WA country councils are paying millions to keep their local doctors

The nearest GP is 120 kilometres away. That is the situation facing residents of the Shire of Narembeen in WA’s wheatbelt if the current arrangement fails. To prevent that outcome, the shire directs 16% of its entire annual rates income — $370,000 — to fund a local medical practice. That covers the surgery, a house and a car. The shire president describes the arrangement as financially unsustainable. She also says losing the GP would be worse.

A new report commissioned by seven WA councils has mapped this quietly spreading crisis, finding they collectively spend $1.7 million a year just to keep GPs in their communities. The report, produced by the Local Government Rural Health Funding Alliance, drew on data from 30 councils across Australia. The core finding: rural residents are paying for their medical care three times. Through the Medicare levy. Through out-of-pocket consultation fees. And through council rates that are quietly redirected to attract and retain a doctor.

This is not a fringe issue. It is the operational reality of rural general practice in 2026 Australia.

What the report found

The mechanisms councils are using vary but follow a pattern: they fund premises, housing, vehicles, and sometimes direct operating subsidies. Without this support, a private practice in a small rural community often cannot cover its costs from Medicare alone.

The consequence of that arithmetic is already visible. Kalbarri’s only GP closed in June, leaving more than 1,500 people facing a two-hour round trip for a standard appointment. In Donnybrook, a practice serving the town has been on a council-leased building since 2021 — and that lease expires this year. The shire is now reviewing whether the practice can buy the site, and 400 local residents have signed a petition to keep seven doctors in town.

These are not abstract policy scenarios. They are real communities with people who have chronic conditions, older residents who cannot easily travel, and families with young children. The two-hour round trip is not a minor inconvenience. For someone managing a complex chronic condition, it is a barrier that compounds poor health.

Who is accountable and who is paying

The pattern the report describes is one of misaligned accountability. Local councils are funding a gap that, by any reasonable logic, is a federal responsibility. Medicare was designed to fund GP and health services across Australia — including in rural and remote areas. The councils interviewed by the ABC are clear: this cost should not sit with local government. The Narembeen shire president says the federal government should fund the gap. The WA state government says it will keep pressing Canberra.

In the meantime, local communities are building their own responses. Kalbarri crowdfunded more than $70,000 to establish a not-for-profit, community-owned, bulk-billing clinic. The model proposes leasing a shire-owned building and returning any profits to the community. The tender decision is expected in November. It is a community solving a problem that should have been solved at a national level — but the urgency does not wait for policy alignment.

Both-and: what the data shows and what it leaves out

This report documents a real and worsening problem. The maldistribution of the medical workforce in Australia is one of the most persistent structural failures in the health system. The workforce incentive programs that exist — bonuses, scholarships, provider number restrictions in some categories — have not closed the gap. Rural GP numbers remain inadequate relative to need.

What the report does not capture is the full downstream cost of rural GP shortages: higher hospitalisation rates, delayed diagnoses, worse chronic disease outcomes, and greater pressure on emergency departments that were not designed to absorb unmet general practice demand. The $1.7 million in council spending is the visible figure. The invisible figure — in preventable hospital admissions and health deterioration — is much larger.

The report also does not examine the workforce pipeline. Medical school graduates remain heavily concentrated in metropolitan areas for training and tend to stay. The structures that might redirect that pipeline — more regional training positions, more rural placements, better pay parity for rural practice — require sustained federal investment that has not materialised at scale.

2 cents: what this means for patients and GPs reading this

If you live rurally and rely on your local GP: what these councils are doing is the reason your service still exists. The arrangement is fragile. The conversation about whether it should be the federal government’s job — not the local council’s — is worth joining. Community petitions, local government lobbying, and submissions to health inquiries are not bureaucratic theatre. They are how these arrangements get sustained or reformed.

If you are a GP considering a rural position, the Rural Health Commissioner and RACGP’s rural health resources are worth reviewing. The financial support structures have improved in recent years, even if they have not solved the problem.

For everyone else: this story is about access. Rural Australians are not choosing to go without local GPs because the model is inconvenient. They are doing it because the system has not funded the gap. This report makes that visible.

Verdict: yes — the triple-payment reality is documented, and the structural gap it reveals matters for anyone thinking about health access in Australia.

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Sources cited

1. Country residents paying three times to keep local doctors — ABC News, 27 October 2026
2. RACGP — rural health advocacy and rural GP position statements