Future of general practice front of mind in Canberra

Michelle Wisbey

15/11/2023 4:16:06 PM

Member feedback from the Health of the Nation has reached Australia’s lawmakers, as a sense of urgency grows around safeguarding the profession.

Sophie Scamps, Mark Butler, Nicole Higgins.
Independent MP Dr Sophie Scamps, Health Minister Mark Butler, RACGP President Dr Nicole Higgins, and GPs in Training representative Dr Emily Rushton in Canberra.

‘Government in Canberra sees general practice as the backbone of the healthcare system’.
Those were the reassuring words of Federal Health and Aged Care Minister Mark Butler, speaking at Wednesday’s launch of the RACGP’s 2023 Health of the Nation report at Parliament House.
The seventh annual landmark report revealed an urgent need to bolster the GP workforce amid a worsening doctor shortage and lessening interest in the profession, with 29% of GPs admitting they intend to retire within five years.
This grave situation comes as general practice faces unprecedented rising costs, patient demands, and red tape, including a looming payroll tax disaster that could push many clinics to the edge of collapse.
Through the report, the plight of GPs has been spread across Australia, receiving widespread media coverage on all platforms, and reaching hundreds of thousands of readers, listeners, and viewers.
To officially launch the report, RACGP President Dr Nicole Higgins took part in a panel discussion with Minister Butler, alongside New South Wales Independent MP and former GP Dr Sophie Scamps, and RACGP GPs in Training ACT Faculty representative Dr Emily Rushton.
In her opening speech, Dr Higgins said several short-term solutions could ‘stem the bleeding’ of general practice, but that long-term investment remains key to ensuring GPs can meet the future needs of patients.
‘General practice cannot aspire to be the preferred speciality or even to be competitive, until our professional status is recognised and renumerated at both training and post-fellowship levels,’ she said.
Health of the Nation revealed 80% of practice owners are concerned about the viability of their practice.
And it is the consequences of these anxieties that were laid bare in the report, as GPs unwillingly pass on rising costs to their patients.
In one year alone, the percentage of GPs bulk billing all patients has halved and the average cost of visiting a GP has jumped by more than $10 per consultation.
Speaking on the panel, Minister Butler said general practice was ‘unapologetically the focus’ of funding in the Federal Government’s May Budget as a first step towards addressing reoccurring pressures.
‘We want to build this slowly and steadily in a way that ensures the maximum confidence from GPs, and through them, because that’s how it’s going to work, the confidence of their patients,’ he said.
‘I don’t want to rush through this in a way that I’ve seen happen before … if you rush it and you don’t focus on building confidence it will fall over and we’ll be back where we started again.
‘There is a cultural issue that we face … what I’ve wanted to do through this whole process is build the status of general practice.’
But those words come at a time when 71% of the report’s survey respondents have experienced feelings of burnout, while overall job satisfaction has plummeted to 66%.
Additionally, only 20% of practising GPs said they would recommend their profession to junior colleagues, and 13.1% of medical students reported general practice as their preferred specialty of future practice.
Dr Rushton told the panel it is difficult to attract young doctors to general practice when the current GP workforce is ‘disillusioned and underpaid’.
‘We need to look at allowing GPs in Training to have access to the same conditions and entitlements that trainee doctors in hospitals access – maternity leave, study leave and pay parity,’ she said.
‘General practice as a qualification opens a lot of doors but unfortunately a lot of those lead out of community-based general practice.’
Dr Scamps agreed, telling the panel the system is currently the ‘wrong way up’ with more focus needed on the preventive treatments general practice can offer.
‘I absolutely loved my role [as a GP], and it did take me a number of months to come to the decision to leave because of course we know that general practice is far more than just a job or career, it is those really deep and strong relationships that we have with our patients,’ she said.
‘But there’s so much money going into the end of the journey at the hospital system when we absolutely need to be focusing on the bedrock, the backbone of primary healthcare.’
Following the launch, Dr Higgins spent the day meeting stakeholders, holding press conferences, and spreading the report’s contents and key messages.
But even as Health of the Nation continues to attract widespread attention, she said there is still much work to be done, labelling Australia’s current healthcare system as ‘insufficient’. 
‘The cost of providing care, like our electricity, our wages, continues to exponentially rise at a time when we’re having an exponential drop-off in bulk billing,’ Dr Higgins said.
‘We need to be able to provide support to GPs, so when we’re talking about funding, it’s important that we have longer consultations, that we’re supporting mental health.
‘We are preventing increasing costs down the line.’
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Dr Christine Colson   15/11/2023 8:26:34 PM

Fixing general practice is not rocket science. How many eminent attendees does it take to find some common sense?

I wrote an email to Mr Butler, tonight as it happens, about item numbers; here are some excerpts:
'...Would you prefer that I concentrate on the patient or that I try to untangle the spaghetti that is medicare. There are thousands of item numbers, each with its own gobbledegook ‘explanation’…'
'...I started reading the changes to the item numbers but I gave up. The twists and turns in the ‘descriptors’ seemed only designed to be a trap to catch more ‘defrauding’ GPs...'
'...How can I remember all that rubbish when I’m saving my memory bank for details that may save a life?...'
'...If you are serious about wanting to save general practice, SIMPLIFY AND REDUCE THE BLOODY ITEM NUMBERS, as a first step. Thankyou...'

Dr Paul Michael Coughlan   16/11/2023 2:02:00 PM

Mr Butler ,
the "cultural issue" is rooted in thirty years of poor Health policy and the systematic undervaluation of General Practitioners as determined by the rebate structure , the dressings fiasco ,the aftercare fiasco the MRI rebate fiasco .............................................and the payroll tax issue.
Meaningful changes , not platitudes , are required.
Too late now in the game to kick for touch.
p.s. An NHS style system is not meaningful change -check out their burnout rates.

Dr Ted Collinson   16/11/2023 3:20:40 PM

Too little, too late.
I'm retiring.

Dr Edward Thomas Wu   19/11/2023 7:59:43 AM

Dr Scamps has put her finger on the most important point that only those who have actually practiced as a general practitioner can experience and understand:
‘...... it is those really deep and strong relationships that we have with our patients,’ she said'.
Now the rule makers and the regulators (such as AHPRA /medical boards and Medicare) of the discipline General Practice have make it impossible for us to do this, why should anyone of us want to learn or practice as general practitioners?

Dr Angela Maree Roche   23/11/2023 12:43:54 PM

I was horrified and perplexed to read Mr Butler’s words of “ we want to build this slowly “ and “ I don’t want to rush through this in a way that I’ve seen happen before …. If you rush it you don’t focus on building confidence it will fall over and we’ll be back where we started .” We are in a crisis now. How “ slowly “ does he want to act? It’s probably already too late to turn the ship around . Do we wait for the whole town to burn to the ground and then send the fire trucks in . This is perhaps the real truth . Do they want to build a different system from the ground up ?