The Royal Australian College of General Practitioners (RACGP) is welcoming the trial of a new model for GP training in Tasmania, which aims to support GP training in rural communities.
Prime Minister Anthony Albanese and Tasmanian Premier Jeremy Rockliff announced this new trial of a single employer model for rural GPs in training today, Friday 27 January.
The trial, expected to commence in July, will allow up to 20 registrars to be employed by the Tasmanian Government for the duration of their GP training.
One of the current challenges for GPs in training is that they typically rotate through placements at different employers every 6-12 months. Under the single employer arrangement, GPs in training will have the same employer for the duration of their training and retain the usual entitlements employees accrue over time, such as sick leave and parental leave.
RACGP President Dr Nicole Higgins said the trial is a step forward for improving access to GPs for rural communities.
“The GP shortage in Tasmania is especially alarming for rural communities, with 99 GP positions being advertised across the state,” she said.
“But rural training works. The evidence shows GPs who experience quality training in rural areas are significantly more likely to stay there and serve those communities. The RACGP represents four out of five rural GPs, the most of any organisation in Australia. We train both rural GPs and rural generalists through a strong community-based training program incorporating experience gained in both hospital and community-based general practice care.
“The RACGP has been involved in discussions with the Tasmanian Government and the Department of Health to develop this model and we will continue to provide input to support GPs in training in Tasmania and across Australia.
“The Tasmanian trial aims to give rural GPs in training that are part of the trial greater consistency and certainty during their hospital-based and community-based training placements. These are sensible measures to remove some of the barriers to choosing general practice as a specialisation.”
Dr Higgins said it is important that this and future trials be carefully assessed to ensure they do not have unintended negative consequences for GPs in training or practices.
“A successful single employer model must ensure no registrar or practice is worse off,” she said.
“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.
“The model must also work for the practices and health centres hosting GPs in training and break down barriers rather than create them.
“In some single employer systems, governments charge practices a lump 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 (NCTER). This is a sensible approach that recognises the role of the practice.
“We must ensure there is a robust evaluation of the trial.”
RACGP Tasmania Chair Dr Tim Jackson also welcomed the trial. He said the lack of health care services in rural and remote communities is reaching a crisis point.
“It’s very exciting for Tasmania where we’ve got a GP workforce shortage,” he said.
“The immediate result of this is we’re going to see more GPs in training out the country, which will be good. Long term, I’m hoping this is the beginning of increasing the pipeline of the workforce with GPs.
“As a college, we’ve been talking to the different levels of government to come up with innovative models to work to fix the sustainability problem in general practice.
“I’m 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. 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.”
RACGP Chair Dr Higgins warned much more needs to be done to address the current health crisis and ensure access to high quality GP care for all.
“The problem is that decades of neglect and underfunding has made it harder and more expensive to see a GP, and this has caused the crisis in our hospital system, with wait times blowing out and ambulances ramping,” Dr Higgins said.
“Funding has been stripped from general practice care by successive governments over decades, while the need for care has been skyrocketing. Tasmania feels this more than other states with one of the most rural and remotely dispersed populations, an ageing population and higher rates of chronic conditions and multimorbidity.
“The RACGP has proposed a plan for governments to address the current health crisis, with action now to stem the bleeding and long-term reform that ensures the future of GP care for all Australians.
“We need serious investment in general practice to ensure everyone has access to high-quality care regardless of their postcode or income, and to attract the next generations of GPs who will be caring for our communities.”