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Dump flawed rural classification system now: AMA, RDAA

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The Abbott Government has been urged to make replacement of the flawed remoteness classification system for doctor incentives a top priority.

At a meeting on 18 February, the AMA and the Rural Doctors Association of Australia issued a joint call for the nonsensical Australian Standard Geographic Classification – Remoteness Areas (ASGC-RA) system to be dumped and replaced with a scheme that accurately reflects the situation confronting small rural communities.

The shortcomings of the ASGC-RA system have led to a host of incongruous outcomes, such as classifying well-serviced regional cities as being more remote (and hence, entitled to greater incentives) than many smaller rural settlements.

This can mean that doctors working in large regional centres receive greater incentive payments than do those working in small, remote communities, making it extremely difficult for them to compete for medical practitioners.

The system’s deficiencies were acknowledged by former Health Minister Tanya Plibersek when she addressed the AMA National Conference last year, and AMA President Dr Steve Hambleton said the Coalition Government was also acutely aware of the ASGC-RA’s terminal flaws.

“We know that Health Minister Peter Dutton and Assistant Health Minister Fiona Nash are well aware of the significant drawbacks of the ASGC-RA classification system, and the negative impact it has had on many small rural communities,” Dr Hambleton said.

“But action is now long overdue, and rural doctors and communities are starting to wonder how long they are going to have to wait to see some improvements.”

RDAA President Dr Ian Kamerman said the system caused particular hardship for small rural communities, who often found it difficult to attract and retain doctors.

“Rural doctors provide a wide and vital range of services in these smaller communities,” Dr Kamerman said. “The doctor you see in their practice is often the same one delivering your baby or treating your heart attack at the local hospital. A classification system that cannot take this into account – and cannot tell the difference between Townsville and Tumut, or Cairns and Cowra – is obviously flawed.”

Both the AMA and the RDAA back the modified Monash Model of rural classification, which was developed based firmly on evidence, and which incorporates a range of factors such as population size that are not included in the ASGC-RA.

But both Dr Hambleton and Dr Kamerman stressed that in introducing and evaluating any replacement to the ASGC-RA, key stakeholders must be closely consulted and involved.

Adrian Rollins