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Rural reform faces backlash

26-May-2009

By Michael East

THE Federal Government’s decision to replace the RRMA system with a new remoteness classi fication will drive doctors from small country towns, rural doctors warn.

Flaws are already starting to emerge in the government’s plan to base rural incentive pay ments on a new five-point scale called the Aus tralian Standard Geographical Classification — Remote Areas system, doctors say.

The system — which will take effect from 1 July — determines areas by their distance from major centres. For example, it places the inland NSW town of Gundagai, which has a population of less than 2000 people, in the same ‘inner regional’ category as the beachside community of Port Macquarie, with a population of about 40,000. Gundagai is 160km from Canberra.

The government launched the $134.4 million scheme in conjunction with a pledge to award generous lump-sum payments to doctors who choose to work in remote locations.

But it means doctors who relocate to Port Mac quarie would be paid a grant of $15,000, the same as they would receive to relocate to Gunda gai or other small towns in the proximity of major centres.

Retention grants would also be identical in both towns.

Under the current RRMA system, Gundagai is classified as RRMA 5, which gives doctors access to greater incentives than Port Macquarie’s classi fication as RRMA 3.

Former AGPN chair Dr Tony Hobbs has called on Health Minister Ms Nicola Roxon to review the new classification system, warning that it may have “unintentional adverse consequences”.

Gundagai GP Dr Paul Mara said the new system would see doctors leaving small inland towns for more popular coastal areas.

“This new system does not support rural medicine at all,” he said. “Doctors in Byron Bay would not need to do half of the work per formed in towns like Gunda gai or Cootamundra — such as after-hours work — [but] will still be paid the same.

“Who in their right mind is going to sacrifice their lifestyle when they can be earning the same and live on the beach? This is not going to attract doctors to this part of the world at all.”

The new classification system will also see some areas lose their rural status.

Gawler, which is 40km from Adelaide with a popula tion of 18,000, will go from being classified as RRMA 4 to a major city, meaning doc tors will lose access to any relocation or retention grants.

Gawler GP Dr Anthony Page said he was shocked by the decision to change the classification system.

“This will have a major impact on the town,” he said. “We have a number of ageing doctors who will just retire with the loss of the retention grants.”

Dr Page said representa tives from the town went to Canberra to request a review of the changes, but the gov ernment “simply said no”.

To find your classification go to: www.doctorconnect. gov.au/ and click on ‘Remoteness Area Locator’.

Latest Comments

Read all 2 comments

And they call us rich?
I am here in this small village as a single doctor -- the other is on leave and no locum is available.
I work 24 hours -- all manner of patients/cases in a rural hospital, stressed out, my wife unhappy because she has no job, is socially isolated and we don't have a life and not that I am ever home to support her. Our kids just have to attend the local childcare where they pick every cough or diarrhoea.
Then my salary is over 100k for being on-call 24 hours and I am not entitled to anything and any service because they are all means-tested. Therefore, I pay the highest tax, I get nothing because "I am rich", I don't have a life, my wife and kids are miserable, I cannot go for CME because I do not have the time and the money and I do not have any support or even another soul to chat with and then ... I am also not considered remote enough for a reasonable incentive!
What else can they really do to me?
Medical Doctor? no thanks! Rural Doctor? No Thanks! Hospital doctor? No Thanks! On-Call? What for - for more taxes?
Posted by Timor Ekwus 27/05/2009 3:45:49 PM
One would think seeing the flaws in the new system is a no brainer.
Oh, wait ...
The other thing that always bothered me was the taxation of the grants. With us usually being in the highest tax bracket (from hard work over very long hours, not just sitting in a cosy office and wasting investors money), the government giveth the grant and the taxman taketh away half of it right away.
Hence a $15000 grant is really <$8000 to spend, which almost covers the extra expenses for a large family having to travel from and to small country towns per year. For us, our family of 6 attending the Sydney or Brisbane opera or similar cultural or entertainment events costs some $2,500 in travel costs alone.
Likewise, attending most CME events is a very expensive exercise for doctors from small rural towns - and mostly free for urbanites. "Rural grants" indeed. And now they are adding insult to injury.
Posted by Dr Horst Herb 26/05/2009 5:25:24 PM

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