Governments must involve GPs in disaster planning and prioritise reopening practices to help communities recover from natural disasters like the NSW floods, the Royal Australian College of GPs (RACGP) says.
Six GP training practices in the Taree and Forster region had to temporarily close during the recent floods, including Health Hub Taree and Awabakal Medical Service, an Aboriginal community-controlled health service in Cardiff.
Health Hub Taree GP Dr Simon Holliday says it took advocacy from local MP, Tanya Thompson, to get the power back on in his clinic.
"We had 25 centimetres of water through the place and no power for four days," Dr Holliday said.
"From when the sparkie first had a look at the place to when the power got turned on would have been 48 hours."
Dr Holliday said better planning could have allowed he and other GPs to treat members of the community elsewhere while the clinic was closed.
About 200 patients are seen at Dr Holliday's practice each day.
"Our raison d'être is to serve the public and the patients," Dr Holliday said.
RACGP Rural Chair, Associate Professor Michael Clements said the Northern Queensland Primary Health Network also had to advocate for priority return of power supply to Ingham practices affected by flooding earlier this year.
He said GPs should be front of mind in disaster planning, preparation, response, and recovery.
"When disasters happen, and in the immediate aftermath, GPs are an absolutely essential service," Associate Professor Clements said.
"GPs help people affected by trauma who have lost loved ones, homes or businesses – often they are helping people on the worst day of their lives.
"We are there to treat immediate injuries, infections and illnesses, keeping patients out of hospitals and commencing the healing process for the community straight away.
"It's vital that governments do everything they can, before, during and after a natural disaster to enable GPs doing this work." Associate Professor Clements said GPs must be formally included in national, state/territory and local government disaster and emergency planning groups and committees, including the National Emergency Management Agency.
"The Federal Government is responsible for general practice, while emergency planning is managed by state and territory governments," he said.
"Every level of government should include the capabilities of their local GPs in their disaster management planning and response.
"Dedicated funding should also be directly allocated to general practices for preparation, response and recovery from emergencies and disasters."
Medicare rules that prevent healthcare in a disaster must be changed
Associate Professor Clements also raised concerns about Medicare rules that can unnecessarily prevent some International Medical Graduates (IMGs) and GPs in training from treating patients during and after a natural disaster.
Many IMGs have specific named practice locations on their Australian Health Practitioner Regulatory Authority (AHPRA) registration, meaning they cannot legally practice elsewhere if their usual clinic is underwater.
"They are in limbo if that site floods and they are being asked to support patients from another location," he said.
"Given that we know these events will happen again we need AHPRA and Medicare to build in temporary exemptions and flexibility in declared disaster zones."
Medicare provider numbers, which are required to claim Medicare funding for a patient's care, are tied to the address of the clinic where a medical professional usually practices.
If that clinic is underwater, without power or otherwise unable to be used because of a natural disaster, provider numbers become transferable so GPs can deliver healthcare in evacuation centres and other locations.
But this exemption does not apply to IMGs and temporary residents training to become Fellows of the RACGP, meaning they cannot bill Medicare for providing medical services if forced to relocate by a natural disaster.
"These doctors are required by law to practice in rural, regional, or remote areas," Associate Professor Clements said.
"Many of these locations are at risk of natural disaster – these risks are only growing as climate change escalates.
"Medicare should enable medical professionals to contribute as part of disaster response."
The RACGP's Key recommendations for the inclusion of GPs into evacuation centres propose:
- local Primary Health Networks (PHNs) can play a critical role in establishing lists of GPs and other medical personnel who can assist in emergencies ahead of time
- general practices be designated and prioritised as essential services during disasters
- dedicated funding be allocated to general practices for preparation, response, and recovery from disasters
- reductions in red tape that affects GPs in emergencies, including Medicare compliance activities
- the RACGP and PHNs be included in national, state, territory and local government disaster and emergency planning groups and committees.
The RACGP has also created a resource to guide GPs working in evacuation centres during an emergency.
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