AN understaffed and subsequently overstretched SA country GP workforce is once again in the spotlight, with the opposition heavily criticising the state government for not addressing key issues surrounding the state's rural health system.
Opposition health spokesperson Chris Picton said inadequate remuneration and working conditions for rural GPs, "band-aid" solutions to address workforce shortages, and concern surrounding still-closed emergency departments were key areas that needed attention.
"The state government is stonewalling country doctors in their attempts to save the future medical workforce of rural and regional SA," Mr Picton said.
"The Rural Doctors Association of SA has heard directly from medical students who are eager to work in SA, but are moving instead to Qld due to the pay and conditions offered there.
"For us to be losing passionate up-and-coming doctors to Qld just shows how ludicrous the situation has become."
Gumeracha Medical Practice GP Chris Withnall agreed that working conditions in other states were far more lucrative for rural doctors.
"I worked in Cooktown, Qld, as a junior doctor, and I got a house, a car, and payment every time I was called in, and at that time, I wasn't even fully qualified as a GP," he said.
If you've got the choice to do the same work in two locations, you'd go to the one which pays better, even if you love the other one.
- LYN MOLINARO
"Outside SA, there is a salary to provide service, rather than a fee-for-service, which is what we have here.
"Our current remuneration doesn't really include any payment for being available, we're only paid if we go and see a patient, for the time we spend with the patient."
Dr Withnall said the problem "isn't just about the money", but about being on a level playing field for the sake of attracting and keeping doctors in rural areas - a statement echoed by the clinic's practice manager Lyn Molinaro.
"If you've got the choice to do the same work in two locations, you'd go to the one which pays better, even if you love the other one," she said.
RELATED READING: Rural GP agreement gridlock dragging on
Two months ago, Gumeracha Medical Practice had eight full-time doctors, but three have since left, with one other having taken extended leave.
Ms Molinaro said seeking a better work-life balance with less demanding on-call hours was a large factor pushing doctors away, and preventing others from joining.
"Our practice is responsible for looking after on-call services at the hospital here, and feedback from the last lot of doctors we interviewed was that they didn't want to work in hospitals, or do any sort of emergency department work," she said.
Rural emergency departments are a complex issue in themselves, with six of nine emergency departments - including Gumeracha - remaining closed, after initially closing in March 2020 to minimise the risk of COVID-19 transmission, particularly to co-located aged care facilities.
In addition to Gumeracha, EDs in Barmera, Tailem Bend, Strathalbyn, Eudunda and Mount Pleasant remain temporarily closed, while Kapunda, Penola and Karoonda ED clinics have reopened.
A statement from SA Health confirmed the closures were temporary.
We have heard serious concerns from regional communities whose EDs have stayed closed for the larger part of 18 months.
- CHRIS PICTON
"We are carefully considering and planning ED re-openings to ensure they can support service delivery safely, sustainably and with the appropriate level of resourcing, local GP support and medical workforce," it read.
But Mr Picton said a lack of information about potential reopening was not fair on rural communities.
"We have heard serious concerns from regional communities whose EDs have stayed closed for the larger part of 18 months," he said.
"(Health Minister) Stephen Wade needs to properly explain: are these EDs ever going to reopen, and will the previous standard of care still be offered to these communities?"
Mr Wade did not directly respond to Stock Journal questions surrounding how the EDs would run when reopened.
"Whilst I am not directly involved in the rural doctors contract negotiations, I appreciated getting an update on them," he said.
"Building a sustainable rural medical workforce is a high priority for the Marshall Government. The Rural Generalist Program is a key initiative in our $20m Rural Health Workforce Strategy."
Mr Wade was part of a meeting with Rural Doctors Association of SA president Peter Rischbieth, Australian Medical Association SA president Michelle Atchsion and vice president John Williams on Thursday last week, in which the SA Rural Medical Fee Agreement was discussed.
Dr Atchison said that during a productive meeting, Minister Wade listened to an explanation of doctors' concerns about the SARMFA contract offer and the ongoing impact of the issue on health services in rural communities.
"Discussions are continuing about the best way forward," Dr Atchison said.
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