Rural health near crisis point
By ANNA PATTY
29jan02
The Daily Telegraph
By NSW country health services are in crisis, with more than a third of bush doctors about to retire and younger graduates reluctant to replace them.
A Rural Doctors Association (RDA) survey, obtained exclusively by The
Daily Telegraph, has found 70 per cent
of the existing rural workforce will
retire within 10 years, with most doctors now aged over 50.
The RDA survey found ageing GPs were working longer hours, while rising insurance premiums were forcing others to shun essential services such as obstetrics, anaesthetics and surgery.
Dr Peter Wong, the only full-time
GP in Dorrigo, retired aged 50 on December 31 -- leaving up to 3000 people in the town and surrounding plateau without a local doctor.
Working 12-hour days seeing his 2700 patients, he hardly had time to realise his three-month training stint in the town had turned into 22 years.
In contrast, a GP in Sydney's eastern suburbs sees about 400 patients. "Here, I'm it," Dr Wong said. "I'm dealing with skin problems, emergencies and post-mortems. I'm a jack-of-all-trades."
Younger GPs, especially women who make up 60 per cent of medical graduates, increasingly want to work part time and not take up procedures including surgery, obstetrics and anaesthetics.
The RDA survey canvassed 409 doctors who care for an estimated 600,000 patients.
Conducted in December, the survey found that female doctors made up 36 per cent of the rural workforce under 40.
A total of 33 GP obstetricians surveyed said they did not think they would be in the bush in five years' time and 130 said they would leave within 10 years as they were nearing retirement age.
Of the 93 GPs practising anaesthetics, 22 said they would leave rural NSW in five years and 55 said they would leave in 10 years. Of the 49 surgeons surveyed, 14 said they would leave the bush in five years and 33 within 10 years.
Moree procedural GP, Dr Ken Woollard, who organised the RDA survey, said there was "an enormous emphasis on training to support metropolitan health services, with neglect of the training of multi-skilled doctors required for the bush."
NSW RDA president Dr Sue Page said newly-trained doctors wanted to work fewer hours than their full-time predecessors.
"As the doctors are getting older, they are also working more than their fair share," Dr Page said. "About 35 per cent of rural doctors are near retirement age and doing 40 per cent of the work."
According to Dr Page, a quarter of male doctors want to work part time, but few part-time options are available in country areas.
National AMA president Dr Kerryn Phelps said doctors were finding it hard to attract casual doctors (known as locums) to fill in for them temporarily. "Rural doctors are going years without a holiday, working on-call 24 hours a day, 365 days a year," she said.
The Federal Government has launched a range of training initiatives and incentives, including rural bonded scholarships to attract and retain young doctors in the bush.
Health Minister Kay Patterson said the long-term initiatives would take several years to bear fruit.
Prime Minister John Howard soon will hold a summit to address the issue of rising medical indemnity insurance for doctors.
The NSW Government last month announced it would cover indemnity costs for all doctors caring for public hospital patients.