A lack of GPs will lead to less appointment availabilities, clinic closures and eventually more pressure on the emergency department.
That is what Peel practices are forecasting as the GP shortage in the region reaches breaking point.
The Distribution Priority Area (DPA) policy was designed to address shortfalls of regional GP practices.
But a federal government decision to rezone Mandurah as metropolitan and Pinjarra as outer-metropolitan has made it near-impossible for health service providers to attract and retain doctors, and could see clinics struggle to deliver services from January.
After years of pleading with the Commonwealth to change the Distribution Priority Area (DPA) classification, an exceptional circumstances assessment was launched earlier this month to help assist clinics in the recruitment of doctors.
GP shortage addressed in new review
The review will assess patient demographics, absence of services, and changes to the workforce to see whether a clinic should receive support to attract GPs.
Canning MP Andrew Hastie, who has been lobbying to safeguard the future of Peel practices, said it was an important new review mechanism which would provide an opportunity for local circumstances to be assessed.
However, the review may have come too late for clinics with Pinjarra Doctors, Metceni Health, and Peelwood Family Medical Practice all experiencing a lack of GP registrars for 2022.
Pinjarra Doctors managing director Mala Pillay, welcomed the review but said it should've happened sooner.
"It will make a massive difference for the healthcare service in Pinjarra should we be rezoned to DPA on its own merit from the Peel and be able to take overseas trained doctors," she said.
"It will alleviate the pressure on filling the workforce gap for Pinjarra, however, the review should be expedited for areas like ours facing a crisis.
"This is the long term more sustainable solution to the medical workforce shortage we should be aiming for.
"I got the submission in for a review as soon as possible but I was informed we are looking at a six to eight week turnaround time. We need a crisis intervention solution to sustain the current service."
Peelwood Family Medical Practice principal doctor Stephen Sun said he hoped the review offered reprieve for his practice.
"It's good they're going to review us as a practice individually and I'm hoping that will have some reprieve for us but I can't see that being pushed forward to help us for this coming year," he said.
"I've worked in the Peel region for 17 years and I've never been approached by anybody for consultation regarding the DPA classification.
"I'm not sure if the decision was made in consultation with other practices but if that were the case I don't think the change in DPA would've ever happened."
Extension lead to no reprieve
The assessment comes following Peel practices receiving a much sought-after extension to take on new registrars in 2022.
Dr Sun said it was a dire situation for his practice.
"Usually by this time of the year we would have our 2022 cohort of registrars all sorted sometimes even into 2023. Since the change of DPA classification it's dried up," he said.
"The extension came a little late for us. We have two GP registrars currently but they already looked for other placements because they had to. We're going to lose them next year so we're really stuck.
"From the patients point of view we are losing two full time GPs on an average of about 50 appointments a day so over a week that is several hundred appointments that is gone just like that.
"What is going to happen to those patients is they're probably going to end up in emergency because they can't get into other practices."
"We've been struggling to attract doctors since 2011 and we have made no progress as we are back to three doctors," Ms Pillay said.
"The reality is that broad federal government decisions will not immediately solve Pinjarra's problem. Time is of the essence and it takes quite a lot of time to recruit doctors.
"These solutions have come a little too late for Pinjarra's crisis."
Attracting doctors to Peel
Metceni Health practice manager Robin Dean said COVID-19 and a lack of DPA classification had both played a massive part in the clinic's lack of doctors.
"A lot of GPs want to work in Perth so it's hard to get doctors who want to live and work in Mandurah without a DPA classification," she said.
"We have more of a chance of getting overseas doctors but due to COVID-19 and being non-DPA we can't attract those doctors either."
Usually by this time of the year we would have our 2022 cohort of registrars all sorted sometimes even into 2023. Since the change of DPA classification it's dried up.Dr Stephen Sun
"One thing that would help is making Peel more appealing for doctors to work and bring the family here," Dr Sun added.
"I was a Perth boy. I moved here thinking I would only be here for six months but 17 years later I'm still here.
"It's a great place to live so how do we make it more attractive for doctors but also their families and spouses?"
Local MPs call for decision to be reversed
At a state budget meeting, Murray-Wellington MP Robyn Clarke continued to urge the federal government to reverse the decision.
"Some bureaucrat in a tower in Canberra just put a pin in a map and said that will be a metropolitan area - they don't understand the significant impact it has in the region," she said.
"If we lose our GPs in Pinjarra the residents have to come to Mandurah which puts added pressure on the practices here.
"This is a boundary issue that should never have happened."
Both Ms Clarke and Mandurah MP David Templeman urged residents to put pressure on the federal government.