Scope of practice: Exactly how the RACGP is advocating for you

The scope of practice review is drawing close to the finish line with the fourth phase of consultation, the draft final report, imminent.
 
It’s causing a storm of talk in GP circles, to say the least, because our members have valid concerns, as do I.
 
As your President, I’ve made it my mission to ensure your concerns are heard by those who matter in the review, as well as the big decision makers, including Federal Health and Aged Care Minister Mark Butler.
 
Here at the RACGP, an enormous amount of work has gone into our advocacy.
 
We’ve done 23 submissions on relevant issues, and four for the current review.
 
We’ve consulted widely with members to inform our advocacy, including through three webinars, a workshop, stands at recent RACGP conferences, and representatives attending the scope of practice roadshow across Australia.
 
Of course, it’s important to recognise the recommendations of this review aren’t set in stone and may never be adopted or implemented. Countless government reviews gather dust and go nowhere.
 
Other professions have been making a lot of noise, and while this may be alarming at times, it does not mean they are getting what they want.

But what I have been saying on repeat is that there is no substitute for the quality care you get from a GP who knows you and your history.
 
Every year, more than 22 million Australians choose to see a GP for their essential healthcare. GPs have the highest qualifications in primary care, over 10 years training – and our training matters.
 
We’re advocating for GPs to be better funded to provide multidisciplinary team-based care.
 
GPs are already leading these teams, and there are so many inspiring examples of multidisciplinary practices right across Australia.
 
Practices with GPs, nurses, pharmacists, mental health counsellors and diabetes educators all working together to get the best results for their patients.   
 
The problem is current funding models don’t support this type of care.
 
So what funding do we need?
 
The RACGP supports a blended funding model, with fee-for-service at the heart.
 
We will never support a model with UK-style capitation – I’ll fight this to the end. It simply doesn’t work, as our NHS refugee colleagues can attest.
 
But amid these challenges, it’s important to remember that there are also positive opportunities in this review for GPs and our patients.
 
The overwhelming majority of RACGP members believe they can increase their scope to benefit patients.
 
We can prescribe and dispense more medicines, and provide more services if red tape is cut, such as for acne treatment, iron infusions, and dementia.
 
This will reduce the need for referrals to other specialists and make it faster and less costly for patients to get the care they need
 
And for maternity care to stay in general practice. We know what happens when it doesn’t, and it’s not good.
 
Recently, I attended the Royal New Zealand College of General Practitioners (RNZCGP) GP24 conference in Wellington, and one pressing issue caught my attention.
 
In New Zealand, GPs were excluded from antenatal care, and replaced with a model of midwife bundled care. And the country has seen an increase in birth injuries, deaths, and poor perinatal outcomes. 
 
This is tragic. The human cost of ill-thought and politically motivated policy cannot be swept under the carpet.
 
And we cannot let it happen here.
 
GPs have an important role in antenatal care in Australia, supporting women and families from preconception, throughout their pregnancy, and often during birth in rural and remote communities.
 
We need to ensure it stays this way. And Australian women have choice and access to get this care from their GP, no matter where they live.
 
To this end, I’m calling for GPs to be supported to obtain and maintain skills in pregnancy care.
 
We can’t tell for sure what will be in the next scope of practice report until it’s released. But what I can say, is rest assured, I’m advocating harder than ever for you, your patients and our profession.
 
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