Senate Community Affairs Legislation Committee, , 1:17:01 to 1:27:27
Inquiry into GP service shortages in regional Western Australia and the criteria used for thin market sustainability assessments.
Topics: Health, Employment
Speakers: Speaker 20, Dr Liz Develin, Sean Lane, Mark Roddam, Hon Jenny McAllister, Ellie Whiteaker
Thank you. Good morning. Um my questions around GP services and I'd like to know has the department undertaken any thin market service sustainability or market viability assessment of GP services in the Southwest wheat belt or Great Southern regions of Western Australia since 2020. Uh if you have, can you please provide uh the date, scope and findings of each?
Senator, um, if I if I may, I I think that these questions are I understand largely associated with outcome two. We have some officials who may be able to assist you, but I just wanted to alert you that the relevant officials appeared in the other part of the programme, and so there may be some limitations on what can be provided.
Okay. Thank you.
Good morning, Senator. I will pass to my colleagues. I think you've asked the question around thin markets and particularly you might want to repeat for us the particular region you were talking about.
Yeah, that's totally cool. It's uh within the South West Wheat Belt or Great Southern Regions of Western Australia since 2020.
Senator Mark Autumn, First Assistant Secretary Primary Care Division. Um through the primary health networks and uh the West Australian Primary Health Alliance in Western Australia, we continue to monitor uh the general practice uh market, if you like. Uh I would need to check specifically advice we've had in relation to South Western Australia, but that is a role we do in conjunction with um the local experts.
Um so have you undertaken any assessment in these specific shires? Shires of Ravensthorpe, uh Jerem uh Gerramung up, uh, Nawangerup, Cogin up, Lake Grace, or Narambean.
I'd need to take that specific detail on notice.
Okay. Um because I'd love to know if those uh if if a thin market assessment was um undertaken for those shires, uh, what were the outcomes and recommendations? Um what criteria and thresholds does the department use to classify a community as a thin market or at risk of market failure, and to make it eligible for commonwealth intervention, including through the general practice incentive fund. Um, yeah, thank you, Senator Sean Lane, Assistant Secretary Workforce Division. So we uh are responsible for delivering of the uh thin markets program, which we refer to. Um coming back to your previous question, we have been engaging uh with WA Health and the country WAPHN on uh eligibility and accessibility to this program for that particular region. Uh at the moment it hasn't been identified as a site suitable, um, but we continue to engage uh with uh those stakeholders in those regions. So what could Criteria makes a site suitable.
Yeah, so the actual programme, Senator, looks at uh the actual underlying causes for the thin market, uh, and that can range from uh you know, in terms of workforce, it could also mean accessibility. Uh, there's a there's a range of issues that can cause uh a thin market. Um, in terms of the thin markets program, what we look at is uh it is looking at uh whether the solution can be resolved within the period of the funding. So we are looking at uh the ability to work with local stakeholders, uh the relevant state government and the relevant PHN on uh whether a suitable service system recovery plan as we talk uh as we refer to is able to be put in place and delivered within a 12 to 18 month period. We do look to make sure that the um sustainability issue um can be addressed. Um it is not a program designed to address long-term sustainability issues.
Um, how does the department identify communities who may be at risk of losing local GP services? And like have you gauged how many West Australian communities have been identified to be losing GP services locally in the last five years?
I don't have that information, Senator Hunts.
Senator, um, as my colleague Mark Roddam described, one of the key features of the primary health networks is actually having a very good understanding of what's happening in their local market. They are expected to have a very good sense of the interactions in their market and the um services available to the community. So that really is an ongoing monitoring function of the primary health network program.
Do we have any data to reflect what the status is in WA?
So, Senator, we will obviously have data around the interactions with the medical benefit scheme, what people are accessing, we will also have registrations of providers, those that are involved in the My Medicare program or the bulk billing program. But for granular data about uh concerns about particular GPs or practices leaving the program, we would wait for the intelligence of the either the primary health network and also states and territories are particularly interested in these matters as well.
Um because what I've heard from uh locals in those particular shires is that the department has said the Wheat Belt and Great Southern uh regions were considered but not prioritized for the general practice incentive funding. Um, which criteria did they fail to meet and what evidence was relied upon?
Senator, there is a range of primary care and incentive programs, so we may need to um understand which particular of the incentive programs, a range of them, some of them are related to workforce, some of them relate to after hours, some of them are out multidisciplinary care, so we may need some more granular information to understand the context of that question, I suspect.
So if we were to look at, say, for example, um how we're seeing local governments contribute to attract and retain GPs, for example, to um you know, uh provide them cash subsidies or housing or vehicles or you know, other facilities. Is that something the department collects data to to be able to gauge how much Commonwealth funding needs to go into those spaces?
Uh Senator, so we don't collect data on the incentives that a local government might be offering, because I am aware local communities uh sometimes embark on those programs themselves. We don't have a data source that collects that sort of information. As I said, we receive intelligence through the primary health networks, we look at practices registered through the My Medicare programme, we look at bulk billing statistics, and we also pick up intelligence from the states and territories.
So when you say that you're um picking up intelligence from various and territories, um since 2024, what engagement has the department had with the WA Primary Health Alliance, the WA Department of Health and other stakeholders about GP sustainability when it comes to you know the wheat belt and the great southern regions of WA?
We need to check about the specifics of that, uh Senator on notice, but we do have a primary care forum involving uh the primary health alliance and the Western Australian government, um which is a mechanism to exchange information. We also have um a schedule in the National Health Reform Agreement, which seeks to uh improve information sharing in relation to thin markets and rural and remote health as well, uh, which is um coming for negotiation soon.
Has the department considered a dedicated funding stream or block funding or sustainability funding uh or payment for communities with no viable GP market?
We continue to work on solutions for thin markets, Senator, and uh advise the government accordingly.
Is there anything that's come out of that relating to WA and what WA would be receiving?
We tend to look at those policies on a national basis, Senator, because those uh challenges are uh consistent across the country in terms of those workforce challenges and getting services into more rural and remote areas.
I understand. So who would be the best people for me to ask these questions about actual you know um on the ground service delivery or ensuring that these thin market that there's something being done about the thin markets in the rural and regional areas of WA? I mean it's the biggest day in the country, uh, and we've got the challenge of how spread out uh various shires are um and not having a GP in uh for weeks on end just puts that burden on households and locals. Um the local government can only help so much without the Commonwealth pitching in. So where do I get that information around what's happening on the ground?
As Dr. Develin and I have both said, uh, there's a range of information we have to get to the specifics of your questions of the regions you're uh asking about, we'll provide that on notice.
Okay.
Sorry, Senator, if I can just also add um in terms of the Thin Markets program, we actually have two sites within WA that are being funded through this program. Uh so that is uh $2.37 million for Kananara and also $3.1 million for Newman. So we have been engaging and delivering Thin Markets program sites uh within WA, and as I said earlier, we continue to engage with WA Health and the PHNs on identifying other potential sites.
Yep, the SHIES that I did mention you've taken on notice. I would love to get some information around that, but that's all I'll put the rest of the questions on notice. Thank you, Chair.
Thank you, Senator Payman. Uh I'm going to go to Senator Gatonby for a couple of quick questions and then Senator Ruston.