Tens of millions of dollars have been paid to Australian medical schools to boost the number of doctors in regional areas, but only half of those schools have been meeting the minimum standard for the funding.
For the past 10 years medical schools have been expected to maintain the proportion of rural students enrolled in their degrees at 25 per cent to receive a share of Rural Undergraduate Support and Coordination funding.
The program was established by the Federal Government to help address the chronic shortage of doctors in rural Australia by producing more graduates willing to set up practice in the bush. Half the schools have failed to meet that target, including some of the country's biggest: the University of Sydney, the Australian National University and the University of Queensland.
In the last reporting year, 2010, the rural enrolment figure was as low as 7.5per cent at the University of Queensland and the national average was 21per cent.
Figures from the Department of Health and Ageing requested by The Canberra Times show the Government has given $51 million to the RUSC program since 2000 and $17 million of that amount was allocated in the three years from 2008 until 2011. In 2011, the program was merged with another critical rural health training scheme, the rural clinical schools, to become the Rural Clinical Training and Support Program. Both initiatives combined will receive $288million from the Australian Government in the period from 2011 to 2014.
A spokeswoman for Health and Ageing said the 25per cent benchmark for the 15 universities that received funding through the RUSC scheme was ''only an indicative target and those universities that did not meet the target were asked to demonstrate what actions were proposed to improve performance against this target''.
The spokeswoman added that since the merging of the RUSC and the rural clinical schools programs in July last year, the 25per cent target for rural students had become mandatory and universities would have to give annual reports on their performance.
The Associate Dean of Sydney University's School of Rural Health, Tony Brown, said many medical schools had not tried to meet the ''aspirational'' 25per cent target before the merger, because the RUSC funding was too small compared with other incentives.
''There was a feeling it was a big task and it was always framed in aspirational terms, rather than being mandatory,'' he said.
A spokesman for ANU said the university's medical school tried to reach the benchmark, but increasing competition between medical schools for students made it difficult.
However, the spokesman said when the 25 per cent figure was made mandatory in 2011, nearly 28 per cent of offers to study medicine at ANU were to students of rural backgrounds.
But the president of the Rural Doctors Association of Australia, Paul Mara, said the data demonstrated that the Government's measures to increase the number of doctors in the bush were failing at the first point of contact with the medical system - a doctor's university training.
''If, at the very fundamentals, universities are not playing the game and the department is not monitoring that they're selecting rural-based kids, then we're missing out on that very first important strategy,'' Dr Mara said.
''Because we know that, there's a greater chance that regional kids will come back to the country to work.
''What you can say is that the department does not understand rural health and that might be one reason for their failure to monitor whether these people are meeting their guidelines.''
The most recent figures from the Australian Institute of Health and Welfare show there were 4600 excess deaths in rural Australia from 2004 until 2006, compared to major cities, and the most common causes were heart disease, circulatory disease, chronic obstructive pulmonary disease, motor vehicle accidents and suicide.
Health and Ageing's annual report for 2010-2011 shows 39 doctors relocated to rural areas to work in that period, well below the Government's target figure of 70.
In its submission to last year's parliamentary inquiry into overseas trained doctors, Rural Health Workforce Australia said the number of Australian-trained doctors working in the country had increased by only 28per year between 2000 and 2008, despite a raft of financial and other incentives.
Emeritus Professor John Dwyer, former head of medicine at UNSW and consultant to Charles Sturt University, which wants to set up its own medical school, said the RUSC program was ''bad policy'' and the Government should re-allocate places in medicine from universities that did not meet the targets to universities that did.
First-year domestic medical students with a rural background in 2010 at medical schools that received RUSC funding:
University of Adelaide - 9.7per cent
Australian National University - 16 per cent
Deakin University - 25.4 per cent
Flinders University - 21.3 per cent
James Cook University - 41.8 per cent
University of Melbourne - no student intake in 2010 in preparation for the commencement of its Masters degree in 2011
Monash University (post-graduate) - 32.9 per cent
Monash University (undergraduate) - 17.9 per cent
University of Notre Dame Sydney - 24.1 per cent
University of Notre Dame Fremantle -15.4 per cent
University of Newcastle/University of New England - 37.9 per cent
University of NSW - 29.3 per cent
University of Queensland - 7.5 per cent
University of Sydney -13.0 per cent
University of Tasmania - 35.9per cent
University of Western Australia (post-graduate) - 15.9 per cent
University of Western Australia (undergraduate) - 25.3 per cent
University of Wollongong - 27 per cent
First-year domestic students with a rural background at all medical schools in 2010: 20.9 per cent
Source: Medical Training Review Panel 14th Report
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