Patients can be left waiting longer than three weeks to get an appointment with their preferred doctor, says Gippsland GP Dr Malcolm McKelvie, as the region’s dire healthcare services remain under the spotlight in the lead up to the federal election.

Dr McKelvie spoke to the Gippsland Monitor this month, highlighting the difficulty of providing specialist care in Gippsland.

“In both regional and metro areas, if you want to see your GP and they're a good GP, then you might have to wait two or three weeks or longer,” he said. “If you want to see any GP, then access is greater in the city.”

Switching between GPs can also have implications for the standard of care that the patient receives, according to Dr McKelvie.

“If [a patient] can't get anyone in our practice, it means they've got to go to the urgent care clinic or another practice, which then fragments the care. And we know that continuity is important for better health outcomes.”

Where Dr McKelvie thinks the disparity is most prominent is in specialist appointments.

“The nature of the beast is that the tertiary hospitals are in Melbourne, and so access to specialists is limited,” he said.

A 2021 research paper in the Australasian Journal of Regional Studies found that “Gippsland has fewer healthcare professionals per capita than Australia overall (except for nurses) and has a disproportionate number of professionals that are older or recruited from overseas.”

Decline of specialist practices

Dr McKelvie said the biggest disparity between metropolitan and regional healthcare was in services like Allied Health and specialist practices.

According to him, it is difficult to entice specialists to stay in Gippsland with many opting for the population density of the city rather than rural areas. This forces patients to travel long distances in order to receive treatment.

“Podiatry, at the moment, is quite a problem. I've got patients who are seeing community nurses who are sort of setting themselves up to cut toenails. 

“The podiatry practices in the area are saying they can't attract new podiatrists. That's similar across lots of Allied Health physios and speech pathologists and occupational therapists.

“The big one is mental health, access to psychologists, psychiatrists. I think there’s this one private psychiatrist operating in Traralgon. There's another one who's 80 years old, still practising in Warragul, but he's about to retire. Private psychiatry is a desert out here.”

Dr McKelvie is concerned these disparities between Melbourne and Gippsland health services is also exacerbating differences between public and private health.

“We've still got a world class health system. We're just trying to make it better,” he said.

“We're a very rich, very lucky country, but we are not doing the inequality thing very well for the public and private. We've definitely got a two-tier health system. Access to private services is great, and access to public services is often not.”

What do the candidates think?

The Gippsland Monitor spoke to federal MP for Monash, Russell Broadbent; Independent candidate for Monash, Deb Leonard; Labor candidate for Gippsland, Sonny Stephens; and Greens candidate for Gippsland, Rochelle Hine about healthcare in Gippsland. Comment was also sought from Liberal candidate for Monash, Mary Aldred; Nationals MP for Gippsland, Darren Chester; and Labor candidate for Monash, Tully Fletcher.

Independent incumbent MP for Monash (formerly representing the Liberal Party) Russell Broadbent

Broadbent said he was frustrated that Monash often seems to get left behind with healthcare funding, saying “the money that comes in for mental health tends to go into the Morwell, Traralgon area and is managed by the Community Health Service.

“The money that does come into Latrobe Valley for mental health doesn't get to Wonthaggi, Phillip Island, Leongatha and Korumburra.

“One of the things that I delight in the government's announcements around extra money for Headspace will be that Warragul will get a headspace, and I'll make sure of it.”

Broadbent is adamant that he has no control over where health funding goes, and that “the federal government spends the money on mental health… The money goes to the states for distribution, and that money only goes where the state wants it to go. I have absolutely no control over that.”

Independent candidate Deb Leonard

Leonard expressed her outrage that Monash has been consistently left behind when it comes to healthcare, saying “in some areas you have to book an appointment every six weeks just in case you get sick.”

Mental health has been one of the primary issues of Leonard’s campaign. “We have really high rates of suicide in regional and rural areas. A lot of our most of our towns, have been rocked by suicide, especially by young males.”

Leonard said if elected she would “advocate for far greater funding of public health services and also a boost to bulk billing or Medicare rates, so that more doctors are incentivised to bulk bill their appointments and make sure that mental health and dental is included under the Medicare.”

Labor candidate Sonny Stephens

Sonny Stephens said that Gippsland, like many areas in Australia, required a unique approach.

“There are often unique differences between various parts of regional Australia,” she said. “The sorts of initiatives that you would put in Gippsland will be quite different to those that you would apply in the Alice Springs area or the north west of Australia.”

“Nobody in Gippsland would have an expectation that they could access the array of specialties that exist in a metropolitan area.

“The important part is to make sure that people from Gippsland can access those without disadvantage. There are ways of compensating people for the travel and the time and perhaps the accommodation required if you are going to a service that is not available in Gippsland.”

Greens candidate Rochelle Hine

Greens candidate for Gippsland Rochelle Hine spent 20 years as a social work clinician and manager in mental health, women’s health promotion and public health so she is very aware of the impacts of lack of healthcare services.

“GPs are very much overloaded because rural communities tend to have older populations and more people with chronic health issues,” she said. 

“GPs are often the ones who are managing and supporting people with mental health challenges. There are fewer counselling and support options, fewer headspace services, fewer youth spaces and fewer mental health promoting activities

“The Greens have a great policy to include mental health and dental health under Medicare, they're not optional extras. They're a critical part of our health and well being, and they're two areas that are incredibly preventative for poor health outcomes into the future.”