It is no secret that trying to get a doctor’s appointment in Broken Hill is a nightmare at best and life threatening at worst – but a two to three-month wait? Yes, it is normal to wait that long for a simple doctor’s appointment.
When one of our journalists attempted to get an appointment with a doctor here last week, they found there was no chance of getting one before December.
Dr Michael Bonning, President of the Australian Medical Association (NSW) told the Barrier Truth those wait times are “some of the worst I have heard of”.
“Even compared to Lismore, Coffs, Armadale, Tamworth, a three-month wait is longer than I have heard of. If that is the standard wait time in Broken Hill, then I expect that it is worse than most other places.”
He said Broken Hill’s remoteness, made the situation much worse.
“It’s not like you can just go down the road to find another doctor. That kind of inaccessibility of health care services, whether it is distance or time, is worrying,” Dr Bonning added.
The availability of doctor appointments is not an issue unique to Broken Hill. It’s a national issue which has been getting steadily worse.
Many experts trace it back to 2013 when Medicare rebates for GPs were frozen. They stayed that way for five years. This year doctors received a 65 cent increase.
“It made it harder to provide primary care by bulk billing. It also caused people to leave primary care practice during that period,” Dr. Bonning said.
When the five-year freeze occurred, it forced many GPs to ask patients to pay for GP visits. That in turn meant some people who were unable to pay didn’t visit GPs, rather waiting until their issue got bad enough to be seen at hospital Emergency Departments [ED].
A trip to the ED ultimately makes it harder on the patient, as their symptoms have often worsened and are having a larger impact on their health.
There is also the additional impact on ED medical staff as they are having to perform more intricate procedures or tests, and waiting times balloon out there too.
“We’ve got to find a way to make primary care services more attractive to practitioners and more accessible for patients,” says Dr Bonning.
There is also the fact that many young medical graduates are not interested in general practice. Dr Katie Price, President of the Royal Australian College of General Practitioners [RACGP], told us that just 13.8% of graduates are going into general practice.
The number of GPs in Australia has been declining at an alarming rate, particularly over the last 10 years. As recently as 2019, the RACGP reported that for every new GP there is close to 10 specialist doctors amongst medical graduates. Becoming a GP is also something that is sometimes looked down upon by med school grads.
“There’s a bit of a negative attitude toward general practice, the kind of ‘just a GP’ thing,” Dr Price says.
Dr Price thinks we need GPs to be visible in medical schools.
“We also need GPs lecturing in universities and hospitals where they can start talking about the wonderful career that is generalism,” she says.
It’s clearly a combination of all these things that has attributed to the dearth of GPs across Broken Hill and regional NSW.
In a damning indictment, Dr Price said Broken Hill is a microcosm of what is going to happen to the rest of the country should the situation not improve.
“If people think that it is bad in Broken Hill, it’ll be coming to their town soon.
“It is going to take a long time to turn things around for rural medical schools and rural medical students.”
One idea Dr Price suggests is loosening the red tape that stands in the way of international medical graduates.
“It is taking far too long to place international medical graduates,” Dr Price said.
It can take up to a year and cost thousands of dollars to bring international medical graduates into regional areas.
Broken Hill Mayor Tom Kennedy says Council has been working toward securing a short-term fix locally.
“Some of our councillors are speaking to practices in Sydney who provide doctors for a week a year as part of their community service,” Mayor Kennedy said.
“That could provide doctors all year round, albeit on a rotational basis.”
If government can’t fix the mess that Broken Hill, and more broadly the nation, find themselves in at the moment, we are likely to see wait times stay at their current rates, and potentially even soar.
Adjustments to the Medicare rebate and clearing the red tape that prevents international medical graduates from alleviating some of the pressure on the system are good short-term fixes. As far as a long-term solution is concerned, after speaking to medical professionals, it seems that it is quite some way off.
We contacted the office of the Assistant Minister for Rural and Regional Health, Emma McBride on several occasions, but received no response.