RACGP’s message to Royal Commission: GPs need more support during natural disasters

Medical News: The Royal Australian College of General Practitioners’ (RACGP) has called on government to ensure GPs are front and centre when natural disasters such as bushfires strike.

The RACGP’s submission to the Royal Commission into National Natural Disaster Arrangements contains some salient warnings about how GPs can be better involved in crises such as the summer’s bushfires.

RACGP President Dr Harry Nespolon said that many aspects of the bushfire emergency response worked well.

“Following strong advocacy from the RACGP and other bodies we saw positive actions taken such as the funding for bushfire mental health support and expansion of telehealth and telephone items.

“Prioritising applications from GPs able and willing to work in practices in bushfire-affected communities was also welcome in addressing workforce distribution issues. These were sensible measures and we did all we could to make sure our GPs were taken care of.”

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However, Dr Nespolon said that other facets of the bushfire emergency response exposed deficiencies that frustrated some GPs keen to do all they could to help.

“One of the main problems we faced is something that existed long before these bushfires. The states and territories are responsible for emergency planning and the Federal Government has responsibility for general practice, so it creates confusion and makes it hard to include GPs in wider healthcare responses to natural disasters.

“GPs weren’t sufficiently consulted because primary care is not integrated into emergency responses. There were just no formal arrangements in place to utilise hardworking GPs during the initial response phase when fires were tearing apart communities.

“So you have the absurd situation of GPs rolling their sleeves up to help and being turned away from refuge and evacuation centres because they were not part of the area’s response plan.

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“They were held up by red tape and couldn’t assist people in need who had suffered serious injuries. Some of these people had lost loved ones and homes and care and treatment from a local GP who knows the community would make all the difference.

“That is unacceptable because the majority of presentations to evacuation centres during the bushfires were for things a GP could treat. That includes an initial mental health consultation for people who had been to hell and back.

“There is also a lack of GP representation on recovery committees even though we are the ones supporting distraught communities for months and months after the smoke clears.

“We were also concerned that information wasn’t being provided that could have made a real difference. For example, there were not accessible courses to support rapid mental health upskilling at a time when many people in affected areas were really struggling.

“Natural disasters, including this summer’s bushfires, are not going to go away – in fact it’s almost certain they are going to get worse. The RACGP recognises climate change as a health emergency so crises like we saw last summer are going to become more common.

“GPs are on the frontline doing their best and we need all the support possible to help patients experiencing the most challenging periods of their lives.”

The RACGP has called on government to implement vital reforms, including:

·    The role of GPs as frontline health providers must be formally recognised in any national natural disaster arrangements in Australia across preparation, mitigation, response and recovery

·    funding for the establishment of national and state based health disaster response round tables with strong primary care representation via the RACGP

·    development of a standardised national framework for the engagement and coordination of GP teams in support of isolated communities during disasters.

·    requirement for Primary Health Networks to develop a skills register of practicing clinicians (e.g. those who have anaesthetics training) who can respond during disasters, local trauma cases and pandemics, both in a locum and volunteer capacity

·    formal, funded general practice representation in state/territory disaster response plans

·    funded travel for GPs to work in affected areas during the recovery phase and increased funding for general practices to allow for the employment of extra locum GPs and psychologists/other mental health providers to support the recovery phase over the first year.