How will the upcoming annual DPA review affect your medical centre?
How will the upcoming annual Distribution Priority Area (DPA) review affect your medical centre?
The Department of Health is expected to announce the result of the latest review of DPA areas at the beginning of July.
From conversations with our client and candidates, it is clear that there is still confusion about what a change in DPA status will mean to their GP recruitment strategy or job search.
This blog aims to provide a simple overview of Section 19AB of the Health Act and answer questions relating to DPA and the impact of the upcoming review. More site specific answers are available by following the links or contacting one of the DXC Medical team.
What is Section 19AB of the Health Insurance Act (1973)?
Section 19AB of the Health Act requires all Overseas Trained Doctors (OTDs) and Foreign Graduates of Medical Schools (FGAMS) to practice in a DPA area for a period of 10 years. This is often referred to as the 10-year moratorium. For this blog, we will refer to FGAMS as OTDs.
What is a Distribution Priority Area (DPA)?
A distribution priority area is a geographical area that has been identified has having a shortage of medical practitioners.
The DPA system takes into account gender and age demographics, and the socio-economic status of patients living in an area.
An area is automatically classified as DPA when it is:
- classified under the Modified Monash Model as MM 5 to 7
- in the Northern Territory
You can check the status of a location by using the Health Workforce Locator , selecting the DPA layer of the map and searching for your town or suburb. The size and boundary of the DPA can seen by hovering your cursor over the area.
When does the DPA review happen and how will I be informed?
The review happens each July and will updated on the Health Workforce Locator. There is no formal announcement, so you will need to check the site for the update. This review will be final and not reviewed again until July 2022.
Will our current OTDs (within their moratorium), still be able to work at our practice if the location loses its DPA status?
Yes. All doctors currently working at the practice will be unaffected by any change.
Will we still be able to recruit OTDs to our practice if the location loses its DPA status?
If you are already in advanced discussions with an Overseas Trained Doctor and can prove this to the Department of Health, then it is highly likely that the doctor will still be able to join your practice.
The Department of Health will usually request an email trail and signed contract, dated prior to the annual review date.
We strongly recommended finalising any agreements with a letter of offer or contract before the 1st July 2021.
OTDs who apply to your practice after it loses its DPA status, will not be eligible to work in that location until or unless:
- The geographical regains its DPA status at a future annual review
- The doctor is eligible for another specific 19AB exemption (see below)
- Your practice has a ‘DPA replacement provision’ (see below)
What is a DPA replacement provision?
A DPA replacement provision allows a practice in a non-DPA location to replace an outgoing GP who is still under the moratorium and is leaving the area. This is only applicable if the exiting doctor holds a 19AB DPA exemption, given at a time when the location was classified as DPA.
It is important that the practice asks the doctor to close their provider number and provide evidence of the closure.
This comprises of two documents:
- A Statutory Declaration by the doctor that they have closed their provider number(s) for the given DPA location, has left the DPA and has no plans to return to the DPA
- A letter from medicare to the doctor, confirming the closure of the provider number for the given SA2 location
The practice must then submit these documents to medicare (for review by the Department of Health), when they apply for a provider number for a doctor still in their moratorium.
Nb. It is important to note that the opportunity to replace an outgoing OTD will expire if you are unable to replace them within 12 months from their last date of billings.
What other 19AB exemptions are open to us and how do we apply for them?
There are several 19AB exemptions, but we will focus on the three most common options here.
The locum exemption allows a doctor still inside their moratorium, to work in a non-DPA for a maximum period of 6 months. This exemption cannot be extended and doctors are not eligible to apply for another locum exemption in the same location, following the completion of the 6 months.
Due to the complex nature of assessment of eligibility for this exemption, it is advised to contact the Department of Health (Access Policy Section) at 19AB@health.gov.au with the specific details of both the doctor and spouse.
The definition of this exemption states that the spouse:
- does not have to be a GP or healthcare provider
- must not be restricted by 19AB themselves
- must reside in Australia
The Department of Health has confirmed that there is no specific radius requirements and that they will assess each application based on the information provided. It is recommended to submit as much supporting documentation as possible.
An overseas trained doctor may apply for an academic exemption if the following requirements have been met:
- They have a proven track record in education and training (in Australia or overseas)
- Clinical Appointment with an accredited medical school recognised by medicare. See the list of recognised medical schools on the provider number application form.
The exemption is usually the same length as the Clinical Appointment contract the doctor has signed with the university.
The DXC Medical team have been successful in gaining recent Academic Exemptions from a number of leading universities. Please contact the relevant DXC office for more information on the process and paperwork required.
More information on these exemptions can be found at https://www.legislation.gov.au/Details/F2016L00134/Explanatory%20Statement/Text
Section 19AB of the Health Act and potential exemptions can seem incredibly confusing and complex.
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