This year, we need to consider some changes to our healthcare system so that getting in to see the doctor doesn’t depend on where you live or what you can afford to pay.

Reports of GP clinics closing in rural communities across the country throughout 2023 should sound alarm bells for the growing gap between equitable, affordable and accessible primary healthcare. Late last year, it was reported that Western Victoria had lost more GP services than almost anywhere in Australia over the previous year.

Doctor shortages have also led to the recent closure of clinics in small communities on the Sunshine Coast in Queensland and Hobart in Tasmania, with some estimates that nearly 200 GP clinics had been forced to close in the past year. Worryingly, the current shortage of GPs is expected to become even more of a challenge across Australia.

The number of GPs who intend to retire over the next 5 years is accelerating, with rural and remote areas expected to be the hardest hit. Colac is facing its worst doctor shortage yet in 2024 – which is only becoming more difficult with a growing population.

The cost-of-living crisis is also having a massive impact on the ability for consumers to access the care they need.

The number of people delaying a visit to their general practitioner, or not seeing a medical specialist when needed due to cost, continues to rise. Increasing gap fees for patients and ongoing workforce shortages are the result of a primary care system that has failed to keep up with the demands of a growing population and changing consumer needs and expectations.

We need a plan that meets the healthcare needs of all Australians. Victorians shouldn’t be waiting weeks to see their GP or dialling emergency services in an effort to skip the queue.

While sustainable and predictable migration policies are needed to build our health workforce, there are other ways to address these challenges. We cannot simply fix the problem with ‘more GPs’. Victoria’s community health services have been providing healthcare for 50 years and can relieve the existing pressures facing our health system. The community health service model is a uniquely Victorian asset that delivers a range of services spanning primary care, allied health, prevention and health promotion. Community health services complement private general practice, providing bulk billed services across major metropolitan services and small rural areas.

Key to this is the use of a multidisciplinary workforce that can treat people with complex and chronic care needs, especially those who face barriers to getting the care they need.  

Growing rates of chronic disease mean that Victoria’s community health services are only going to see greater demand. The fact that more of us are living longer is a great outcome for population health but with that also comes the need for increased investment in prevention.

 In 2020–21, there were 556,000 avoidable ED presentations in Victoria that could have been avoided had primary or community healthcare been available.

The VHA’s recent paper on Victoria’s community health service model shows that expanding the community health service model to other states and territories can strengthen our primary care system.

An example of this in action is a community para-medicine model that has been applied at Sunraysia Community Health Services, based in Mildura.

The CP@ program has been shown to reduce emergency service calls and chronic disease risk, all while connecting people to primary care services where needed. Adapted from an international model in Canada, the program employs paramedics to provide care to people who would otherwise miss out − increasing the use of an available workforce.

If this program was introduced at scale, it could alleviate the critical workforce shortages facing our healthcare system. This could free up emergency services, GPs and other parts of our health system so they can focus on the most vital areas of patient care. 

But there is more work to be done to create a modern primary care system where all Australians are supported to be healthy and well.

While the Whitlam Government’s national Community Health Program ended in 1981, community health remains an integral component of Victoria’s health system.

With sustained investment in the community health model by the Commonwealth, state and territory governments, we can create a fairer and more affordable healthcare system.

Leigh Clarke is the CEO of the Victorian Healthcare Association.

This article originally appeared in the Sunday Herald Sun on Sunday 21 January 2024.