WA’S medical system is crucially dependent on overseas sponsored doctors.
The Australian Medical Association says overseas-trained doctors on temporary visas make up one quarter of the medical workforce in rural WA.
Temporary, overseas-trained doctors also fill 300 positions in Perth’s teaching hospitals.
Getting such people to come is no problem – there are 1,000 applicants each year – and in the past two years 40 doctors on temporary visas have opted for permanent residency, even though it meant committing to a rural region for five years.
In particular, WA is suffering a critical shortage of general practitioners, up to 600 the AMA says.
Regional and remote rural areas are feeling the impact most but so are outer metropolitan areas such as Clarkson and Serpentine.
To help fill the shortfall the AMA WA Locum Service sponsors 100 overseas doctors each year, for between three and 12 months at a time.
But indemnity issues exacerbate the difficulties, with heavy fees including ‘tail cover’ for 24 years after the doctor ceases practice in Australia.
The AMA is taking responsibility for the tail cover for those it sponsors now, but is in talks with the State and Federal governments to resolve the issue.
While confident of an eventual good resolution, AMA WA executive director Paul Boyatzis warns: “It would be a catastrophic outcome for WA if this issue can’t be solved”.
Together with the WA Centre for Remote and Rural Medicine, the AMA attracts overseas applicants through a program called Mediventure, promoting working in rural WA as “the medical adventure of a lifetime”.
The scheme was heavily marketed, initially, but now mostly works by word-of-mouth.
“We have a constant stream wishing to come over,” Mr Boyatzis said.
But of the 1,000 applications received each year, only 10 per cent were usually accepted, on strict criteria including proof of training that was accredited and accepted in WA, post-graduate qualifications in general practice, and the skills needed to work in isolation, he said.
The AMA Locum Service is currently looking after 100 doctors and their families sponsored from overseas, and up to another 40 will arrive before the end of the year.
Mr Boyatzis described the shortage as critical to the survival of communities.
“In a town, you can do without architects, accountants and lawyers, but you just can’t do without doctors,” he said.
“If you ask people what they want in their town, the number one thing they tell you is a doctor.”
The impact for single-doctor towns if the doctor leaves permanently was enormous, Mr Boyatzis said.
“If there was a hospital it would have to close, and this would impact heavily on workers, as the hospital is usually one of the larger employers in a town.
“The town would also lose its pharmacist, with no-one there to authorise scripts.
“Then people would start leaving the town, and then the school might have to close and the supermarket.”
The AMA works with local shires and mining companies to establish doctors in towns, providing the infrastructure, set-up systems, and a doctor and staff to run the practice, until a permanent doctor can be placed in the town, to take over.
Some of the mining companies sponsor some of the expense, Mr Boyatzis said.
Merredin, Three Springs, Wagin and Gingin are among the towns where this has worked successfully.
While it is preferable to find local doctors who know the WA health system, it is difficult to provide the required numbers, so most of those recruited for these areas are on short stay from the UK, Ireland, the Netherlands, South Africa and New Zealand.
Some fill positions when a local permanent doctor falls ill, or takes leave.
WA needed to train more doctors, Mr Boyatzis said, while the Federal Government did not adequately understand how difficult it was, with the size of the State and its regionalisation.
There were many towns where a single doctor was covering vast distances, he said.
The Federal Government’s recent grant of an additional 45 university places by 2005, through the University of Western Australia and the University of Notre Dame Australia, was welcomed.
“However, it takes between 10 and 12 years to get any of them through the system as general practitioners,” Mr Boyatzis said.