Senate inquiry told woman's health in remoter areas is a concern

The Senate's Community Affairs References Committee took statements from primary health services from across Tasmania and Australia, discussing the issues and possible solutions for the state's struggling primary health sector.

Atop the list of issues raised was the state's ability to attract and retain general practitioners.

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One of the doctors to provide evidence to the inquiry was Launceston-based GP Dr Jerome Muir Wilson who said the system was failing to adequately remunerate those working in remote areas.

He said the health sector could look to other industries that had managed to create and retain a workforce in remote locations - such as the mining industry.

Dr Muir Wilson said developing a fly-in fly-out model which rotates doctors through the community and paid a competitive rate could help retain GPs who often left due to burnout or lack of community facilities.

He said the model would give GPs the option to live in an area that suited their lifestyle when off rotation, and a greater continuity of care by maintaining a long-term workforce who could build a connection within the region they worked.

Newstead Medical practice partner Dr Toby Gardner also provided evidence to the committee in relation to retaining workers.

He said the profession was not being promoted as much as others at the university level and said having more GPs in teaching positions was one way to engage students and promote the profession.

Dr Gardner said while remuneration was important and should remain a focus, support and mentoring for those looking at the profession was equally as important to retain staff.

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Responding to a question by committee chairperson senator Janet Rice on staff retention, Eastern Victoria GP Training director of medical education and training, Professor Neil Spike said understanding the needs and the health issues of individual communities was imperative in recruiting the right staff.

He said it was clear that doctors from remote and rural areas were more likely to return and stay in similar communities, and stressed that a local understanding was still needed at a national level.

Increasing the role of local government authorities in the process was an item raised by Derwent Valley Council general manager Dean Griggs.

Mr Griggs said the region - which relied heavily on agriculture and tourism - had less of an issue with recruiting GPs than it did with retaining them.

He said a practice in the region had recently lost four GPs, but four more had been recruited and were expected to begin shortly.

Mr Griggs said the revolving door of GPs meant it was difficult for community members to build a relationship with their primary health providers.

Responding to a question by senator Anne Urquhart about waiting times, Mr Griggs said residents in the region could wait up to six weeks to be seen by a GP for chronic conditions, while others were being forced to present at a hospital.

Mr Griggs also raised concerns about the classification of certain regional clinics under the Modified Monash Model, claiming some clinics were at a loss under the national classification.

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Women's health services have also been impacted by the shortage of primary health and support services in regional locations.

Women's Health Tasmania chief executive Jo Flanagan provided evidence via teleconference and said with low levels of health literacy in the regions, many women did not understand basic health issues placing increasing reliance on GPs.

Ms Flanagan said many women were putting off visiting their GP due to high costs and challenges presented with access like long travel times to and from clinics.

She said there was a demand for additional services that could support GPs which should be considered when discussing possible solutions for GP shortages.

Ms Flanagan pointed to nurse practitioners as a viable alternative to general practitioners, saying roles existed for NPs along with support services including mental health professionals and social workers.

She said a holistic range of services would help address the intersection of health issues experienced by women in remote areas and reduce the pressure on any one individual service.

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Changes to the way GPs will be trained in the future were raised by General Practice Training Tasmania chairman Paul Viney and chief executive Judy Dew.

Under changes to the training model, the training of GPs is set to move to the Australian General Practice Training Program, administered by the Royal Australian College of General Practitioners and The Australian College of Rural and Remote Medicine.

Mr Viney said changes to the system should be deferred until 2025 to allow time for further consultation, which would allow for more preparation, saying any changes should not be done in the middle of a pandemic.

"I ask you to consider this question, we are in the middle of a once in a century pandemic, would you even consider undertaking this radical change to GP training if the process hadn't already started," he said.

Mr Viney said only yesterday the training organisation announced 35 new general practice registrars were to commence their training with the organisation.

Andrew Chounding is The Examiner's Health Reporter, if you have a health-related story please email Andrew.chounding@examiner.com.au

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