Five GP clinics have closed in Bendigo in the last year and five have opened in their place - but services have been hard hit as doctors cut hours and the cost of running services spike.
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Health officials have warned that the sector in the Bendigo region is in "real crisis".
Murray PHN chief executive Matt Jones said of the 153 GP practices across Victoria, 50 per cent are facing moderate to high need for staff.
He said the region's health landscape was currently "quite fluid".
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"We have a number of practices closing, but we also do have numbers of practices opening as well," Mr Jones said.
Not a 'straightforward equation'
"So it's not a straightforward equation, there's been overarching reduction because what the real issue is that we're challenged by access to GP services in regional Victoria.
"That's certainly being experienced in Bendigo."
Mr Jones said "composition" of GP clinics was changing.
"People are wanting different experiences and (GPs) are not providing the same number of full-time sessions as historically has been the case," he said.
Mr Jones said that the shift was "a little bit like what's occurring in society" with more people seeking to work part time.
"That's true of general practice and less general practitioners wanting to work full time," he said.
He said there was also added pressure on after-hours services as GPs looked for a better work-life balance.
Practices struggle with clinic costs
Mr Jones said practices had been "really hit hard" by the Medicare rebate freeze over the last 10 years.
"Their costs have been increasing significantly," he said.
"They're also looking at other things like payroll tax and other changes that are also biting hard.
"So their ability to have not only more GPs come into the practice, but a sustainable service for the community is being threatened.
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He said that increasingly the challenge would be staying financially viable if they were unable to attract and keep GPs.
"The number of practices opening and closing is a crude measure of what is a complex issue, but a situation that is in real crisis and it needs specific and targeted action to address," he said.
"We need to make sure that we've got accessible primary healthcare services because without that, emergency departments are overrun and we need to build bigger hospitals."
'One size' model not suitable
Mr Jones said the "one size fits all" model imposed on the country's health industry needed to be changed.
"We've got a lot of data and there's been a lot of hand wringing, but there's not much action," he said.
"Our health system is based upon universal access to healthcare and taxpayers are paying two per cent of their incomes through Medicare Levy to have access to that care.
"But that model is a one-size model that fits across all of Australia and it doesn't work well in areas of small populations distributed over large distances without economic capacity.
"So we need to be looking at the co-ordination of healthcare capability at a population and regional level so then it's then able to be delivered locally.
"We need flexibility in the funding models and we need flexibility in the regulation to enable that to occur."
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Alex Gretgrix
Journalist based in Bendigo, Victoria, covering health and a few local shires at the Bendigo Advertiser. Contact via alex.gretgrix@austcommunitymedia.com.au
Journalist based in Bendigo, Victoria, covering health and a few local shires at the Bendigo Advertiser. Contact via alex.gretgrix@austcommunitymedia.com.au
