Sutherland Division of General Practice Profile

Demographic and population health data:

According to the 2006 Census, the total population of the Sutherland Shire is 203,122.  The Estimated Resident Population, which is updated annually, shows that there were 219,828 residents at 30th June 2009.  This represents an increase of 1.4% from the previous year. The population of the Sutherland Shire is ageing and it is expected that by 2020, 40% will be aged 55 years and over, and this number will continue to grow.  Compared to the Sydney Statistical Division (SSD), there was a similar proportion of people in the younger age groups (0 to 17) but a larger proportion of people in the older age groups (60+). Overall, 23.9% of the population was aged between 0 and 17, and 18.1% were aged 60 years and over, compared with 23.6% and 16.7% respectively for the SSD.  The median age in the Sutherland Shire was also older than the SSD at 37 years compared to 35 years.

The change in demographics has implications for general practice in that the older we become, the more frequently we visit our GP and these presentations are often more complex.  For example, the distribution of unreferred attendances shows that the oldest group (75+ years), male and female, consult their GP 12.65 times every year compared to younger patients (25-44 years) who have an average of 4.25 consultations per year. (1)  

Health Status:

The major causes of premature mortality in the Division, as for Sydney and Australia as a whole, are cancer and diseases of the circulatory system. The New South Wales Population Health Survey 2005-2007 Report on Adult Health for the area notes key differences between residents in the Sutherland Shire compared to New South Wales as a whole:

• Higher rates of risky alcohol consumption across all age groups;
• Higher rates of high risk alcohol consumption for younger age groups;
• Higher rates of current Asthma
• Higher rates of overweight and obesity (53.2% compared to 50.5%)
• Higher rates of adequate physical activity in all age groups, except 75+ years;
• Overall lower rates of smoking – 15.2% of residents currently smoke in Sutherland Shire compared to 18.8% in NSW;
• Self rated health status higher – 82.8% of Sutherland Shire residents rate their health status as excellent, very good or good compared to 80.7% of NSW residents;
• Lower rates of Diabetes or high blood glucose
• Lower rates of high or very high levels of psychological distress
• Lower rates of potentially avoidable deaths due to suicide or self-inflicted injury (6.5 per 100,000 compared to metropolitan Sydney (8.3), NSW (8.9) and Australia (10.8).
• 8.1% of residents indicated they had difficulties getting health care when they needed it compared to 14.4% for NSW;

General Practitioner Supply in the Sutherland Shire

As at 30 June 2010, an estimated 235 GPs work in the Sutherland Shire, of which 99 (42%) are female.  Almost 35% of GPs indicate that they work part time.  A more accurate estimate of workforce is Full time equivalence (FTE) and Full time workload equivalence (FWE). (2)

In 2006 Medicare estimated that there were 151.9 FTE GPs in the Sutherland Shire.  The Primary Health Care Research and Information Service (PHCRIS) estimate that as at 30 June 2007, there were 195 FWE GPs in the Sutherland Shire. This equates to a population to GP ratio of 1 FTE GP: 1447 residents or 1 FWE GP: 1093 residents.  As a comparison, surrounding metropolitan areas FWE rates are:  St George 1: 966; Eastern Sydney 1:748; Bankstown 1:778; Fairfield/Liverpool 1:929 and Macarthur 1:931. (3)   

A survey of local workforce has found that a number of smaller practices in the area have closed their books to new patients and practices report difficulty attracting new doctors to the area.  The western part of the Sutherland Shire is designated a District of Workforce Shortage, indicating that the population’s need for healthcare has not been met, and practices in that area are eligible for incentives under the More Doctors for Outer Metropolitan Areas Initiative.

(1) Australian Government Department of Health and Ageing.  General Practice in Australia: 2004.
(2) FTE (full time equivalence) is a modified count of doctors that takes into account the partial contribution of doctors who work less than full time. FTE is calculated by dividing each doctor’s Medicare billing by the average billing of full time doctors for the year, with the FTE figure for each doctor capped at one.  FWE (full time workload equivalence) is a measure of medical workforce supply that takes into account the differing working patters of doctors.  FWE is calculated by dividing each doctor’s Medicare billing by the average billing of full time doctors for the year.  There is no cap on a doctor’s FWE. 
(3) PHCRIS, Key Division of General Practice Characteristics 2007-2008.

Health services
Since January 2005 the Sutherland LGA has been a part of the South Eastern Sydney and Illawarrra Area Health Service. There are six divisions of general practice in SESIAHS: Eastern Sydney, South Eastern Sydney, St George, Sutherland, Illawarra and Shoalhaven.

The Sutherland Shire has one district hospital, The Sutherland Hospital, and a geriatric palliative care facility at Garrawarra, which collectively have 516 beds. In addition, there are two private hospitals: President Private and Kareena Private, providing 180 beds. Eleven private nursing homes and nine hostels provide 1,453 beds.