A new report has revealed WA's North West faces the greatest challenge with doctor shortages of anywhere in the state, while local governments in other remote areas are campaigning for the federal government to cover the costs to retain GP services. For the third consecutive year, the Pilbara had the highest proportional movement of GPs out of the region, losing 23.4 per cent of its workforce, according to Rural Health West's report. Further north in the Kimberley region, there has been an 8.1 per cent drop in GPs, and had the lowest number of doctors move into the area. Aboriginal Health Service GP Fiona Cleary in Roebourne, 1,500 kilometres north of Perth, said they had to close a pop-up medical clinic in nearby Karratha for several weeks due to a lack of staff. "Not having access to GPs then puts a second pressure onto the hospital, so then they get all the patients coming in with GP stuff, not emergency stuff," Dr Cleary said. She said access to childcare and the cost of living in the Pilbara contributed to the high turnover rate. The median cost of a rental in Karratha is $1,183 a week, according to a May CoreLogic report. While Dr Cleary's rent is partially subsidised through her organisation, she said it would "definitely deter" her from staying in the region if she had to pay the full price in Karratha. City of Karratha Mayor Daniel Scott said affordable housing continued to be the biggest barrier to attracting health professionals, with nearby towns like Wickham "desperate" for GPs. He said the shire was creating a new housing policy for GPs and allied health services, after a fund supporting GPs recently expired. Dr Cleary's colleague, Aaron Donald, said the high turnover disadvantaged the community's wellbeing. "It can break down care because you don't have the flow of knowing the history, knowing what's been tried before," Dr Donald said. "If you're only here for a year or two, that's a fairly limited amount of time to try to build a relationship where patients trust you". GP clinic cannot reopen The Kimberley's regional hub of Broome has seen a clinic close, with no prospect of it reopening. The Broome Doctors Practice was vacated last week after closing its doors suddenly in February, leaving patients in the lurch. At the time, Spectrum Health chief executive Philip Coelho was optimistic the clinic would reopen later this year in a newly built surgery. But Mr Coelho confirmed the practice will not be relaunched, citing difficulties in getting doctors to regional areas. "We have removed everything and handed the practice back to the landlord," he said. "The simple reason is because we don't have doctors, or a supervisor, who will go up there." Federal funding wanted In Western Australia's south, the proportion of GPs leaving the region was lower than in the Pilbara at 13.5 per cent. Six local governments have an alliance to draw attention to the amount they are having to pay to attract GPs to the remote areas and want the federal government to cover the costs. The local governments of Gnowangerup, Jerramungup, Kojonup, Narembeen, Lake Grace, and Ravensthorpe collectively contribute about $1.5 million annually towards GP services. That is not including housing, vehicles, and buildings for the surgeries. The Shire of Narembeen has fewer than 1,000 people, and in the 2023–24 financial year spent $305,000 or 16 per cent of the income from its rates to recruit GPs. Over the same period, the Shire of Lake Grace, with a population of about 1,200 people, paid $250,000 amounting to 7.3 per cent of the rates income. Shire president Len Armstrong said the money should be coming from the federal government. "It takes money away from our core business of providing infrastructure and community structures for our communities," he said. Rural Doctors Association of Western Australia president Clark Wasiun said financial incentives were not the only factor in recruiting GPs. "It's not about throwing money at the doctors," Dr Wasiun said. "If there's better infrastructure in some of these towns, and the most obvious one that comes to mind is childcare services, that will not just encourage them but enable them to go to those more remote towns." Happy with model, not cost Livingston Medical provides GPs to local governments in the alliance. Michael Livingston said they had a "rural generalist hub" model which included working with doctors who were training and ensuring those taking up the roles had proper support. "We reckon we save the state about $14-20 million a year in preventable retrievals, that is when people don't have to be flown out because there's a doctor there who can see to the patient," Dr Livingston said. Mr Armstrong said going through Livingston Medical had reduced the pressure on the Shire of Lake Grace to source its own doctors. "We've only been working under this model for going on two years, we're fairly comfortable with it, we're just not comfortable that we've got to pay a cash component," he said. "We've most probably tried half a dozen different models and methods of getting doctors into our area, even at one stage here in Lake Grace we were flying in and flying out doctors from Albany." The proposal from the six local governments for federal funding was listed for discussion at the recent Australian Local Government Association National General Assembly. Federal Health Minister Mark Butler said the government was considering the findings of the Working Better for Medicare Review, which examined existing policies to attract and distribute the health workforce, including for regional, rural and remote areas. Getting a taste of rural life The Rural Clinical School of WA began in 2002 and works with medical students who are in their penultimate and last year of studies. The students undertake training at one of 15 regional sites across the state, and project officer Juliet Bateman said the program was oversubscribed by about 50 per cent. Ms Bateman said the program was limited to the availability of places that met the necessary criteria, including being able to offer appropriate supervision. Dr Wasiun said spending time in a regional area while training could be a game changer. "If there's that exposure to rural places for junior doctors, then you've got a much better chance of that doctor staying in that rural area or moving on to another rural area rather than going back to the city," he said.