The Royal Australian College of General Practitioners (RACGP) has called on governments to help GPs on the frontline in flood-affected communities.
It comes following the college’s previous calls for governments to institute reforms that will assist GPs in caring for people in communities impacted by natural disasters such as bushfires, cyclones and floods. The college has consistently argued that GPs should be central to disaster relief.
RACGP President Dr Karen Price warned that urgent action was needed.
“GPs are rolling up their sleeves to assist flood-affected communities, but we need a helping hand,” she said.
“We are urgently calling on the federal Government to prioritise requests for GPs to be allocated emergency provider numbers. During disasters GPs need to apply for emergency numbers as they may need to work in evacuation centres. This includes the work of locums, which are self-employed GPs who can cover where there are temporary shortfalls in general practice care, including areas impacted by these floods.
“Without this emergency provider number GPs won’t be able to claim from Medicare. Normally, it takes about a month to obtain a provider number so we must make sure that the federal Health Department fast-tracks them so that GPs can help flood-affected communities.”
Dr Price said that lessons from previous natural disasters must not be forgotten.
“During previous natural disasters, regulatory barriers have hindered the capacity of GPs to assist at emergency centres,” she said.
“We know, for example, that GPs were effectively locked out of evacuation centres during the New South Wales bushfires of 2019-2020. Let’s make sure that in the days and weeks ahead this does not occur. The worst outcome would be the situation where GPs are able and willing to help but not being utilised at these centres because they are not part of the area’s response plan. If there is red tape in the way let’s get rid of it so that GPs can do what they do best – help patients in need during a desperate time in their lives.
“Whether it’s bushfires or floods or any other natural disaster, GPs can treat many of the presentations at evacuation and refuge centres. It’s not just physical injuries either, we can provide an initial mental health consultation to people who have been through a frightening experience and potentially lost loved ones or forced to flee homes or businesses in ruin.”
Dr Price said that general practice must be front and centre when disasters strike.
“The 2019-2020 summer bushfires exposed long-standing deficiencies when it comes to the involvement of GPs during natural disasters,” she said.
“Unfortunately, GPs are not always front of mind, and we are not always properly consulted, because general practice care is not integrated into emergency responses.
“The fundamental problem underlying all of this is that different branches of government aren’t always talking to each other. The state and territories are responsible for emergency planning and general practice falls under the jurisdiction of the federal Government. So when, for example, floods hit communities - GPs are not always kept in the loop.
“We must ensure that there is a properly coordinated disaster response between local services and state and federal government bodies. I’m hearing reports that during the first week of the floods local health professionals, including GPs and nurses, came together at evacuation centres amidst utter chaos to support large numbers of displaced people. It was ad hoc with very limited technological support. So once again, I think this is something that we can learn from and improve on.
“GPs are essential in helping people when floods, bushfires or other disasters occur. In the years ahead, we must be formally recognised as frontline health providers in any natural disaster arrangements. Let’s also make sure that there is strong general practice representation on recovery committees so that we can have a say in helping communities devastated by natural disasters.
“These floods will severely disrupt the lives of many people in Queensland and in New South Wales. There have already been a number of deaths and people are losing homes and businesses and undergoing a truly terrifying experience.
“Bushfires, cyclones, floods and other natural disasters will happen again and again and will in fact get a lot worse due to climate change, which the Royal Australian College of GPs recognises as a health emergency. When disasters like this strike, we need to make sure that GPs are front and centre because we are the ones who can help people in need, and we will be the ones helping to pick up the pieces in the aftermath.”
RACGP Specific Interests Disaster Management Network Chair Dr Glynn Kelly said that GPs should be involved in preparing for disasters – human-made or natural.
“General practice should be involved in federal and state and territory and local disaster planning so when a flood, cyclone or bushfire happens, general practice is aware of where it may need to help out,” he said.
“At the moment, general practice helps out by saying, ‘hey, there's a need in Lismore so let's try and do something for Lismore’. But in reality, what would be better is that let's say for Lismore, that there was a plan for Lismore where general practice was involved in the development and delivery of that plan and that the plan was then activated to ensure a maximally effective response
“It’s vital to remember that natural disasters can occur at any time, and this means that we should be better prepared at a system level. General practice has been saying for some time that we should be represented on a round table basis at federal level and state and territory level and council levels. This also means being involved in planning, preparation and exercising before disasters strike and being involved in debriefings afterwards as to what worked well and what didn’t work well and what can be done to improve disaster responses.
“In every disaster in Australia that I've been aware of, GPs and general practice teams have always stood up where they're needed. My mantra is - if there's no preparation and planning, it can't be as effective as could otherwise be the case, and it won't be as safe as it could be otherwise.”
Dr Kelly also warned that the floods will take a toll on the mental health of many people.
“I think the mental health of people in flood-affected areas – or indeed all disasters – is a significant concern” he said.
“GP’s often need to be there for their patients for weeks, months or even years after a disaster. We’ve had two- and a-bit years of a pandemic, so there are already a lot of people in the community with mental health issues. So, whereas some people who might normally be resilient – it’s very hard to do so given everything that has already happened in recent years. It’s just one thing after the other and that can really wear patients down.”
The RACGP’s submission to the Royal Commission into National Natural Disaster Arrangements can be found here.
Details of the Royal Commission into National Natural Disaster Arrangements’ (bushfire royal commission) final report, which included a recommendation backing calls from the RACGP for greater GP involvement in GP disaster management, can be found here.