• The College’s feedback to the Better Medicare and Scope of Practice consultations
• National initiatives commissioned by the joint health ministers to implement recommendations from:
  • The Kruk Review into regulations for international health practitioners
  • The National Health Practitioner Ombudsmen Training Site Accreditation Process Review.

Working Better for Medicare Review – Part One
Consultation on the Working Better for Medicare Review , commissioned by the Commonwealth Health Minister, Mark Butler, and led by Prof Sabina Knight and Adjunct Prof Mick Reid, closed in March.

ACRRM’s submission notes that whilst Australia’s overall doctor to population ratio is among the highest in the OECD and many areas of medical practice are in plentiful supply or even over-supply, maldistribution of the medical workforce, both in terms of location and specialisation, continues to result in pervasive workforce shortages across rural and remote Australia.

• Rural and remote models of care should be designed and funded to ensure peoples’ access to continuous, local healthcare.
• The DPA and DWS programs would benefit from incorporating consideration not just of workforce need but also the appropriate model of care for each rural area.  
• The College acknowledges the considerable scholarship that underpins the validity of the MMM and the significant input of rural doctors and communities who informed it, whilst recognising that the model will not perfectly reflect need and there may be need for additional mechanisms to accommodate exceptions.
• The College’s request to reinstate the former arrangements which limited DPA locations to rural and remote areas was reiterated. 

Working Better for Medicare - Part Two – Healthconsult targeted consultation
The CEO and Policy team met with Healthconsult earlier this month to provide specific feedback around S19AB and the District of Workforce Shortage policy levers. ACRRM’s feedback (insert link once sub is on website) stressed that all policy and programs should be based on the principle that rural and remote models of care should be designed and funded to ensure equitable access to continuous, high quality local primary medical and health professional care along with acceptable and timely access to emergency, secondary and tertiary care.  

Any reform of Section 19AB and the DWS should be viewed as part of a suite of workforce solutions which address a range of issues including workforce supply and distribution together with trends such as increasing sub specialisation at the expense of generalism and changing expectations of younger generations.  

Scope of Practice Review
The Scope of Practice Review continues, and ACRRM has provided feedback on Issues Paper One, which focuses on health professionals who provide primary care and the associated evidence about benefits, risks, barriers and enablers to support them to work to their full scope of practice.

ACRRM’s submission acknowledges the value of expanded and full scope practice in conditions of relative professional and geographical isolation and limited clinical resources such as occurs in rural and remote areas including Aboriginal and Torres Strait Islander communities. In these contexts, the economies of a highly specialised staff and resource system of care that can occur in major centres do not apply. Despite the absence of scale economies there is strong evidence that the Rural Generalist model provides an excellent return on investment and an economically effective service delivery model, in addition to providing significant benefits through a fit for context skilled workforce and the benefits of strongly integrated care.  

At the core of any rural and remote health policy must lie the commitment that people in rural and remote areas warrant the best possible care and as a minimum, at a standard comparable to that provided to their urban counterparts.  To maximise the care that rural and remote communities can access, the training and professional development provided to healthcare professionals should support the Rural Generalist/full scope approach to practice.

The Scope of Practice Issues Paper #2 is due for release this month, with consultation running until June/July 2024. 

Contact the Policy team
The College advocates on behalf of our members in a range of forums, collaborations, and partnerships. The College regularly engages with policy development, review, and reform agendas at national level. We provide written submissions, organisational delegations, consultations, private briefings and in-person evidence to a range of national reform agendas. 

The Policy team values all members’ input on policy issues as they arise. Member input allows us to provide submissions and representations which are more powerful and more reflective of the realities of rural and remote practice on the frontline. 

Contact Policy@acrrm.org.au  if you would like to provide feedback on a particular issue or consultation.