Rural towns do not have 50,000 people living there - doctors group

This is the claim of the Rural Doctors Association of Australia which says the government has got its methodology all wrong.

A "rural town" can have a population of 50,000-100,000 people under the current arrangements, the association says.

"To deliver more of the right doctors with the right skills to rural communities, the crucial first step is to understand what is a 'Real Rural' town ... and what isn't," association president Dr John Hall said.

The government has a number of well-funded programs which aim to deliver doctors to small rural communities.

But according to Dr Hall, larger regional centres are able to siphon that support away because of the "clumsy" rules in place.

The heart of the complaint is the Modified Monash Model which is a formula based on census results and used across government departments to determine which category an area falls into.

The model measures remoteness and population size on a scale from MM1 to MM7 - MM! is a major city and MM7 is very remote.

The doctors' association claims many of the workforce measures funded by the government to recruit and support rural doctors are available to MM2.

It wants the rules changed to MM3-7 only.

Under the model, in MM2 the regional area includes "a town with a population greater than 50,000".

MM3 includes "a town with a population between 15,000 and 50,000".

Regional Health Minister Mark Coulton said: "The government is committed to improving health access and outcomes for Australians living in rural and regional areas of the country, however recognises taking a 'one size fits all' approach does not always allow programs to meet their objectives.

"That's why we are backing new models of primary care developed at the grassroots by rural and remote communities and flexible training arrangements for Rural Generalists through the Murrumbidgee model."

The Murrumbidgee model, launched in October in Wagga Wagga, will give junior doctors, interested in working in rural general practice in the Murrumbidgee region, the experience, exposure and qualifications they need to become rural generalist doctors - GPs with additional skills such as obstetrics or emergency medicine.

"The government invests large sums to improve rural health outcomes and it is vital that this funding is directed to best achieve this," Mr Coulton said.

Dr Hall said government funding must "ensure measures are targeted to entice doctors" to the areas they are most needed.

Examples of Commonwealth programs which apply to large regional centres and suburban centres, as well as small rural towns, include the Bulk Billing Incentive, the Australian General Practice Training Program Rural Pathway, Rural Junior Doctor Innovation Fund rotations, and the Specialist Training Program.

"The time has come for the government to rework clumsy measures that are not 100 per cent effective in delivering doctors to small rural communities - and instead, at times, encourage doctors to work in larger regional cities and suburban centres," Dr Hall said.

"This is because numerous measures designed to entice doctors to small rural communities are currently also available to doctors in very large centres.

"The Commonwealth is investing well over $1 billion every year to address the significant maldistribution of the medical workforce, and improve access to care for rural and remote Australians.

"But large regional centres are absorbing the bulk of this funding.

"It is time to ensure these dollars are invested into rural and remote communities where the struggle to recruit and retain doctors is real.

"Doctors in large regional cities and suburban centres generally work 9am-5pm, often live away from their 'work life' (and patients) via a short commute, have large tertiary hospital support nearby, and have easy access to many cultural and educational choices for them and their families.

"By contrast, doctors in 'Real Rural' towns often have significant after-hours and on-call workloads, often work both at the general practice and local hospital, and generally need to live in their communities (so they often need to interact more with patients outside work, even if unintentionally)."

"We are not saying that doctors in large regional and suburban centres do not face their own challenges, and specific pockets of these larger locations may need support measures as well.

"But the measures provided to entice doctors to 'Real Rural' locations should be different, more targeted, and more significant.

"In short, don't give rural doctors the same initiative as their suburban or regional city counterparts - give them their own."

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