Meet the new RACGP President-elect, Dr Harry Nespolon

Dr Harry Nespolon is a New South Wales-based GP with a long resume.
 
His background includes a Masters of Business Administration; membership on a number of boards and committees, such as the Northern Sydney Local Health District; a stint as Chair of GP Synergy, the NSW and ACT training provider; and ownership of two general practices.
 
Dr Nespolon has also worked for the Australian Medical Association, and as an RACGP examiner and representative on the Code of Conduct Committee for Medicines Australia for more than 10 years.
 
With such a notable history behind him, Dr Nespolon was aware that others may expect to hear some ‘words of wisdom’, though he was unsure he would be able to meet such expectations.
 
‘I think I’ve got lots of words, whether they’re of wisdom or not is for others to judge,’ he told newsGP.
 
How does it feel to be the RACGP President-elect?
For me, personally, it’s about what it looks like in two years’ time, not about what it looks like today, so we actually can achieve something, change some things, make life better for our members.
 
How do you feel your prior experience will help you in your role as RACGP President?
I think one of the criticisms is that the college is sometimes a little too academic. We need to make sure that we are helping our members rather than getting in the way, so that’s what I’ll certainly be looking to.
 
The business side of general practice tends to get ignored. If you look at Government, there’s a feeling that they act like they own the practices, when they don’t.
 
General practices are small businesses and have exactly the same problems as any other small business. They are not charities. We need to make money and we shouldn’t be ashamed of that or apologise for it.
 
I’d like to hold policy a little bit more accountable for running a general practice business in Australia.
 
I also think my time at a regional training provider will be invaluable when we take over the Australian General Practice Training [AGPT] program. [Running a training program] is a lot harder than people think, and if we don’t set up the right structures early on we might not get the quality.
 
One of the problems with the GP training program is that is seems to change every few years. It’s very unstable, not good if you’re trying to attract the best and the brightest, which we should be. So hopefully once it comes under the college it will be able to go through a period of stability and, if there are changes, they will be for the better rather than for the sake of making changes.
 
What is your vision for the RACGP over the next two years, and potentially beyond?
There are two aspects to it.
 
I would like to see the college internationally recognised as one of the best providers of GP training; I know it’s a big call, but we might as well have lofty vision.
 
Secondly, whenever you hear people talk about ‘the college’, they talk about the college and the members as two separate groups; it shouldn’t be, it should be one group.
 
So hopefully at the end of the two years [of my time as President] the members feel the college is advocating for them, has made their jobs easier, and has provided an appropriate level of rewards for their expertise and ongoing training.
 
In your opinion, what are the greatest strengths of the RACGP?
It is the membership that is our greatest strength. They have the potential to be a very strong, powerful group in society for change and for advocating on behalf of their patients.
 
So there is no doubt, it is the members.
 
What are the biggest challenges that you see facing the RACGP and the general practice profession in general?
The biggest issue facing general practice is funding. We can’t go through a five-year period where we’ve effectively had an almost 20% cut in the rebate for patients and somehow pretend that doesn’t affect general practice.
 
There are a lot of practices out there struggling with viability and the Government has to invest in general practice. They can’t keep just building hospitals; that’s never going to keep up with our ageing population and most people actually don’t want to go to hospital, they’d rather be treated near where they live.
 
The other issue that’s emerging is the mental health of GPs and how we support them. Everything is all tied up together. The funding, the injustices that most members see in the way that AHPRA [Australian Health Practitioner Agency] operates, dare I say it, even the way that PLAN [Planning, Learning and Need] operates, all adds unnecessary stress to being a GP.
 
So we as a college need to see what’s the best way that we can lower the pressure on general practice, both from a financial and non-financial point of view.
 
How has general practice changed in the last decade, and how do you think it might change in the future?
One of the biggest issues that does come up is GP ownership of practices. What we have seen in the last 10 years is an increase in the size of general practice businesses. The days of the solo GP seems to be decreasing because the finances make it very hard.
 
But also we’re finding an increase in the rate of non-medical or non-GP ownership of practices. Certainly, the competition in general practice has become much greater, between GPs and from non-GPs.
 
I’m not sure there’s any evidence of this yet, but the feeling would be that if you own and work in your business, it’s not just about the money – it is about patients. You’re more likely to want non-financial outcomes. So that’s an area that’s changed a lot.
 
From a positive side, we’re also seeing that GPs who are running their practices are becoming much more sophisticated, they’re using more IT, not just in medical records but in the way that they run their back office. We’re also seeing the rise of the professional office manager.
 
And one of the other most important things is there are a lot more female practitioners; whether or not the old model of the grey-haired male doctors running the practices necessarily works when we’ve got a predominantly female workforce. Do we need to change to help support them?
 
Having said that, the other big demographic change is that GPs are coming in to general practice older because of the changes in training.
 
A lot of people, when they go into to general practice now, are in the middle of their families rather than about to start their families. So a lot of the issues that people mention when they talk about the ‘feminisation of the workforce’ are equally issues for men: men also don’t want to be working seven days a week, they want to be participating in life and in their families.

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