For OTDs working in private practice, either wholly or in part, the Health Insurance Act 1973 (the Act) places restrictions on the areas in which they may practice through Section 19AB. This section of the Act requires the medical practitioner (both GPs and specialists) to work in an Area of Workforce Shortage (AOWS) for a period of up to ten years. These provisions appear to have been particularly influential in increasing the numbers of medical practitioners in practice in rural and regional Australia. As at February 2008, there were 4,669 overseas trained doctors, including GPs and specialists, with current Section 19AB exemption status3. (Rural Doctors Association Australia submission)
AOWS are determined on the basis of the original RRMA area boundaries, but the measure is updated regularly using the most recent population and Medicare data, with an area being deemed an AOWS if it falls below the national average of FWE GPs. Inner metropolitan areas cannot be deemed an AOWS. Attachment C maps AOWS across Australia.
The use of overseas trained doctors, whilst propping up the current system, is fraught with problems and it defies logic that we bring in these doctors who require very substantial amounts of support then put them in communities where they are least able to access the support they require. We are also aware that there is often a high level of resentment at being forced to go rural particularly when these doctors may have immediate family who live in metropolitan areas.
(Rural Doctors Association Australia submission)Attachment C also provides a number of other maps showing the distribution of other organisations providing services to rural and remote areas for which the Australian Government contributes funding, namely Aboriginal Medical Services, Multi Purpose Services and Royal Flying Doctor Services. Doctors working in these and other services and on state contract are not captured in Medicare where all their work is salaried, but are captured in the other collections.
3 Overseas Trained Doctors administrative data, February 2008.