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Size counts as incentive change helps some, costs others

GPs working in some of the nation’s smallest towns and most remote communities are set to receive a hefty increase in Commonwealth subsidies, while around 5000 working in major regional cities will lose thousands of dollars in incentives under changes to a program intended to attract doctors to work in rural areas.

Assistant Health Minister Fiona Nash has announced that incentives for doctors to live and work in 450 small towns across the country will be raised under changes to the GP Rural Incentives Program (GPRIP).

Under the changes, the annual incentive for doctors working in towns with fewer than 5000 residents will increase from $12,000 to up to $23,000, and the incentive for practitioners working in remote areas will be increased from $47,000 to as much as $60,000.

But the qualifying time to receive the incentive has been increased from six months to two years for doctors in rural and regional areas, while doctors in remote locations will have to wait 12 months.

And an estimated 5000 doctors working in regional centres with a population of more than 50,000 will lose their incentive payments under the changes, which come into effect from 1 July.

The change is being implemented as the AMA lobbies the Federal Government to establish a training program to give junior doctors experience in a rural general practice.

The AMA has urged the Commonwealth to adopt the recommendation of the Independent Expert Panel – which it established to advise on the redesign of the GPRIP – for the introduction of “a program that provides a high quality community medicine and general practice training in rural and remote areas through extended placements for junior doctors”.

The recommendation follows the Government’s decision last year to scrap the Prevocational General Practice Placements Program, which left general practice as the only major specialty without a program for prevocational training experience – something AMA President Associate Professor Brian Owler said was vital to sustaining and building the GP workforce.

“This sort of experience can influence junior doctors to pursue a career in general practice, and it can also give doctors who choose other specialties a valuable insight into how general practice works,” A/Professor Owler said. “A carefully targeted prevocational GP training program can also help boost rural and remote workforce numbers”.

The GPRIP has been overhauled following the Government’s decision late last year to dump the discredited Australian Standard Geographical Classification – Remoteness Area (ASGC-RA) classification system and instead use the Modified Monash Model (MMM) to guide the allocation of resources.

While doctors in large regional centres will lose incentives payments under the revamped incentives system, Senator Nash said the new arrangements were much better aligned with community need.

The Minister said under the current system, around $50 million was being paid out each year to doctors working in 14 large regional centres, including Townsville and Cairns.

The scheme created incentives for doctors to remain in well-serviced cities which had little trouble attracting doctors, she said.

“The new GPRIP system will deliver a fairer system for smaller towns; redirecting money to attract more doctors to smaller towns that have genuine difficulty attracting and retaining doctors,” Senator Nash said. “It makes more sense to use that money to attract doctors to where the greatest shortages are – small rural and remote communities, not big regional cities. This means bigger incentive payments will go to doctors who choose to work in the areas of greatest need.”

The AMA was among several health groups that welcomed the move to dump the ASGC-RA classification system and replace it with the Modified Monash Model, but had urged the Government to include transition arrangements for any changes to incentive payments.

The Association said it would assess the impact of the Government’s decision to cut incentive payments to GPs in large regional centres from the beginning of next month.

Adrian Rollins