THE DAY started out normal and then I received a phone text message with a screen shot of a media release about the closure of Toodyay’s Alma Beard Medical Centre.
When I got home, the first thing my partner Simon said to me was “don’t reply to all the Facebook comments” because he was worried that it might be too upsetting for me.
I read all the comments, replied to one and noticed one thing in common about the Shire of Toodyay.
This may be the only time in history that I will stand up and say that this time “it is not the shire’s fault”.
I am thinking “what would my former partner and much-loved Toodyay doctor, the late Richard Walkey, do to help calm people’s heightened levels of anxiety about this?”
Well, the truth is we all need to know why the medical centre is closing and why we could never get anyone to come to Toodyay to work as a permanent doctor.
Here are some facts as I see them.
There is an Australia-wide shortage of doctors which goes back to the days when Kevin Rudd was Prime Minister (2007-2010 and 2013).
Doctors can earn much more money in the hospital system in the Perth metropolitan area than in regional WA or prefer to work in practices with a back-up hospital nearby.
Doctors prefer country practices to be fitted out and walk-in ready but Toodyay is not like that – it would cost up to $200,000 to bring our town up to a level to suit accreditation for a GP practice to receive sufficient payments to subsidise income.
Country doctors expect to be provided with a car and house, and for the shire to guarantee their income until the practice can generate a minimum income of $250,000 a year, which could increase if a couple was to come.
A GP practice requires staff, pathology services and a practice manager.
The Federal Government’s Medicare bulk billing scheme does not cover operating costs – these can be recovered only by charging patients an additional ‘gap’ fee.
When Richard and I had the Toodyay practice, it showed a billing loss against running cost of $120,000 a year based on wages for nurses – it would be more now.
Practice income comes from a variety of sources such as billings, practice incentive programs, service incentive payments, hospital billings and payments for after-hours services (not many doctors will do that).
Other billing can include shared treatment plans with other service providers such as for foot care or stress counselling, which are high paying and operate over many visits.
For a new Toodyay doctor to walk in now, there is no history of services to enable these payments to occur, so income would be down for two years until history and patient
numbers increase – another negative for attracting doctors to the area.
In addition, not all doctors want to work as country GPs, and even though the distance to Perth is relatively short, it can have many setbacks.
To be the partner of a doctor in any area also has its challenges.
Another negative is burn-out, which is a big problem for country GPs if they are the only doctor in town.
I have my own views about whether Toodyay can get a doctor in the short term but the main point of this is to offer some facts based on my own personal experience.
Please put down the pitch forks because the shire in not in the wrong.
They may not have the money to fix all our problems, but it is up to ratepayers to decide on that.
