The Wheatbelt town of Quairading recently got national attention for offering up to $1 million in incentives to attract a new GP. The package included a $400,000 salary, housing, and staff accommodation.

It was an extreme but understandable response from a community left stranded after losing their only GP.

This isn’t just a problem in Quairading.

About half a million people across Australia live in “GP deserts” — areas where there are too few GPs to ensure everyone can get the care they need.

Residents in GP deserts receive 40 per cent less services per person than the national average. This means people get less of the check-ups, screenings, and medication management essential for staying healthy.

WA has more GP deserts than any other State or Territory. East Pilbara, West Pilbara, Kimberley, and Esperance are among them.

And the GP deserts tend to be where people need care the most.

West Australians living in GP deserts tend to be sicker — they are 1.5 times more likely to die from an avoidable cause than people elsewhere in Australia. These are deaths from conditions such as infections and heart diseases that could have been avoided with earlier care.

And the care they do get is more expensive. Doctors in the Pilbara bulk bill less than 70 per cent of GP services (compared to the national average of 77 per cent).

East Pilbara has the second highest average out-of-pocket contribution per service in Australia, with patients paying more than $60 on average when they see a GP.

It’s not a new problem either.

For at least a decade, people in GP deserts have endured an unacceptably low level of primary care. While the average Australian received 6.4 GP services in 2023, residents in the Pilbara have been living with less than four GP services per year since 2014.

Recent rural health policies have helped a little. The uptick in rural bulk billing is an early sign that the 2023, $3.5 billion investment in tripling bulk-billing incentives is working. Rural medical schools and programs have also contributed to an increase in the number of graduates specialising in rural general practice.

But the fact that GP deserts have persisted year after year demonstrates that one-size-fits-all policies for rural Australia won’t bridge the most egregious gaps in care. Remote Esperance and Gascoyne have vastly different needs than Far North Queensland, another GP desert.

Australia needs a more targeted approach. All communities should be guaranteed a minimum level of primary care. When they keep falling below that level of care, they should automatically get funding from the federal government to increase services. And the WA and Federal governments should share responsibility for ensuring residents get the care they need.

The funding must be flexible because every GP desert is different.

Some communities have small hospitals and Aboriginal-controlled health organisations, while others don’t.

So some communities may simply need extra staff in an existing clinic. Others may want to introduce telehealth for routine check-ups, or a multidisciplinary care model, where different practitioners are brought together to provide care at a single contact point.

We know that local solutions can work. Like Quairading, Triabunna, on Tasmania’s east coast, is a desperate community whose local council has introduced a levy to fund more care.

Instead of putting it towards a GP salary package, however, Triabunna is trialling a new multidisciplinary care approach. GPs, pharmacists, nurses, and specialists, including a visiting psychiatrist from Hobart, are providing care through a centralised service.

This reduces pressure on GPs, and ensures residents get more care, more efficiently.

There is no lack of ideas about how to increase available care, the problem lies in funding them. From the east coast of Tasmania to remote WA, communities bear the burden of plugging gaps without secure funding.

Setting a minimum level of GP services won’t be hugely expensive. Guaranteeing at least 4.5 GP services per person per year would cost the Federal Government about $30 million a year at the normal cost to Medicare.

Even if that cost was doubled or tripled, it would still be only a fraction of the billions of dollars of extra incentives GPs are getting to bulk bill — a small price to pay to close some of the biggest gaps in care across the country.

For too long, West Australians living in remote areas have had to put up with appallingly low levels of primary care. In the looming Federal election campaign, every party should promise to ensure healthcare funding follows communities, not clinicians — so Australia can finally eliminate GP deserts.

Peter Breadon

Health Program Director
Peter Breadon is the Health Program Director at Grattan Institute. He has worked in a wide range of senior policy and operational roles in government, most recently as Deputy Secretary of Reform and Planning at the Victorian Department of Health.

Wendy Hu

Associate
Wendy Hu is an Associate in Grattan Institute’s Health Program. She previously worked at McKinsey & Company in the public sector, industrials and infrastructure, and consumer practice areas, and at the Office for Women in the Department of the Prime Minister and Cabinet.