West currently has 91 positions listed.
The latest report from the WA Department of Health (DoH), General practice workforce supply and training in Western Australia 2018, noted that by 2025, based on the number of GPs entering the system, WA would be between 408 and 974 doctors short of anticipated demand – even without the closures.
“GP demand modelling is complex and further work is required to validate shortfall figures and quantify future demand,” the report said.
“However, multiple modelling data sources suggest that the VRGP workforce in WA is insufficient to meet demand, and that existing (2018) shortfalls will increase to 2025.”
The most current data on the workforce was produced by Deloitte Australia, and their General Practitioner workforce report 2022 estimated that in 2021, WA had a GP Full Time Equivalent (FTE) of 3,684, yet in addition to 187 GPs retiring in 2021, 147 were estimated to join them in 2025, with 23 and 18 deaths, respectively.
Yet only 120 domestic registrars joined the workforce in 2021, with 127 predicted for 2025, and while 117 GPs arrived in WA in 2021, the report warned that the effects of the pandemic on immigration could further reduce capacity.
That will put on a lot of pressure on the GP colleges, RACGP and ACRRM, which have taken over GP training as of the start of this year.
RACGP President Dr Nicole Higgins pointed out that the current workforce shortages were partly a result of consecutive governments underfunding general practice care.
“That so many practices have been forced to close because Medicare rebates don’t come near the cost of providing care is an immeasurable loss for communities across Australia,” Dr Higgins said.
“So much is lost that cannot be measured when a community loses a practice and patients must find another clinic. You can move health records, but not the relationship a patient had with their GP, and the trust and knowledge that GP gained over years of consultations.”