‘Very exciting’: Tasmania GPs in training trial welcomed

Jolyon Attwooll

27/01/2023 4:11:28 PM

A new trial announced by the Prime Minister aims to give rural GPs in training more certainty as they work towards Fellowship.

Prime Minister Anthony Albanese
Prime Minister Anthony Albanese announced the trial in Tasmania on 27 January.

The Chair of RACGP Tasmania Dr Tim Jackson has strongly welcomed a new trial designed to tackle chronic rural GP workforce shortages in the state.
It will allow up to 20 doctors to be paid under a single-employer model, offering GPs in training more certainty and stability as they work towards Fellowship.
The trial was jointly announced by Prime Minister Anthony Albanese, Minister for Health and Aged Care Mark Butler, and Tasmanian Premier Jeremy Rockliff in the north Tasmanian town of Latrobe on Friday 27 January.
Dr Jackson said the model, which is expected to begin in July this year, is one the college has been advocating for in discussions with federal and state governments, and he believes it has the potential to make a significant difference.
‘It’s very exciting for Tasmania where we’ve got a GP workforce shortage,’ Dr Jackson told newsGP.
‘Currently, there are 99 GP positions being advertised in Tasmania.
‘With increasing chronic disease and mental health conditions, the lack of healthcare services in rural and remote communities is reaching a crisis point.’
Dr Jackson hopes that the trial will bring relief to general practices in those parts of the state that have struggled to recruit staff.
‘That’s important because we know that the further you’re away from the city, unfortunately the worse health outcomes you have,’ he said.
‘Long term, I’m hoping this is the beginning of increasing the pipeline of the workforce with GPs.’
Prime Minister Albanese said $8 million of a $100 million commitment in the October Budget to develop different models with state and territory governments would go to the Tasmania trial, the first of 10 expected to be set up across the country this year.
‘I’m convinced that this will make a difference,’ he told reporters on Friday.
‘Being a GP is an honourable profession ... the reason why primary healthcare is so important, and GPs are so important, is that if you get that knowledge of care between a doctor and their patient, it’s more than just a transaction, it’s a relationship for life.
‘It’s a relationship which is about making sure that health issues are diagnosed early, that intervention happens as soon as possible, and of course we know if that happens, it will cost less because we will have less people who have acute health issues.’
The Tasmanian Health Service will be reimbursed through Medicare for the salaries offered to GPs in training. It will allow them to avoid multiple employers during their vocational preparation, which can mean they lose entitlements such as sick leave and parental leave, and enable easier transfers between hospital and community-based placements.
The model is similar to an existing trial in Murrumbidgee in NSW, which started in 2020, while another recently launched in the Riverland of South Australia. However, this is the first state-wide model.
RACGP President Dr Nicole Higgins said she hopes the trial will address ‘alarming’ GP shortages in rural communities, with evidence suggesting medical graduates who receive quality training in rural areas are significantly more likely to stay.  
‘These are sensible measures to remove some of the barriers to choosing general practice as a specialisation,’ she said.
However, Dr Higgins also called for careful assessment of the trial, as well as others likely to be announced in the coming months, to ensure no unintended consequences for general practice.
‘A single employer model should be optional for the GPs in training, as otherwise it could set a ceiling for pay as an incentive to become a rural GP, rather than a floor,’ she said.
‘In some single employer systems, governments charge practices a lump [sum] daily or weekly sum to cover GP training.
‘It’s important that practices are charged for each hour the GP in training works under the National Terms and Conditions for the Employment of Registrars.
‘This is a sensible approach that recognises the role of the practice.’
On Friday, Premier Rockliff highlighted ‘real challenges’ accessing GPs across the state, while Minister Butler said Tasmania had a lower GP ratio per population than the national average, as well as bulk billing rates that are substantially less than elsewhere.
‘The fact is, we know that fewer and fewer medical graduates are choosing general practice as their preferred career,’ Minister Butler said.
‘It used to be about 50% of young people coming out of medical school who would choose general practice as their lifelong career instead of one of the other specialties. That figure is now less than 14%.
‘That is just not enough to secure a sustainable workforce in general practice for the future.’
He said the trial will ‘significantly lift’ the attractiveness of general practice in Tasmania.
The single employer model trial is described as cost-neutral to the Commonwealth, but the Federal Government is providing $8 million over two years to the Tasmanian Government for infrastructure and administration support.
The Tasmanian Government is contributing $5 million over four years.
Dr Jackson said he is encouraged by the cooperation between the separate levels of government.
‘I’m also just really hopeful this is the beginning of a new era where we see state and federal governments come together to support general practice, particularly the workforce, and make it more sustainable,’ he said.
‘Although the health system is divided between Commonwealth and state, it really is one health system, and it’s better if we all work together.’
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Dr Joseph Dinesh Rodriguge Fernando   28/01/2023 7:53:07 AM

What a joke , without fixing Medicare rebate for GPS , doing other things won’t help.
What ever training we get at the end of the day we will get $39:75 , specialists early 4 times more than GPs .
Medical students can’t be fooled by these nonsense

Getafix   28/01/2023 8:26:04 PM

I am gratified to hear Mr Albanese's description of what general practice has to offer.
This is at least an effort to improve a problem ,which without some sort of intervention, will lead to an implosion of health care services in rural Australia.
It is a tricky balance to find some degree of professional independence from the government while in reality requiring government funding to make it all work.
Watch this space.

Dr Peter James Strickland   28/01/2023 11:48:22 PM

Beware GPs --this will NOT improve your lot, nor that of patients in the long-term at all. Do NOT be conned here that the Federal Govt is improving general practice. Registrars coming out to rural areas are NOT experienced GPs and will need supervision in almost all cases. You will notice that Minister Butler and PM Albanese are NOT doing anything about the rebate amounts increases --funny that!! Medicare is NOT being strengthened, but merely being weakened --we need viable highly trained GPs in the 'scrub', and have those already there properly remunerated. Anyone giving this so-called initiative the thumbs up needs their head read!

Dr Andy Rees   29/01/2023 5:28:19 AM

For Registrars - a wonderful outcome. For the profession an excellent precursor (in the context of the threat of payroll tax) to engineer a State based NHS - for States may (and do) engage in civil conscription [Latham, CJ. - BMA v Commonwealth (1949) 79 CLR 201]. Bankrupt independent private practice and then hold out hope through a State agency and sole employer. They are going to “fix” general practice. (Much in the way lepidopterists fix butterflies.)

A.Prof Christopher David Hogan   4/02/2023 1:29:31 PM

It is hard to predict the future.
So I will ask questions.
What happens when the fees registrars are paid are less than what they earn in practice after they graduate- if they bulk bill?
Will practice management & financial literacy be a compulsory part of Registrar Training?