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Day 2 – FRAME Business Meeting
 
RCS / RMS Directors Breakfast Meeting
  • Directors and Heads of Schools met to discuss the outcomes of the elections and the proposal for an alliance between FRAME and Medical Deans.
FRAME Business Meeting
 
1.  Ms Sarah Marks, Advisor to Senator Fiona Nash, Assistant Health Minister
  • Sarah conveyed Ministers Nash’s apologies for not being able to attend the meeting. The Minister is keen to work with stakeholders. There is a lot going on in the area of rural health and lots of opportunities to do good work.
  • The Minister’s direction in rural and regional health is to improve health outcomes, workforce and access.
  • $52.5m is being provided for GP infrastructure grants. The PIP for teaching medical students is doubling. Practices will have more capacity to teach students in rural areas.
  • The Minister’s office is looking closely at the RA classification system and receiving feedback on its perceived inadequacy and ideas to amend it to better serve communities.
  • Sarah will brief the Minister prior to her meeting with the FRAME Policy Group. FRAME members are encouraged to email Sarah if they have any queries or concerns.
Discussion included the following topics:
 
Infrastructure funding
  • Infrastructure funding is for private general practices to add a room to the practice, enhance surgery capacity to take on students. RCS in some states still need support for infrastructure. FRAME would like to see the re-establishment of infrastructure funding alongside operational funding.
  • More funding is required for multidisciplinary teaching infrastructure in small hospitals. First tranche of RCSs were created in 2002 – facilities and infrastructure now old and tired. Without funds to upgrade, it is a significant issue.
  • Many RCS have infrastructure for existing numbers of students, but it would be a challenge to increase capacity.
Reliable broadband for teaching and learning
  • Changes to NBN, how rolled out in rural areas. Good fast reliable broadband is important for teaching, learning and service delivery and for telehealth.
  • Using digital technology for the delivery of the program saves travel time and is also a safety mechanism.
  • The government is working with local hospital networks on IT issues / networks however there are on the ground operational issues.
Rural Training Pipeline
  • RCS Infrastructure is there and can be used and built on rather than creating additional networks.
  • RCS Infrastructure and human resource capital offers opportunities for prevocational and vocational training.
  • General Practice pathways for rural medical graduates are important. It is essential that in the new GP training structure, rural pathways don’t get hijacked by the metro agenda.
  • Tackling the pipeline College by College is a failed strategy. RCS know local landscape – medical students, junior doctors, and are committed to seeing the training pipeline work.
  • Different models are needed in different areas. What works in one region might not work in another.
  • Vocational Training – seems discriminatory that PIP payment is confined to private general practice. We want to develop generalist surgeons but there are no practice payments for specialist generalist training eg surgeons. This could be an incentive for those working in rural areas.
Medicare Co-payment
  • Doubling of PIP payments is great but FRAME expressed concerns regarding the negative impact of the GP co-payment. Medical education may suffer.
  • There are concerns about the co-payment in high Indigenous populations / poor health outcomes / poor access to service / low access per population to Medicare dollars. The co-payment in rural areas is biased against those already having poor access and outcomes.
  • In rural areas, patients present to the hospital more than in metro areas.       The co-payment goes against the government’s policy of better primary health care and prevention. More patients will go to hospital, therefore losing continuity of care, intervention, and placing increasing pressure on hospitals.
  • Co-payments go against primary care health outcomes.
  • Co-payments have huge potential to reduce profitability and attractiveness of rural general practice, therefore negatively impacting on workforce.
Relationship between health and education portfolios – FRAME spans both.
  • Changes in funding of higher education will have significant impact on rural and remote campuses.
  • Deregulation of fees will impact on people from rural and remote areas accessing higher education. It is already expensive for students from rural areas to attend university metro campuses.
  • Good scholarship programs are needed to ensure rural areas are not disadvantaged - HECS relief or incentives for rural people to access higher education / work in rural areas are required.
Research as an integral part of RCSs.
  • RCSs need to have meaningful capacity to provide students with research support, otherwise they won’t be able to meet curriculum requirements and won’t be appealing.
  • Rural research is different from urban research. It can be difficult to develop research on local issues due to national perspective that research needs to be of national or international interest.
  • Plea for practical rural health research, funded differently or parameters around rural research.
Funding agreements
  • FRAME acknowledges the constraints and welcomes the opportunity for reform and streamlining processes.
  • However, it is important for the Minister to understand that RCSs are businesses and without a funding agreement, staff contracts cannot be renewed.