"Help us to make rural and remote more attractive" - that's the call from western Queensland mayors grappling with the impact of the shortage of medical staff in the bush.
So critical is the doctor-patient ratio and the impact on rural communities that it was the basis for a number of resolutions at the 2021 Local Government Association of Queensland conference.
Incentive schemes to encourage GPs to relocate, including HECS debt repayments linked to rural and remote service, the reintroduction of bonded scholarships, relocation incentive schemes, and guaranteed development opportunities, were put forward by the Flinders Shire Council.
Mayor Jane McNamara said Hughenden had been having difficulties trying to recruit a replacement doctor and had gone a month without a doctor recently.
In addition, they'd been fighting for a second doctor for a while, given Hughenden had a population of over 1000, and two doctors would mean they could rotate and get the required rest breaks.
"COVID and not bringing in as many overseas doctors to fill gaps has exacerbated the issue, but the payment of Medicare has hardly risen over a decade," she said. "By the time GPs run a clinic, it's hardly profitable."
She quoted statistics that showed only one in three doctors were remaining GPs, and that there were 23 placements for doctors standing vacant in rural and remote areas in March.
Cr McNamara said people got to do real doctoring in the bush.
"It's varied but very educational," she said.
QCL recently reported that a Senate committee enquiry into health services in rural areas was told medical students were using government rural placement schemes to get low rate university loans with no intention of going bush.
There has not been a specific review of bonded medical programs since the Mason Review nine years ago.
Mount Isa Mayor Danielle Slade said it was important to note that under the current incentives, the Gold Coast was classed as regional.
"What's the incentive to go more rural," she asked. "Maybe there should be tax breaks too.
While the hospital at Mount Isa is a hub for a huge slab of the north west, including Mornington Island, Doomadgee, Boulia and Northern Territory communities, Cr Slade said the problems it faced were common across rural Queensland and was why the Western Queensland Alliance of Councils was looking at holistic solutions.
Critical shortage an 'unacceptable risk' in Isaac
The struggling system has also been concerning the Isaac Regional Council, which called on the LGAQ to lobby the federal government "to assess the effectiveness of the 2019 Stronger Rural Health Strategy, specifically the impacts of sub-standard health services, in order to deliver an equitable model of fit for purpose health care to Australians living in rural and remote areas".
It said that despite the strategy's worthy initiatives, evidence was that the strategy was not cutting through, and that the model for allocation of medical professionals to rural and remote communities was inadequate.
Mayor Anne Baker said the council's advocacy position formed the view that the critical shortages present an unacceptable risk to its 17 communities.
"Current clinical services planning for hospitals and allied health services does not satisfy demand generated by the true population of resource communities," she said.
There are 31 operating metallurgical and thermal coal mines in the Isaac region, which is 25 times the size of the ACT but has only three multipurpose health centres in Clermont, Dysart and Moranbah.
The region has a permanent population of 22,500, which is what funding methodologies are based on, but on any given night that can be 34,000.
"Failure to acknowledge the additional strain on government services and facilities in regional and remote communities created by large non-resident populations means these services and facilities are not adequately or equitably funded to support total population demand," Cr Baker said.
"The impacts of underfunded primary healthcare are compounded when the government continues to ignore the data showing the true effect of our non-resident population on local infrastructure and services."
Cr Baker said federal Treasury coffers stood to reap an "extraordinary hit of royalties" thanks to escalating coal prices - premium coking coal reached $US670 a tonne ($A900) in March, a 32 per cent increase for the month, the highest levels in history.
"Whether it's the resource sector, renewables or agriculture - they are all flourishing, so why can't we get fit-for-purpose medical services," she asked.
"People should not be treated as second-class citizens because they choose to live in regional Australia when the industries, we work in, contribute so much of the nation's wealth."
Cr Baker said instances of mine-related accidents highlight that Council's previous representations were valid and need to be addressed as a matter of priority.
"Current clinical services planning for hospitals and allied health services does not satisfy demand generated by the true population of resource communities," she said.
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