Almost three out of five GPs reported managing patient expectations about vaccinations to be one of the most challenging issues of the pandemic, with multiple changes to vaccine eligibility requirements leaving many people confused and overwhelmed, the president of the Royal Australian College of General Practitioners, Dr Karen Price, said.
In her foreword to the college’s Health of the Nation report, published on Thursday, Price said: “Unfortunately, some of these patients took their frustrations out on general practice staff”.
“Differing eligibility requirements across jurisdictions added to the strain.”
The report is published annually and provides an insight into the state of general practice in Australia. It includes the findings of a survey of 1,386 GPs between April and May, of which 70% were in major cities, 20% inner-regional, 8% outer‐regional, and 2% remote and very remote.
Of concern to the college and exacerbating challenges of the pandemic is that not enough junior doctors are choosing a career as a GP, the report said.
“Our workforce is ageing, with the proportion of GPs over the age of 65 increasing from 11.6% in 2015 to 13.3% in 2019,” Price said.
At the same time, not enough medical graduates want to be GPs. The proportion of final-year students listing general practice as their first-preference specialty has fallen to just 15.2% – the lowest since 2012.
“International medical graduates will continue to play a crucial role in bolstering the GP workforce; however, we must also grow our locally trained workforce,” Price said. “We also need more GPs to practise outside of major cities.”
GPs are also increasingly seeing patients with mental health concerns. For the fifth consecutive year, psychological conditions including sleep disturbance and depression were the most reported reasons for patient presentations to GPs. Over 70% of GPs selected “psychological” in their top three reasons for patient presentations, a number that has risen steadily from 61% in 2017, the report said.
“To help these patients in need, we need new Medicare items for longer mental health consultations so we can really get to the bottom of what is going on,” Price said. Of the survey respondents, 26% ranked Medicare rebates as their highest priority.
Price called for more secure, long-term funding from the federal government, saying; if the government is serious about boosting the general practice workforce of the future so all patients can continue to access high-quality general practice regardless of where they live, it is vital that this is reflected in long-term funding arrangements”.
The report found GPs in rural and regional areas are more likely to report a deterioration in their work–life balance compared with GPs in metropolitan areas, while GPs in Victoria are the most likely to report a negative effect on their wellbeing, with more reporting effects on their work–life balance and physical health compared with GPs in other states.
“This likely reflects the impact of Victoria’s prolonged Covid-19 lockdown in 2020,” the report found.
In a speech to launch the report, the Greens leader, Adam Bandt, urged a one-off blitz starting next year to clear urgent public hospital surgery lists that have been under pressure during Covid, and supported calls from premiers for a fairer federal-state split for hospitals funding to boost public hospital resources.
State health departments this month called for commonwealth crisis funding to help manage the expected pressure on hospitals as restrictions ease across the country and Covid-19 infections spike.
Bandt said the cost of these measures could be covered by abolishing the private health insurance rebate, which he said would return $59.4bn to the public health system over a decade, which could be spent on getting mental and dental health into Medicare.
Bandt said the Greens would pursue these policies in balance of power after the next election if a minority Labor government is elected.
“Each year, the public hands $6.7bn to the private health sector, where four big corporations control 70% of the market and make large profits off the back of public largesse,” he said.
“There are better ways of spending $7bn a year than giving handouts to big corporations … We want to stop giving handouts to the billionaire corporations in the private health industry, and put that money back into the public health system.”
The Royal Australian College of General Practitioners rural chair, Dr Michael Clements, said everyone deserves to be able to access a good GP, no matter their postcode. The report showed promise for the future of rural medicine, with two out of five (44%) GPs in training reporting that they intend to work in urban areas post-fellowship, a larger proportion (48%) plan to work in rural or a mix of urban and rural locations.
Clements said the trend was promising for the future of rural general practice, despite considerable challenges.
“Of course, we know this is not the reality – in many parts of rural and remote Australia the shortage of GPs is at crisis point,” he said.
“We know that the lack of access to high-quality healthcare is impacting people’s health and wellbeing. People in rural and remote communities are less healthy overall and experience higher rates of chronic conditions and shorter life expectancies.”