Global Awards News

LONDON: A medical team is growing its practice via an “innovative” model of care, whilst most other rural medical centres are in decline.

While other medical centres in regional Tasmania struggle to retain GPs, the Cygnet Family Practice boasts seven permanent doctors, who have lauded its “great” workplace culture and “innovative” model of care.

“It really is a wonderful place to work, as I know many other practices in Tasmania are also,” Dr Maureen Ryan said. “I think we’re just in a fortunate time to have as many doctors working with us as we do.”

Dr Ryan, who lives in Cygnet with her husband and three children, has worked in the town for the last seven years. In that time, just one GP has left the practice.

“Our workplace has a great culture and value for the health of our staff and our patients,” she said.

“Working in a team of enthusiastic practitioners who are passionate about health is fun.”

The Cygnet Family Practice employs registered nurses and a nurse practitioner in addition to its seven GPs, allowing it to adopt a collaborative model of care.

Owner Kerrie Duggan, who is also the sole nurse practitioner at the practice, said each profession had its own skill-set and when they were used in concert with each other “healthcare works better for the patient”.

“Nurses generally are experts in wound care and immunisation … and this enables GPs to focus on patients with medical needs,” she said.

Ms Duggan said the fact that the Medicare Benefits Schedule had not kept pace with the consumer price index meant that doctors working in rural and regional Australia would have to “see more patients in less time” to earn salaries comparable to their urban counterparts.

The Cygnet Family Practice, however, has found a solution to that problem.

“GPs have been drawn to our philosophy of kind, holistic healthcare and have stayed because they have additional nursing support,” Ms Duggan said.

Tasmania’s shortage of GPs in rural and regional areas must be urgently addressed to prevent the state’s health system from buckling under additional strain, a top doctor has warned.

As of March this year, there were 60 GP vacancies across the state, with the Dover and Geeveston medical centres in the Huon Valley being just two recent examples of facilities needing permanent doctors.

Royal Australian College of General Practitioners president Karen Price said shortages were occurring nationwide and the federal government needed to be doing more to incentivise GPs to move to rural, regional and remote parts of the country for work.

“If GP workforce problems aren’t addressed, patients won’t be able to access the care they need and the flow-on effects will be felt throughout Tasmania’s entire health system,” Dr Price said.

“Poor access to general practice care leads to some patients ending up in a hospital bed for a health problem that could and should have been managed by a GP – a scenario in which no-one benefits.”

Dr Price said that while the delivery of primary health care was a Commonwealth responsibility, there were actions the Tasmanian government could take to help fix the problem, such as establishing a grant program to encourage GPs to train in communities “where they are needed most”.

The RACGP wants Medicare rebates, which have been frozen since 2014, to be increased, believing that further investment in general practice is needed in order to attract more doctors to the profession and ensure that patients receive high-quality care.

Many of the struggling general practices in rural and regional Tasmania are owned by councils, which the state’s peak local government body says is unfair on ratepayers.

Dion Lester, the chief executive of the Local Government Association of Tasmania, said owning and running medical centres was not “core business” for councils, regional or otherwise.

“Providing these medical facilities and local practices comes at a big cost for these councils and the local community,” he said.

Mr Lester said councils would often try to sell or sublease their medical practices but received little to no interest from the private sector because they weren’t seen as profitable enterprises.

“In circumstances where private sector operators cannot be secured, state and federal governments must provide financial and other support for those local councils responding to community needs and running these facilities,” he said.

In 2021, a patient attending their GP was $41.12 out-of-pocket on average after receiving the $38.75 Medicare rebate. However, patients in remote and very remote communities faced higher costs.

The newly elected federal Labor government has pledged to spend $250m a year for the next three years on “strengthening Medicare” but that won’t include an increase to the rebate for GP services.

A Senate inquiry into general practice in outer metropolitan, rural and regional areas released its interim report in April, recommending that the federal government look into “substantially increasing” Medicare rebates for general practice consultations.

Meanwhile, in Tasmania, a Legislative Council inquiry into rural health services is also under way, chaired by independent MLC Ruth Forrest.

Ms Forrest said Medicare was designed to encourage 6-minute appointments “which is not long enough and thus rural practices can be financially unviable”.

“A shortage of GPs and the funding through Medicare do not support rural practice where patients tend to be more complex and often delay access to care and have more complex healthcare needs,” she said.

Premier and Health Minister Jeremy Rockliff acknowledged that some Tasmanians were “finding it difficult to make an appointment with a GP”.

He said his government was exploring ways in which general practice and the primary health sector could continue to be funded by the Commonwealth but run by the state and “fully integrated with Tasmania’s single public health and hospital system”.

“I have discussed this with the federal government in recent weeks and look forward to continuing these discussions in the months ahead to ensure that Tasmanians can get the right care, in the right place, at the right time,” he said.