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GP Supervisors are all too aware of time! Our clinical work, our teaching time with registrars and our professional development and education are all funded and measured by time. Strangely appropriate that one of the prizes for Supervisors who opted into the survey conducted last month was an Apple watch!

General practice and general practice training stands on the edge of a series of changes which are likely to have an impact not seen since the introduction of Medicare in 1984.

The changes include the Medicare item number review, trials of the medical home, scrapping of care plan item numbers, handing over of general practice training to corporate general practices, a continuation of the Medicare item number freeze, in addition to the freeze on supervisor teaching payments and practice subsidies (effectively a 14 year freeze with one minor adjustment in 2008).

GP Supervisors Australia believes it is important that general practitioners are involved in these decisions. Rest assured GPSA is advocating strongly on behalf of the profession and supervisors.

The Commonwealth government are proposing a “co-funded” model of registrar training, while details are scant there is potential for corporate general practices to take over large chunks of registrar training, registrars may well then be bonded to work in these practices after they complete their training.

Corporate practices may well become their own RTO (regional training organisations) leaving them free to police themselves. GP supervisors Australia believes the quality of the training is of the utmost importance rather than the ownership of the training practice however the process of registrar training needs to be open and transparent and free of conflicts of interests.

With this in mind, GP Supervisors Australia have contributed to the co-funding model of GP training discussion and sought transparent consultation on how the proposed model will manage inherent conflicts of interest. Make no mistake, this issue is relevant to all practices, clinicians and registrars.

The Honourable Minister Sussan Ley noted at FGP ’16 this month that there was a perception that Australia was edging towards an oversupply of GP registrars in Australia and that health spending would inevitably change with the changing context of the health workforce. GP registrar numbers have grown from 600 in 2008 to the current level of 1500, the addition of the additional 300 co-funded registrar positions next year will mean that registrar numbers have tripled within eight years. GP Supervisors Australia is anxious to see these registrars working where they’re needed, we also wonder if we really need an extra 300 registrar positions at this time. GPSA is concerned to ensure that additional pressure on training practices does not lead to poor quality practice experiences for registrars which could jeopardise training and damage the reputation of supervisors.

Of course with elections looming and discussions turning to a broadly supported medical home model of care for patients with chronic disease the GP supervisor community are rightly holding the bubbly until they see the detail. In the lead up to an upcoming election this Government have announced a series of trials for the general practice home model of care. Funding for this will come from the scrapping of care plan payments.

Teaching, training and research and an appropriate funding model must be core to any sustainable medical home model being implemented. Training models must be built into the medical home. GPSA will be seeking to have an active role in this area. It is important that general practitioners are not worse off under a medical home model. GPSA welcome more detail on the initiative and will contribute positively towards the programmes safe implementation in the GP training sector.

 

Sincerely,

Dr Bruce Willett

Chair GPSA