Macquarie Health Collective CEO Tanya Forster says lack of accessible GPs driving up emergency room wait times

With the latest data revealing Dubbo Hospital's emergency room is still behind on benchmarks for wait times Tanya Forster, CEO of the Macquarie Health Collective, says addressing the shortage of general practitioners is vital.

She said people presenting to emergency rooms for non-urgent concerns, which could be dealt with by GPs, could be putting extra pressure on understaffed hospital emergency rooms.

"If those lower-urgency presentations that don't necessarily require an emergency department are managed in general practice, it will significantly ease the burden on the hospital system and the cost to the government of managing emergency departments," she said.

In recent years, three of the twelve GP clinics in Dubbo have closed their doors despite the town's population continuing to grow. In Narromine, the only GP clinic in town - Narromine Shire Family Health Centre - recently made the "hard but inevitable" decision to move towards private billing.

Ms Forster said a shortage of GPs in Dubbo - and across the nation - was leading to long wait times for appointments, making it harder for people to stay on top of proactive checkups and turning them towards emergency rooms for minor concerns.

Clinics turning away from bulk billing and increasing appointment fees to meet rising costs of doing business was also driving those who couldn't afford the out-of-pocket expenses towards emergency rooms where treatment is free.

"General practice is becoming less and less financially viable so practices are closing - and we have seen that in our region - and GPs are leaving the profession because of the lack of viability of running practices," she said

"Because the financial viability of general practice is lessening, more clinics are charging private gap payments and therefore people who are unable to afford that gap payment are finding it challenging to access GP appointments which are bulk-billed.

"So they have no option but to go to emergency departments where they can access free healthcare."

Score cards and 'traffic light' ratings released as part of the AMA's 'Clear the Logjam' campaign revealed, in 2021 to 2022, Dubbo Base Hospital still failed to meet key benchmarks in patients' waiting times.

Only 79 percent of people presenting to the hospital in an emergency situation received treatment within the 10-minute timeframe required for such incidents, resulting in a 'red light' rating from the AMA.

While the percentage starting treatment on time in the last reporting period has risen from its low of 73 percent in the year prior, it is still well below its high of 93 percent in 2017 to 2018. In the 2019 to 2020 period, 85 percent of patients commenced treatment on time.

Dubbo's emergency department also received 'red lights' for its urgent response time - with only 76 percent receiving treatment within the 30 minute time frame required - and semi-urgent response time - only 82 percent receiving care within the one hour required.

In their report, the AMA pointed to shortfalls in funding to public hospitals as the major reason behind the problems and said waiting times were an issue even before the COVID-19 pandemic.

"Governments at all levels need to invest in public hospitals and, importantly, we need to increase our workforce to adequately meet the needs of a growing and ageing population, who are increasingly presenting with complex, chronic conditions," said AMA NSW president, Dr Danielle McMullen.

"Delays in care for patients with both chronic and episodic conditions can lead to significant deterioration in their condition and ability to participate in work, and their quality of life."

Ms Foster agrees that more funding for hospitals is crucial, but said said reforms to the Medicare system to make general practice more viable for medical professionals would go a long way to addressing the shortage of GPs and easing burden on hospitals.

"Obviously multiple things are required to start to address our healthcare system and the needs for primary care, and a key component of that has to be Medicare reform," she said.

"What we're seeing is less doctors entering the general practice pathway compared to medical specialist pathways and one component that's contributing to that is that GPs typically earn less than their specialist colleagues.

"There's so much media about these issues at the moment and nothing is changing, and until the government does something we're going to continue to have a health system in crisis."

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