Distribution Priority Area has replaced Districts of Workforce Shortage
A new health workforce classification system is in place from 1st July 2019 for GPs and Bonded Doctors. Distribution Priority Area (DPA) has replaced Districts of Workforce Shortage (DWS).
How is DPA classification assessed?
Instead of using a GP-to-population ratio, the new DPA system uses the average number of GPs in Modified Monash (MM) 2 areas as a benchmark. This benchmark is then compared to the needs of an area, taking into account demographics (gender/age) and socio-economic status of patients living in an area (referred to as ‘GP catchment area’). This means that generally, only those areas that have GP ratios that are lower than those in MM 2 areas are deemed DPA.
GP catchments are a new geographical classification, which forms part of the Health Demand and Supply Utilisation Patterns Planning (HeaDS UPP) Tool. A total of 829 non-overlapping GP catchments are aggregations of sub-catchments.
The DPA system also applies a number of blanket rules:
- Inner metropolitan areas are automatically deemed non-DPA;
- MM 5 – 7 are automatically deemed DPA;
- Northern Territory is automatically deemed DPA;
The DPA system will be reviewed annually, however, the benchmark will only be updated every three years.
Map changes in a nutshell
Generally, inner and outer metropolitan areas have become non-DPA. Most MM 2 areas are also excluded. Most MM 3 areas are DPA.
To find out whether a location is deemed a DPA, search the Distribution Priority Areas map on doctorconnect.gov.au.
Non-DPA location: what are the options?
The Health Insurance (Section 19AB Exemptions) Guidelines 2017 are still in effect. This means that if you started negotiations with a practice prior to 30th of June and at the time the location was DWS, you should qualify for a s19AB exemption. You must have evidence in the form of emails and ideally a signed letter of offer or contract to prove that you had arrangements in place before July 1st.
The academic, spousal and replacement provisions for ongoing full-time exemptions still apply, as well as locum and after-hours exemptions.
What does this mean for GPs?
International Medical Graduates (IMGs) who specialise in General Practice are required to work in a DPA in order to obtain a Medicare Provider Number.
An area that has been classified as a DPA for GPs has been assessed as not receiving adequate GP services for the needs of that population. For GPs the DPA uses MM 2 as the benchmark (however not all MM 2 areas are DPA).
What does this mean for Bonded Doctors?
The Bonded Medical Places (BMP) and Medical Rural Bonded Scholarship (MRBS) Schemes provide students with a medical placement in return for a commitment to practice in a DPA for a specified period.
An Australian trained bonded doctor with return of service obligations is required to work in a DPA to access the Medicare Benefits Schedule (MBS). If an area is recognised as DPA, local practices can employ these doctors to increase the workforce and improve the community’s access to medical services that are subsidised by MBS fees.
The methodology for DPA bonded doctors is the same as for DPA for GPs. The benchmark is set at the national level instead of MM 2 to ensure bonded doctors are not disadvantaged due to their existing contractual arrangements. Further information can be found on the Department of Health website.
How about Specialists?
DPAs do not apply to Specialists. The Districts of Workforce Shortage (DWS) classification system continues to operate.
IMGs who practice in specialities other than General Practice are required to work in a DWS for the relevant specialty in order to obtain a Medicare Provider Number. Bonded doctors in specialities other than General Practice can work in Outer metropolitan DWS for their medical speciality or in MM 2-7.
DWS uses population and Medicare billing data to get a Specialist-to-population ratio in each geographical area of Australia. Under the DWS there are eight Specialist classification layers:
- Diagnostic Radiology
- General Surgery
- Obstetrics and Gynaecology
- Medical Oncology
The map has been updated on 1 July 2019 using the current methodology and the latest available population and Medicare billing data. DWS Specialist layers can be viewed at doctorconnect.gov.au.
The Department will establish a Distribution Advisory Group (DAG) later in 2019. The group will be asked to review the Specialist layers and consider whether the GP Catchment area methodology is appropriate.