Latest / 360 with Katie Woolf / GP Superclinic CEO Robyn Cahill says lack of GP's is at crisis point around the Nation

Transcript

GP Superclinic CEO Robyn Cahill says lack of GP's is at crisis point around the Nation · 360 with Katie Woolf

• 0:01
  Speaker 1: It is just on a quarter past nine. We are
• 0:03
  Speaker 1: due to catch up in a few minutes time with
• 0:05
  Speaker 1: Craig Garaway from Saint John's. Following on from that incident
• 0:08
  Speaker 1: in the CBD last night, we know that a restaurant
• 0:11
  Speaker 1: is boarded up, is what's being reported now after that
• 0:15
  Speaker 1: explosion which did injure five diners at a popular venue
• 0:18
  Speaker 1: in the CBD. So we are due to catch up
• 0:21
  Speaker 1: with Saint john Operations manager Craig Garaway in the next
• 0:24
  Speaker 1: few minutes or so and finding out exactly, you know,
• 0:28
  Speaker 1: how those five patrons are going at this point in time.
• 0:32
  Speaker 1: But what we do know right now is that around Australia,
• 0:35
  Speaker 1: the shortage of general practitioners could soon force clinics to
• 0:38
  Speaker 1: cut back on services and in some cases may see
• 0:41
  Speaker 1: them turn away patients unless the government intervenes. Well, that
• 0:45
  Speaker 1: is what doctors and peak medical bodies are warning in
• 0:49
  Speaker 1: some of our other states around the nation now, the
• 0:51
  Speaker 1: concerns of seeing calls for restrictions on overseas trained gps
• 0:55
  Speaker 1: to be eased. While rural practices have been dealing with
• 0:59
  Speaker 1: you know the impact of the shortage for years now,
• 1:02
  Speaker 1: the problem is increasingly being felt in Metro areas and
• 1:06
  Speaker 1: even areas like the Northern Territory and indeed Darwin. So
• 1:09
  Speaker 1: how are things tracking in the Northern Territory at the moment? Well,
• 1:12
  Speaker 1: joining me on the line is Robin Karl, the CEO
• 1:15
  Speaker 1: of the Palmerston GP Superclinic.
• 1:17
  Speaker 2: Good morning to you, Robin.
• 1:19
  Speaker 3: Good morning Kating, Good morning to your listeners.
• 1:21
  Speaker 1: Robin, how are things tracking from your perspective when it
• 1:24
  Speaker 1: comes to the national GP shortage? I guess is what
• 1:28
  Speaker 1: it's been dubbed at this point.
• 1:30
  Speaker 3: Well, general practice in a word, is in crisis and
• 1:33
  Speaker 3: has been brewing for quite some time, and I think
• 1:38
  Speaker 3: the experience of COVID over the last three years has
• 1:40
  Speaker 3: brought it to your head. And the government's both state
• 1:43
  Speaker 3: and federal, really need to take a step back and
• 1:46
  Speaker 3: have a really good look at how they're treating general
• 1:49
  Speaker 3: practice and how they're supporting general practice.
• 1:52
  Speaker 1: Wow, Robin, that's a big call. So you believe at
• 1:55
  Speaker 1: this point it is at crisis point? What makes you
• 1:59
  Speaker 1: feel as though we're at that level?
• 2:02
  Speaker 3: So across the nation now only fifteen percent of all
• 2:06
  Speaker 3: of our medical graduates are electing to pursue general practice
• 2:10
  Speaker 3: as their specialty. Fifteen percent. It used to be around
• 2:15
  Speaker 3: forty five to fifty percent, which was the time where
• 2:18
  Speaker 3: we were always concerned that we didn't have enough GPS,
• 2:21
  Speaker 3: and it was for that reason we had a very
• 2:23
  Speaker 3: large push into recruitment of overseas medical graduates. And if
• 2:28
  Speaker 3: we thought forty five percent was bad, imagine how it's
• 2:31
  Speaker 3: going to be with only fifteen percent of graduates taking
• 2:34
  Speaker 3: up general practice training. Yeah.
• 2:36
  Speaker 2: Right, it's going to be down the track. Well.
• 2:39
  Speaker 1: Already we're feeling that shortage, but in the years to come,
• 2:42
  Speaker 1: it's going to.
• 2:42
  Speaker 3: Get worse, oh, without question. And I think one of
• 2:46
  Speaker 3: the main factors is having worked in both the acute
• 2:50
  Speaker 3: care and the primary health care sector, there's no question
• 2:53
  Speaker 3: that the view and the approach of governments towards primary
• 2:57
  Speaker 3: health care is very much it's a special that can
• 3:00
  Speaker 3: deal with its own problems. So it's the only specialty
• 3:04
  Speaker 3: where training is not fully funded by the public system.
• 3:08
  Speaker 3: It's where private practitioners are expected to carry the burden
• 3:11
  Speaker 3: of training those people who'll come after them and take
• 3:14
  Speaker 3: over their patients. It's also the only special I think
• 3:18
  Speaker 3: the specialty there has the greatest burden of paperwork and
• 3:23
  Speaker 3: confirming and justifying what they do in terms of providing
• 3:27
  Speaker 3: care for their patients. So, on average, a general practitioner
• 3:30
  Speaker 3: who's working full time, in addition to spending that forty
• 3:34
  Speaker 3: or so hours a week in their practice actually seeing
• 3:36
  Speaker 3: patients probably spend another twenty to thirty hours completing documentation
• 3:41
  Speaker 3: and paperwork. Wow, very little support and very little justification
• 3:45
  Speaker 3: in some areas in my personal view as to the
• 3:48
  Speaker 3: need for that work to be done.
• 3:50
  Speaker 1: So, Robin, when you talk about the Northern Territory at
• 3:52
  Speaker 1: this point, what are some of the impacts that are
• 3:55
  Speaker 1: being felt sort of right now?
• 3:58
  Speaker 3: Well, we've definitely seen a significant an increase in patients
• 4:01
  Speaker 3: who are struggling to actually get to see a clinician.
• 4:04
  Speaker 3: And we've already talked in the last few weeks about
• 4:07
  Speaker 3: the fact that most practices now are no longer bolt
• 4:10
  Speaker 3: billing everybody, and that has seen certainly a large number
• 4:14
  Speaker 3: of people looking around trying to find another practice that
• 4:18
  Speaker 3: will see them and continue to bolt build them. I
• 4:21
  Speaker 3: think the problem that we're seeing here in the territory
• 4:24
  Speaker 3: particularly has been exacerbated by COVID. There was very much
• 4:28
  Speaker 3: a reliance on overseas medical graduates over the past few
• 4:31
  Speaker 3: decades for the normal territory and we lost that access
• 4:34
  Speaker 3: during COVID because we simply couldn't recruit for doctors to
• 4:38
  Speaker 3: come from overseas. And so what we've seen is a
• 4:41
  Speaker 3: large number of practices contract their workforce, and we've also
• 4:44
  Speaker 3: seen a significant number of practices clothes. So we aren't
• 4:48
  Speaker 3: able to replace those doctors. We've got a finite resource
• 4:52
  Speaker 3: of general practitioners available and increasing numbers of people who
• 4:56
  Speaker 3: are looking for here.
• 4:57
  Speaker 1: So Robin at the GP Superclinic, get the mind and
• 5:01
  Speaker 1: you know from your interactions with other GP clinics, are
• 5:06
  Speaker 1: there a shortage of gps right now in the Northern Territory.
• 5:10
  Speaker 3: Without question, without question?
• 5:13
  Speaker 2: And what impact does that have?
• 5:15
  Speaker 1: You spoke then about people, you know, not necessarily being
• 5:17
  Speaker 1: able to get in to see their usual doctor. But
• 5:20
  Speaker 1: does it also have an impact do you think in
• 5:22
  Speaker 1: terms of people then maybe presenting to the hospital and
• 5:26
  Speaker 1: or maybe not even going to see anybody until they
• 5:29
  Speaker 1: get to the point where they're really quite crook.
• 5:32
  Speaker 3: I think we are definitely seeing that we've heard the
• 5:35
  Speaker 3: anexotal evidence from the hospital system that they are seeing
• 5:38
  Speaker 3: increasing numbers of patients presenting. We're certainly finding a reverse,
• 5:45
  Speaker 3: a perverse reverse of referrals. So we're getting people who
• 5:48
  Speaker 3: are coming to us who're saying that they've presented to
• 5:51
  Speaker 3: one of the hospital ds and they've been strongly encouraged
• 5:54
  Speaker 3: to actually go back to their GP, because if they
• 5:57
  Speaker 3: remain in the ED day alive, not get seen for
• 6:01
  Speaker 3: several hours, or they just don't see that what they're
• 6:04
  Speaker 3: there for is relevant. And to be honest with you,
• 6:06
  Speaker 3: I think that's what ED should be doing. I think
• 6:09
  Speaker 3: one of the reasons we have is increasing pressure on
• 6:12
  Speaker 3: our hospital systems, and one of the reasons why we've
• 6:15
  Speaker 3: seen people move away from general practice is that over time,
• 6:19
  Speaker 3: the importance of general practice has been eroded by the
• 6:21
  Speaker 3: fact that people can just rock up to any D
• 6:24
  Speaker 3: to have their sub toe or their sniff will dealt with,
• 6:27
  Speaker 3: and hospitals, because of the nature of the way our
• 6:30
  Speaker 3: hospitals are funded, are not able to turn them away.
• 6:33
  Speaker 1: So, Robin, what do you think could be getting done
• 6:36
  Speaker 1: at this point in time, both on you know, on
• 6:38
  Speaker 1: a territory government level, but also on the federal government
• 6:41
  Speaker 1: level to try and fix this situation. And do you
• 6:44
  Speaker 1: think it's going to get worse if they don't start
• 6:46
  Speaker 1: to act.
• 6:48
  Speaker 3: I think what's absolutely critical is for governments, and it's
• 6:53
  Speaker 3: easy to say, we know it's probably never going to happen,
• 6:55
  Speaker 3: but the retric that's coming out. So the Albanezia governments
• 6:59
  Speaker 3: proposed to introduce urgent care clinics to address the pressures
• 7:03
  Speaker 3: on eds. For if they actually stopped talking about those
• 7:08
  Speaker 3: sorts of issues and started looking at why doctors are
• 7:11
  Speaker 3: not practicing in general practice and actually refined the requirements
• 7:17
  Speaker 3: around that so that there'd be more doctors encouraging taking
• 7:20
  Speaker 3: up general practices a specialty, those pressures in ED departments
• 7:24
  Speaker 3: would start to ease because there'd be greater access, they'd
• 7:27
  Speaker 3: be greater availability. One of the easiest things the government
• 7:30
  Speaker 3: could do at a federal level is to enable practice
• 7:34
  Speaker 3: to charge a small co payment with the Medicare billing.
• 7:38
  Speaker 3: So one of the reasons why people are really struggling
• 7:41
  Speaker 3: with not having billing medical practices now, it's not because
• 7:44
  Speaker 3: the practices are necessarily charging a large gap. It's because
• 7:48
  Speaker 3: they have to pay the full amount up front, not
• 7:51
  Speaker 3: just the gap. So that very simple change would make
• 7:55
  Speaker 3: a huge difference to people being able to access care
• 7:58
  Speaker 3: and to encourage doctors to reconsider how they might view
• 8:02
  Speaker 3: general practice and actually go down that path.
• 8:05
  Speaker 2: Why do you.
• 8:06
  Speaker 1: Reckon they're so resistant that, you know, on the medicare stuff.
• 8:12
  Speaker 3: Well, I think initially it's because they had all of
• 8:14
  Speaker 3: this promotional discussions around the fact, you know, you get
• 8:19
  Speaker 3: bolt build you never have to put your hand in
• 8:20
  Speaker 3: your pocket. But what they've always done is neglect to
• 8:24
  Speaker 3: really reinforce the people that bolt billing is not an
• 8:26
  Speaker 3: insurance system, it's not a fee schedule. It's simply a
• 8:29
  Speaker 3: rebate that the government's prepared to provide an individual to
• 8:32
  Speaker 3: help support the cost of their care. And it's never
• 8:35
  Speaker 3: ever covered the full cost of what the care is.
• 8:39
  Speaker 3: And there were studies done as late as the late
• 8:44
  Speaker 3: nineteen nineties which proved that the costs were not covered
• 8:48
  Speaker 3: by bolt billing. So if they were honest about that
• 8:51
  Speaker 3: and really started messaging that bolt billing is a rebate
• 8:55
  Speaker 3: for patients to support their care, and that they're happy
• 8:57
  Speaker 3: for doctors to apply for that rebate directly and patients
• 9:02
  Speaker 3: only have to pay the gap, I think that that
• 9:05
  Speaker 3: would be a different discussion for people. So instead of saying, oh,
• 9:08
  Speaker 3: you'll have to pay out of pocket, but I pay
• 9:10
  Speaker 3: my medicare, the thing we often get is I pay
• 9:13
  Speaker 3: my medicare levy, Why should I have to pay any
• 9:16
  Speaker 3: more than that? But people don't have that same conversation
• 9:19
  Speaker 3: when you talk about private health insurance. They know that
• 9:22
  Speaker 3: that's not going to cover the entirety of their care.
• 9:24
  Speaker 3: They expect to pay the amount of pockets. So I
• 9:26
  Speaker 3: think we have to change the conversation around that. We
• 9:28
  Speaker 3: have to really start selling general practice is a really
• 9:32
  Speaker 3: worthy and important component of our health system, and we
• 9:36
  Speaker 3: really have to start looking at why doctors who are
• 9:39
  Speaker 3: graduating are not taking up general practice and those issues
• 9:43
  Speaker 3: need to be addressed well.
• 9:45
  Speaker 1: Robin Carl, I always appreciate your time, particularly this morning.
• 9:49
  Speaker 2: Thank you very much for having a chat with us.
• 9:52
  Speaker 3: Not a problem, Katie.
• 9:53
  Speaker 2: Thank you.
• 9:54
  Speaker 1: That is Robin Carl, who is indeed the Palmeston GP
• 9:56
  Speaker 1: Superclinic CEO. They've got the respiratory clinic out there as well.
• 10:00
  Speaker 1: Now that number if you do want to send us
• 10:01
  Speaker 1: a message this morning zero four double nine seven double one.
• 10:05
  Speaker 2: Three six zero.
• 10:06
  Speaker 1: But she has said this morning that GP practice around
• 10:10
  Speaker 1: the nation really and in the territory is at that
• 10:13
  Speaker 1: crisis point and we need more of those graduates obviously
• 10:17
  Speaker 1: going into that sector. But it is being felt right
• 10:19
  Speaker 1: now as well in the Northern Territory. Now coming your
• 10:23
  Speaker 1: way in just a couple of moments, we are going
• 10:25
  Speaker 1: to catch up with Craig Garaway from Saint John's and
• 10:28
  Speaker 1: find out a little bit more about this incident that
• 10:30
  Speaker 1: occurred overnight. So what we do know at this point
• 10:33
  Speaker 1: in time is there was an explosion. It's being called,
• 10:36
  Speaker 1: I guess a smaller explosion, but I know that there
• 10:39
  Speaker 1: was a heck of a lot of emergency service, well
• 10:43
  Speaker 1: police fieries everybody involved in the aftermath last night. It
• 10:47
  Speaker 1: happened about eighteen last night down Austin Lane. Really keen
• 10:51
  Speaker 1: to hear from you this morning. If you happen to
• 10:53
  Speaker 1: be out and about having dinner or in Austin Lane
• 10:56
  Speaker 1: and you saw the event unfolding, give us a call.
• 10:59
  Speaker 1: Eight nine four one one four nine is the number.
• 11:02
  Speaker 1: But I know that there was a heck of a
• 11:04
  Speaker 1: lot of first responders there incredibly quickly, including our ambulance
• 11:10
  Speaker 1: paramedics to make sure that everybody was okay. But it
• 11:12
  Speaker 1: has indeed been described as well a ball of flame
• 11:15
  Speaker 1: that went up and extinguished rather quickly. Inside that premises
• 11:19
  Speaker 1: joining me on the line right now to tell us
• 11:21
  Speaker 1: a little bit more is Craig Garaway from Saint John's.
• 11:24
  Speaker 1: Good morning to you, Craig.
• 11:26
  Speaker 4: Good morning Katie.
• 11:27
  Speaker 2: How are you not too bad? Craig?
• 11:29
  Speaker 1: I understand there were five people injured last night in
• 11:32
  Speaker 1: that incident.
• 11:34
  Speaker 4: Yep, that's correct, Katie. About eight o'clock we did receive
• 11:37
  Speaker 4: pe below call in regards an explosion in the Austin
• 11:40
  Speaker 4: Lane there. We responded a number of resources to that location.
• 11:44
  Speaker 4: On the arrival there, we did come across five people
• 11:47
  Speaker 4: had a number of burned thankfully, you know, obviously not
• 11:50
  Speaker 4: too serious, but obviously they still had burned to their
• 11:53
  Speaker 4: face and chest areas, hands required treatment and transport to
• 11:58
  Speaker 4: the Royal Doune Hospital where they're being treated by the
• 12:01
  Speaker 4: hospital staff there at the moment.
• 12:03
  Speaker 1: Goodness, may I mean five is quite a large number
• 12:05
  Speaker 1: I guess to be dealing with in one incident, is it, Craig?
• 12:09
  Speaker 1: It is?
• 12:09
  Speaker 4: You know obviously, you know, we're obviously busy all the
• 12:12
  Speaker 4: time and getting those resources into town very quickly to
• 12:14
  Speaker 4: look after those people is challenging for Communications center with
• 12:19
  Speaker 4: all the other work that's still ongoing at that time,
• 12:21
  Speaker 4: but we were able to get to I think about
• 12:23
  Speaker 4: four resources there very quickly to obviously start treating those people. Obviously,
• 12:28
  Speaker 4: burns very painful injury, and you want to start treating
• 12:31
  Speaker 4: them as quick as you can to reduce infection, and
• 12:33
  Speaker 4: obviously the stress on the people involved.
• 12:35
  Speaker 1: And Craig, it's obviously always a pretty busy area down
• 12:38
  Speaker 1: there in Austin Lane, but I understand that the markets
• 12:40
  Speaker 1: were taking place as well. Is that the case, and
• 12:43
  Speaker 1: how did that sort of potentially hinder everybody being able
• 12:47
  Speaker 1: to get in or first responders being able to get in.
• 12:50
  Speaker 4: Yeah, look, I don't believe there was any problem with
• 12:53
  Speaker 4: us getting in there. Obviously it's a busy area at
• 12:56
  Speaker 4: the best of times. Anyway to hold off the main area,
• 12:59
  Speaker 4: but you know, obviously and she resources were able to
• 13:01
  Speaker 4: get in quite quickly. A lot of people around, so
• 13:04
  Speaker 4: that does make it challenging because obviously everyone's concerned, and
• 13:06
  Speaker 4: you know, it makes it very chaotic. But that's what
• 13:09
  Speaker 4: mergency services all training is, obviously managing those chaotic situations
• 13:12
  Speaker 4: and calming everything down and getting everyone to the best
• 13:16
  Speaker 4: care they can as quickly as they can.
• 13:18
  Speaker 1: Yeah, Craig, I know, obviously not your realm, but any
• 13:22
  Speaker 1: idea whether there was much sort of damage around the
• 13:24
  Speaker 1: place or was it pretty well contained from what you
• 13:26
  Speaker 1: guys could gather.
• 13:28
  Speaker 4: Yeah, look bit chaotic, so it was a bit hard
• 13:29
  Speaker 4: to tell how much damage was done. Obviously that's all
• 13:32
  Speaker 4: being assessed this morning and obviously works. They will be
• 13:34
  Speaker 4: in there today having a look to try and understand
• 13:36
  Speaker 4: what's gone wrong there, and I'll have a bit more information.
• 13:39
  Speaker 4: But my understanding is that it was a flash type style
• 13:43
  Speaker 4: fire and contained very quickly, but obviously that didn't help
• 13:47
  Speaker 4: the people that were actually burned.
• 13:48
  Speaker 1: No, Craig, it sounds like an incredibly busy night for
• 13:51
  Speaker 1: everybody involved, and I certainly hope that those five people
• 13:54
  Speaker 1: are going to be okay. Sounds like they had very rapid,
• 13:58
  Speaker 1: very rapid response from some and hopefully they're on the mend.
• 14:03
  Speaker 4: Yes, look they are. And thank you to the fire
• 14:05
  Speaker 4: service and police who will also assisted us in that incident.
• 14:09
  Speaker 4: You know, without them, you know, it makes it really hard.
• 14:11
  Speaker 2: It really does.
• 14:13
  Speaker 1: Craig Garaway from Saint John's always good to catch up
• 14:15
  Speaker 1: with you. I appreciate your time this.
• 14:17
  Speaker 4: Morning, no problem, Katie, thank you you too.
• 14:20
  Speaker 1: It is just on nine point thirty coming your way
• 14:23
  Speaker 1: in just a couple of minutes. We are going to
• 14:25
  Speaker 1: be speaking to Ruth Palmer, who is the Chief Executive
• 14:27
  Speaker 1: of the Property Council here in the Northern Territory.