Workforce strategy and recruitment: RACGP position

Morgan Liotta

23/04/2020 3:40:23 PM

The college responds to proposed solutions to issues facing the current and future medical workforce.

Doctors and funding figures illustration
The RACGP advocates for general practice to be considered and given prominence in future workforce planning.

The RACGP is calling for general practice to be considered at the forefront of future workforce planning, and for solutions that support and incentivise careers in general practice to be prioritised.
This includes plans to raise the profile of general practice, increase trainee numbers, modernise and improve the Medicare Benefits Schedule, and support the rollout of the rural generalist program.
The calls were made in the RACGP’s submission to the National Medical Workforce Strategy Steering Committee, in response to a list of proposed solutions from public consultation on a strategy paper released last year.
According to the submission, generalism and general practice are under threat due to falling recruitment numbers and robust strategies are needed to support the future workforce.
The college has expressed concern about the loss of leave and entitlements when general practice registrars exit the hospital system, contributing to a drop in application numbers.
Additionally, it believes the reduction in the number of junior doctors applying for the Australian General Practice Training (AGPT) program has reached a ‘critical point’.
‘Significant reform regarding general practice support and funding is required to ensure the sustainability of general practice and the GP workforce, both now and into the future,’ the submission states.
‘New and significant investment in training general practice registrars is needed. While no single change to the training program will be the solution, action is needed to put general practice training on equal, or greater, footing with other medical specialty training programs.’
As part of a proposed solution, the college is recommending a national takeover – the National Entitlements Fundholder – of general practice registrars’ leave and entitlements to increase the number of doctors opting for the specialty of general practice.
The fundholder would be responsible for the maintenance and distribution of registrar entitlements while they are undertaking training and would manage leave entitlements including annual leave, sick leave, extended leave, parental leave, and long-service leave.
‘Consideration could be given to feasibility of registrar salary top-up funding to guarantee minimum salary, ensuring base salaries are not less than their hospital registrar counterparts,’ the submission highlights.
The RACGP is unconvinced of a proposed ‘single employer model’ solution in which state and territory health departments take over the employment of general practice registrars, enabling them to carry over benefits accrued in their prevocational years.
It believes this model remains untested within Australia and that all general practice registrars undertaking training should have the same benefits and flexibility regardless of location, and all practising GPs should have access to the same employment benefits.
The college is also urging the Department of Health to increase the exposure of medical students to general practice to make it more financially attractive, and calling for a scheme to replace the Prevocational General Practice Placements Program (PGPPP), which ended in 2014, saying that reinstatement of a similar model to ‘create a pipeline into general practice’ would be supported.
The RACGP has identified 10 solutions in its submission as the highest priority for supporting the current and future general practice workforce:

  • Develop an end-to-end incentivisation plan to increase trainee numbers in undersubscribed specialties
  • Develop mechanisms to support the portability of employment benefits, enabling doctors to work across different employers, regions and/or health services throughout their careers
  • Expand outreach, network models and telehealth models that provide continuity of care and are attractive to doctors
  • Provide specific and adequate funding to compensate, develop and support supervisors in rural areas, including GP educators
  • Continue to support national rollout of the rural generalist program
  • Increase high quality exposure to generalism in medical school and the prevocational years, potentially through a competency-based transition to practice approach
  • Review opportunities to reduce the ways in which the MBS fee-for-service model incentivises subspecialisation
  • Consider financial incentives for doctors who choose to pursue a generalist career, especially in a rural and remote context
  • Educate the community on the importance of generalist skills
  • Make generalist careers more attractive and shift prestige perceptions
The full submission to the National Medical Workforce Strategy is available on the RACGP website.
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Dr Maria Renee Boulton   24/04/2020 7:15:35 AM

The Government must increase the support to GPs and the profile of General Practice must be raised to make it attractive to new trainees. Many GPs are feeling frustrated and some are considering leaving the profession after the COVID crisis due to lack of PPE, financial stress and lack of Government support in the past few decades and during the COVID crisis. It is a shame as it is a rewarding career in many ways. However we must be recognised and remunerated as the cornerstone of health care. Change this, reward GPs for the great work they do, support GP registrars and their number will increase.