ACRRM welcomes the release of the Working Better for Medicare Review Report this week which reviews key programs aimed at for enhancing the geographic distribution of doctors to underserviced areas. The report covers:

  • Sections 19A and 19B 
  • Distribution Priority Area (DPA) Program 
  • District of Workforce Shortage (DWS) Program .

The report is comprehensive, and while the College is continuing to work through the details, initial responses include:   

The College supports the report’s overall approach which seeks to maintain current policy tools while sharpening them to improve access to high-quality healthcare for rural, remote and First Nations communities. 

However, ACRRM stresses the need to recognise the fragility of rural and remote medical services to changes in policy levers. The recommendations are high level and leave scope for implemented policies to deviate from their original intent, potentially leading to serious adverse consequences for rural services. 

ACRRM will work closely with government as these policies are developed and rolled out.  

Key points from the report include:

  • A key recommendation is for changes to the District Priority Area (DPA) program which enables international doctors to work in areas of workforce shortage. Previous changes extending eligibility under the program saw many doctors in remote areas moving to positions in urban and regional centres. The College welcomes the recommendation for a more nuanced application of the DPA but sees risk in the proposal to dispense with the MMM system as a blanket qualifier for eligibility, in favour of a localised-need approach based on GP catchments. While imperfect, MMM provides some guarantee that rural and remote locations’ needs are not overlooked. While this can be achieved on a case-by-case basis, there is a risk of eligibility creep toward shifting priorities. ACRRM considers it critical that rural and remote areas’ service needs are viewed at scale, to ensure this perspective is not lost going forward. 
  • ACRRM is pleased to see recognition in the report given to the College’s unparalleled success in establishing a training and support pathway that creates rural and remote doctors that stay rural, and its 91%, 89%, 82% rural retention rates of AGPT graduates at 1, 3 and 5 years post-Fellowship. The College welcomes the inclusion of recommendations seeking to strengthen incentives to ensure college rural workforce outcomes are measured and incentivised. 
  • ACRRM welcomes other recommendations including:
    • ensuring rural supervision is sufficiently remunerated 
    • fine-tuning the caps on medical student numbers to better align with rural shortages 
    • providing better supports for rural nursing and allied health training, and 
    • aligning developments with the scope of practice review and Closing the Gap priorities. 

    ACRRM provided a submission to the review in April 2024 detailing its position on the relevant programs. 

    Please feel free to contact the policy team with any queries or comments at policy@acrrm.org.au.