RACGP: Future of general practice care is unsustainable

Royal Australian College of GPs

The Royal Australian College of General Practitioners (RACGP) has urged government to secure the future of general practice care so that no patients anywhere in Australia are left behind.

It comes via the college's General Practice: Health of the Nation 2022 report, an annual health check-up on general practice in Australia.

RACGP President Adj. Professor Karen Price has called for urgent action to address the challenges confronting general practice.

"The future of general practice care is in crisis and it's not of our making," she said.

"If general practice were a patient, I would say that it had several serious underlying health conditions that if not properly addressed will lead to grim outcomes. Unless things change, more and more practices will face the impossible decision of hiking fees for patients or closing up shop. Just 13.8% of future doctors are choosing general practice as their career and sourcing and retaining GPs has now become the highest priority challenge reported by practice owners in 2022. The disrespect and disinvestment in general practice has had predictable and shameful effects.

"Government can help secure the future of the GP workforce by immediately boosting investment in general practice care so that it is put on a more sustainable, long-term financial footing. This will help ease the pressure on vulnerable patients, their GPs, and general practice teams. Proper resourcing will help attract more future doctors to the profession and make sure all patients, including those in remote and rural areas, get the care they need when they need it.

"Almost half of all GPs surveyed for this report said it is financially unsustainable for them to continue working as a GP and our hands are tied in terms of what we can do. The primary reason GPs choose to bulk bill is because their patients, especially those with multiple serious health conditions, cannot afford to pay.

"The latest annual Medicare data shows that there has been a decrease in bulk billing across Australia and that should come as no surprise to government. Medicare rebates are insufficient to cover the cost of providing care. When we asked GPs why they choose to bulk bill, just 3% said it was because the rebate was sufficient. All of this clearly demonstrates that hardworking GPs and general practice teams are finding it increasingly unsustainable to provide care. Urgent action is needed to give general practice an immediate restoration of funds lost through the Medicare rebate freeze plus an appropriate further investment and rebalancing of health system funding."

The RACGP President also called for government to ease the excessive administrative burden on general practice.

"Let's cut the red tape and let our GPs and general practice teams get on with the job of doing what we do best – providing world-class care to our patients," she said.

"What we have are highly trained skilled professionals who know what they are doing being harassed with robo-audits. The odd bad apple should of course be subject to rigorous compliance action but the near constant looking over the shoulder of GPs must stop. It is hardly surprising two-thirds of GPs surveyed for this year's report identified 'understanding and adhering to regulatory changes' as a challenge and that is particularly galling when you consider that this red tape administrative work is largely unpaid time for harassed GPs.

"In addition, more than three-quarters of survey respondents said that ensuring compliance with Medicare takes time away from actually caring for their patients. It's important to consider the toll that this takes on GPs, with 61% reporting that the complexity of Medicare is something that worries them outside of their work day. The near constant threat of compliance action hanging over GPs also affects the type of care delivered. In this year's survey, 47% of GPs indicated that they either avoided providing certain services or avoided claiming patient rebates, despite providing services out of fear of Medicare compliance ramifications. This is ridiculous, it is causing undue stress on GPs and impacting access and affordability of care. Let's get on with our job and find alternative work for those employed in misdirected bureaucracy."

Adj. Professor Karen Price warned that unless general practice care was made a priority the situation would only worsen.

"GPs and general practice teams are doing a tremendous job, but the pandemic and recent natural disasters have made the job even more challenging," she said.

"Almost three in four GPs reported they have experienced feelings of burnout over the past year and less than half of GPs would recommend their profession as a career to junior colleagues. Being a GP is such a rewarding career; however, more needs to be done to make sure this profession is adequately supported and valued. Until that occurs, future doctors will continue to opt for other specialities and more and more GPs will throw their hands in the air and quit. GPs are well placed to find other employment. The ball is in the Government's court and action is needed right away. Unless that occurs, the health of the nation will deteriorate."

The RACGP's Vision for general practice and a sustainable healthcare system outlines the urgent need to restructure the healthcare system into one that provides the right care for patients at the right time and in the right place, and that is sustainably funded into the future.

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