General practice remains the cost-effective engine of the health system, but more needs to be done to grow the GP pipeline and improve general practice sustainability so every Australian has access to high quality care into the future, the 2023 Health of the Nation report finds.
The seventh edition of the Royal Australian College of General Practitioner’s (RACGP) Health of the Nation report focuses on attraction and retention of the general practice workforce. The report draws directly from the reflections and experiences of GPs and GPs in training via the nation-wide RACGP Health of the Nation survey. It finds:
GPs are seeing more patients than ever – less than 1% of people reported being unable to see a GP when they need to, and the average time GPs spent with patients increased.
The GP workforce needs an urgent boost – fewer medical students are choosing general practice training, while more GPs are looking to reduce their hours or leave the profession. Almost three in 10 GPs signalled their intention to retire in the next five years.
Mental health is a growing issue – the proportion of GPs reporting psychological issues in their top three reasons for patient presentations increased from 61% in 2017 to 72% in 2023.
General practice sustainability needs to be addressed to prevent practice closures impacting communities across the country – 4 out of 5 practice owners are concerned about the viability of their practice.
RACGP President Dr Nicole Higgins said urgent action is needed to boost the general practice workforce across Australia, to ensure GPs can meet patient needs now and into the future.
“Our report shows general practice remains the cost-effective engine house of Australia’s health system. Our nation’s GPs help people live longer and healthier lives, and reduce pressure on hospitals,” said Dr Higgins.
“When a person goes to a hospital emergency department, it costs the government and taxpayers, on average, over $600 – and much more if they’re admitted. Whereas it costs only $80 for 20–40 minutes with their GP.
“Australia’s GPs are seeing more patients than ever and spending longer with them. This reflects the increasing complexity of patient needs, and more people presenting with chronic illness, multiple conditions, and mental health issues. In a typical week, 38% of GP consults involve mental health.
“A strong GP workforce is essential for the health of our nation, but it is under pressure. Sourcing and retaining GPs remains the issue that most practice owners rank as their biggest challenge.
“Our report is further evidence that we are facing a looming shortfall of GPs, and we need to do much more to attract and retain this essential workforce, for the health of Australians now and into the future.”
The RACGP President said measures can be actioned immediately to boost the workforce.
“Being a GP is one of the most rewarding jobs, and those in the profession know it. GPs tell us they love their job, but current circumstances make it feel hard to provide the high-quality care we are trained for,” she said.
“GPs are specialists and do the same eight years of medical training as any other specialist, followed by at least three years further training in a general practice. However, GPs are hamstrung at the outset due to discrepancies in conditions and pay between hospitals and private practice.
“This is a significant barrier to becoming a GP, and it can be immediately addressed by investment in three key measures - introducing an incentive payment in the first 6-months of community general practice training, as well as study leave, and paid parental leave for GPs in training. It’s unfathomable that in today’s age GPs in training don’t get paid parental leave, and more so when you consider that more women are becoming GPs each year than men.
“Addressing these three key barriers would make an immediate difference in getting more GPs training and working in the communities that need them.
“We also need more GPs aspiring to become practice owners too; this means we need a strong and sustainable general practice sector. Our report found just 10% of GPs are interested in becoming a practice owner, and four out of five current owners are concerned about the viability of their practice.
“One of the biggest threats to practice viability is a new interpretation of payroll tax which has seen practices in some states hit with enormous retrospective tax bills for extra payroll tax on their independent GPs. Practices have always paid payroll tax on their employees, but it has never applied to GPs because they work under independent agreements. Now practices are facing closure, and having to raise patients’ out-of-pocket fees, because they can’t absorb this extra tax. This needs to be addressed urgently, we need a consistent approach to this tax across Australia and settings for general practice to thrive in every community.
“And most important in the long-term is sustained investment in general practice care, so we can meet the future health needs of everyone in Australia, no matter their income or postcode. This will also work to ensure that general practice is an attractive career, and we’ll have a strong GP workforce, and a healthier nation.”