Introduction
Although the Federal Government has responsibility for the overall primary care sector, the state and territory governments are responsible for emergency planning in conjunction with LHNs/LHDs and, in some cases, the PHNs. Because general practices are generally private businesses independent of state and territory health services, this has contributed to their limited inclusion in the emergency planning process. There are variable formal arrangements in place across LHNs to utilise GPs when a disaster occurs, and GPs who turn up to help at evacuation centres are sometimes turned away because they are not part of the local area’s disaster response plan.
After many years of tragic and costly natural disasters, some PHNs (which are funded by the Federal Government and have a mandate to coordinate primary healthcare in their region) are prioritising disaster planning; however, routine funding for this purpose varies state by state. PHNs can play a critical planning and operational role in ensuring general practice is better integrated into disaster planning. This will ultimately support general practices in disaster-impacted areas to remain open and, as needed, help GPs and their teams provide care in evacuation centres, ensuring communities retain access to vital ongoing medical care.
It should be recognised that although GPs and their teams are keen to actively contribute to disaster planning and response, general practices are private businesses and may be unable to commit money and resources to disaster planning, preparedness or response activities. Services provided by GPs in evacuation centres are not billed through Medicare and GPs are not routinely remunerated. To date, the majority of GPs providing care in evacuation centres volunteer out of a sense of philanthropic good will. Although many GPs are happy to volunteer their services to assist their communities, it must be acknowledged that in doing so they may be missing out on paid work via their usual place of practice.
This document recognises there will always be variations in arrangements and processes for the establishment and management of evacuation centres across jurisdictions and local regions. There is a significant element of local context to the operation of an evacuation centre (eg the needs of disaster-affected communities vary significantly according to many factors, including rurality, the pre-existing health of the local community, the type and severity of the disaster and the duration of need for the evacuation centre). However, the recommendations for the role of GPs in an evacuation centre should be implemented consistently and nationally.