As BHS struggles to cover gaps in their health workforce, Assoc Prof Rait said the hospital was in direct competition for staff with hospitals in western metropolitan Melbourne including Sunshine, Footscray and Werribee.

“To be quite blunt about it, Ballarat is close to the outskirts of Melbourne and people can commute. Ballarat (Health) needs to recognise it’s competing with hospitals in the west of Melbourne, including big redevelopments, and to attract people … it should perhaps consider their pay.”

Lack of specialists, and a shortage of GPs, are among the key priorities the AMA Victoria has identified around Ballarat and regional Victoria as issues ahead of next month’s state election.

“We have very good public hospitals and good infrastructure in regional towns but the problem, the challenge, is attracting and retaining staff,” Assoc Prof Rait said.

Ballarat Health refers patients needing a rheumatologist or plastic surgeon to Geelong or Melbourne, and has only one gastroenterologist.

“To my mind that’s amazing. To have no plastic surgical service in somewhere like Ballarat beggars belief,” Assoc Prof Rait said.

Providing support for specialists who do work in regional areas is key to retaining them in the long term. “It’s not just about money, but also to provide links to colleagues and support.

“They could examine providing links to the large teaching hospitals in Melbourne, perhaps providing a day a week or month, to work as part of a team to give them better links. The chance to interact with peers is what is missing sometimes in regional health services.”

Training more medical students and specialists in rural health services, and offering greater clinical research opportunities could also help attract and retain specialists.

Assoc Prof Rait said a shortage of GPs in regional areas, where there are more than 200 vacancies compared to just a handful in metropolitan Melbourne, was contributing to poor health outcomes among regional Victorians.

“What is a real concern to the AMA is that life expectancy is going backwards in parts of regional Victoria, which is almost unprecedented. We are seeing things decline particularly for rural women with heart disease, arthritis, cancer, obstetrics, anxiety and depression … and the shortage of GPS probably contributes to those.

“We have a very good health system but we have differences in access particularly for patients in rural and regional Victoria.”

Better access to professional development, building skills through better links with regional hospitals, state government target subsidies for provision of certain services, and support for mental health care, drug and alcohol support, maternal and family planning could all go some way to attracting more GPs, Assoc Prof Rait said.

He also urged the state government to advocate to their federal counterparts on the Medicare rebate freeze, which has reduced the income of regional GPs.

“If we want regional centres to thrive and want to decentralise cities there needs to be adequate health care.”

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