Rural health initiatives across the board need refocussing on delivering actual results into truly rural areas with better accountability and rationalisation of programs urgently needed, the Rural Doctors Association of Australia (RDAA) says.
RDAA president Dr John Hall said the association has submitted a raft of practical, costed suggestions to the Federal Government in its budget submission, which outlines how the existing money in rural health could be better invested to achieve real results on the ground.
Dr Hall said that the vast sums of money currently in the system should be enough.
"Over one billion dollars is invested each year into initiatives aimed at improving access to doctors in the bush," he said.
"That we are still facing the same problems, year after year, decade after decade, show the systemic failure of many of these programs, with existing issues clearly not being solved by the current system.
"We have to see better outcomes from this investment or we'll just be throwing more good money after bad.
"We want to see stronger evaluation, we want to see programs streamlined or consolidated to get better bang for buck. Some programs need minor tweaks, some need a significant redesign and refocus, and some have served their time.
"We want to see programs that are showing positive signs, like the Rural Junior Doctor Innovation Fund (RJDIF), that gets young doctors rotating out into rural practices, expanded... and by a lot.
"We are asking for this to be increased fourfold, from 400 junior doctors per year up to 1600 doctors per year doing rural rotations, and extended from post graduate years one and two (PGY1/2) right through to PGY3.
"Every rural doctor out there who has provided feedback to us said that the previous program, the PGPPP, made a real difference to their medical practices and the number of young doctors who discovered to rural as an exciting and rewarding career.
"And yet it was scrapped while other, very expensive, programs that deliver few tangible results in actually rural areas, continue to be rolled out. This needs to stop."
RDAA is also calling for centralisation of processes that could reduce red tape and administrative costs.
"A national e-credentialing system, that would make it simpler, easier and more cost effective for doctors, particularly those with advanced procedural skills, to work across multiple hospitals and states, is desperately needed," Dr Hall said.
"Our members are screaming out for this and we need it as a matter of urgency.
"We have also asked for the definition of rural to be tightened, using the Modified Monash Model classification, of MMM 3-7, to exclude large regional centres and capital cities, such as Hobart, Darwin and Townsville, whose eligibility for a range of rural incentives is, quite frankly, a disgrace.
"As it stands now, many programs are spread across both regional and rural/remote areas. However medicine in these regional areas is much closer to metropolitan based care, than rural care.
"I can assure you, a patient from Quilpie, Tennent Creek or Dover is going to find it much harder to access a consultant specialist than a patient from a capital city like Darwin or Hobart, or a regional centre such as Toowoomba.
"We are asking for better targeting of programs through a reclassification of rural to be MMM 3-7, with areas of unique workforce challenges in metro or large regional centres to have separate programs that meet their specific needs, and not just an extension of rural incentives that further disadvantage genuine rural settings.
"Going forward there must be a clear delineation so that rural intended initiatives and programs actually reach the rural communities they were intended for, and don't get tied up in regional centres showing disproportionate results that don't reflect reality."