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Single-employer model discussed for rural Tassie • The Medical Republic

A parliamentary review of the state’s rural health sector, like the NSW review before it, found a primary care system in shambles.


Tasmania’s rural doctors may well have the chance to work under new and innovative employment models as the state takes stock of its struggling healthcare system.

Earlier this week, the Tasmanian Legislative Council sub-committee investigating the state of rural health on the island submitted its final report.

It revealed that Tasmanians were more likely than any of their peers in the state or territory to have three or more chronic conditions, especially if they lived in a rural area.

Without “specific action”, the report warns, health outcomes for rural and regional Tasmanians are likely to worsen.

While acknowledging that each community requires a bespoke approach, the committee recommended that, where appropriate, the Tasmanian Health Service adopt a single employer model for hospital, rural GP and GP services.

Dr. Dan Halliday, ACRRM’s new president, said The Medical Republic that the report captured the community issues in rural and remote parts of Australia that had prompted doctors to create ACRRM in the first place.

“It recognizes the barriers between transferring a major regional or metropolitan model of care to a remote setting,” he said.

“This is something ACRRM has been fighting for recognition for some time – breaking down and addressing issues of geographic narcissism and ensuring rural communities receive contextually appropriate care.”

The chairman of the Tasmanian Association of Rural Doctors, Dr Ben Dodds, said that while the report did not necessarily present a lot of new information, it consolidated and formalized the experience of doctors in the field.

“It’s really hard to measure how many heart attacks or strokes were averted, and it’s really hard to measure how many people didn’t come to the emergency room because it was affordable. [primary care],” he said gtr.

The Tasmanian report, he said, made that link apparent – ​​the government has finally acknowledged that unless it acts to fix primary care, the hospital system will suffer.

RDAT is particularly interested in helping Tasmania retain its rural GPs by providing fair terms, compensation and salary packages.

“We train great rural generalists who say, ‘hey, you know what looks good? Coastal NSW,” said Dr Dodds.

Other recommendations in the report include advocating at the federal level for increased MBS reimbursements and seeking support for multidisciplinary teams in primary care.

“There are obviously recommendations in this report that look at the whole scope of practice of GPs, but also of our allied healthcare professionals,” Dr Dodds said.

“Were [interested in] building this large multidisciplinary team, because physicians cannot do it alone in these rural communities.

“It’s definitely a team sport, when it comes to providing modern healthcare.”

ACRRM’s Dr. Halliday also supported increased funding for multidisciplinary team care.

The key phrase here is “team”; ACRRM does not support siled models that duplicate and fragment care.

Perhaps unsurprisingly, the report includes a submission from the Tasmanian chapter of the Pharmacy Guild of Australia, which argues for expanding the scope of practice for pharmacists to include the prescription of drugs.

However, those who fear an independent solution based on a community pharmacist may most likely lapse – the recommendations section specifies the delivery of multidisciplinary models of care that support collaborative agreements.

There is no specific mention in the guidelines supporting a pharmacist-led silo prescribing model at North Queensland.