Rural councils shoulder economic cost of GP crisis across WA, call for federal support

Concerns are growing that the increasingly generous pay packages offered by local councils – in a desperate bid to attract and retain GPs – will be unsustainable in the long term.

Key points: The mining town of Kambalda will spend almost $900,000 over two years to secure GP services. A house built for a Norwegian GP will end up costing the shire $1.3 million. rural doctors

The regional Western Australian shire of Quairading, in the state’s Wheatbelt, has advertised a package worth more than $800,000 in a bid to lure a doctor to the town about 160 kilometers east of Perth.

In the Goldfields, the Earl of Coolgardie – 400 km further east – will spend almost $900,000 over two years to provide a GP in the mining town of Kambalda.

The shire’s annual report showed $416,000 was paid to St John Ambulance, which ran the local GP service, with a further $460,000 budgeted for this financial year.

Ms Chapple says the funding of primary health care is not a local government responsibility. (Supplied: WALGA)

The report prompted the WA Local Government Association (WALGA) to call for federal support, with around 30 regional councils across the state providing incentives to attract GPs.

WALGA president Karen Chappel said providing primary health care was a federal responsibility, but there was a growing trend where local governments were paying for doctors.

“[The community] place this expectation on their local government to provide that service and that’s where things go astray,” she said.

“Local governments have an obligation to their community, but in all fairness it is not their responsibility.

“That’s the responsibility of the federal and state government.”

Cash, cars and houses

To attract GPs to regional areas, Ms Chappel said it was not unusual for council-owned housing or clinics to be offered in salary packages, but cash payments were becoming more common.

“Cash incentives and the other incentives — which have become quite competitive — it’s only really been in recent years,” she said.

“It comes down to doctors wanting to be guaranteed an income to come and live in your community.”

In 2016, the town of Norseman on the Eyre Highway spent $800,000 to build a new home specifically for the local GP.

Laurene Bonza, president of Dundas Shire, said by the time the loan on the house was paid in full, the cost to the shire would be about $1.3 million.

Ms Bonza says building a house for the local GP will cost the shire more than $1 million. (ABC News: Hugh Sando) GP costs triple

In December, the shire also sought interests for medical services after a proposed change to the financial agreement with the local GP rose from $60,000 to $250,000 a year.

Chief executive Peter Fitchat said the house, financial support and a car provided by the shire all came at a cost that should not be incurred by a local government.

“All that support should have been provided by the federal government,” he said.

“Local governments contributing to their doctors go way beyond the requirements … that’s something our taxes have to provide.”

Royal Australian College of General Practitioners country chairman Michael Clements said with increasing pressure on the health care system all levels of government had a role to play.

Dr Clements says rural health care is no longer a federal responsibility. (Supplied: RACGP)

“When there is a town that does not have a family doctor, or the last general practice closes like in Mission Beach in my region, the whole community suffers,” he said.

“That suffering needs to be addressed by local governments, it needs to be addressed by the state government and federal [government].”

Dr Clements said a generational change and significant reforms to Medicare were needed to revive general practice, but until then he said supporting rural communities required a whole-of-government approach.

“We see that all levels of government need to respond because this was just such a systemic failure,” he said.