GP clinics in Dapto, Shellharbour and Port Kembla could be forced to close after rule changes allowing recently arrived GPs to work in Australia left out parts of the Illawarra.
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Practice manager at Dapto Healthcare Kerrie Iwanksi said the practice was facing closure due to a shortage of GPs.
"If we don't see any light at the tunnel by the end of the year, we may not be here anymore," she said.
The practice started 2022 with seven GPs but is now down to three doctors to service 7000 patients. One doctor is booked out four weeks in advance and the practice has not been accepting new patients since January.
Despite advertising widely in online jobs boards and medical magazines, the practice has only had one application from a GP, who turned out to be ineligible.
That was why, when Ms Iwanski saw that rules were being changed to open up non-metropolitan regions to become distribution priority areas (DPA), she was elated.
"I was quite excited when it came out, I was really hoping that we would be included in the list because we're so desperate here for doctors," she said.
"When I noticed that Wollongong was included, and our little area here of Dapto has been excluded, I was totally gobsmacked."
The change allows for GPs trained in Canada, Ireland and the UK to relocate to Australia and immediately start practising in those areas determined to be DPAs. GPs trained overseas in other countries can move to DPA areas sooner, rather than the 10 years it would take to practice in a metropolitan area.
The DPAs are based on the Modified Monash Model which ranks regions of Australia from MM1, metropolitan areas to MM7, very remote communities. The Illawarra, from Helensburgh to Shellharbour, is ranked MM1, the same as Sydney.
This meant that the Illawarra was not a DPA, until July 21, when Health Minister Mark Butler updated the DPA to include some outer metropolitan areas including Wollongong as well as Newcastle and the Hunter.
Dapto, Port Kembla, Warrawong and most of the Shellharbour LGA however remained not DPAs, meaning doctors can come from overseas and practice in Figtree, but not Unanderra.
Ms Iwanski said the change did not make sense to her.
"I cannot believe it. It's just the most absurd thing that I've ever seen."
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To fill the gap left by not having enough GPs, nurses at Dapto Healthcare provide preventative healthcare services and reception staff triage patients.
Ms Iwanski said while she understands hospitals too are overburdened, with a lack of GPs, some of her staff have to refer patients who would normally be seen by a GP to hospitals.
The financial burden of not enough GPs also places pressure on the clinic which has the same overheads, but without the fee which each doctor pays to the practice per patient.
"If you've got seven doctors earning what they earn a year, and [the practice is] getting 30 per cent of that, and then all of a sudden, you go from seven to three, your income has dropped to less than half within a six month period," Ms Iwanski said.
"The next stage will be that we'll have to start letting staff go."
The Mercury and staff from the Member for Whitlam Stephen Jones's office have put questions to Health Minister Mark Butler but at the time of publication are yet to receive a response.
For Ms Iwanski and her patients in Dapto, the change means that they will be waiting longer for a doctor.
"Just yesterday, a young doctor who's working at Shellharbour Hospital bought a house at Dapto, because he believed he could work here," Ms Iwanski said.
But due to a misunderstanding about eligibility, the doctor, who had moved to Australia from Brazil, was prevented from seeing patients in Dapto. The change left Ms Iwanski heartbroken.
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