Chaos alert: GP training in tatters?

Chaos alert: GP training in tatters?

In the ‘Blogging on Demand’ series you get to choose the topic. If you have a great idea you want the world to know about, send an email, contact me via social media or leave a comment below. Karin Calford suggested the topic of this post. She sent an email asking: “With the imminent defunding of GPET*, what happens to GP registrar teaching from this point on? Wondering if you would be willing to blog about this.”

I am so pleased that people ask these questions. Karen wrote that, as a patient, she is concerned about the delivery of effective, patient-centred care in the future. As an example she mentioned the importance of teaching communication skills: “How will this sort of valuable non-clinical registrar training occur in the future?”

The responsibility for the training has been in the hands of GPET since 2001. The organisation was launched as a result of government concerns about the training program from the Royal Australian College of General Practitioners (RACGP). GPET was to give a range of groups a voice in the national GP training program. At the time it made an end to the RACGP’s monopoly as training provider.

From 1 January 2015 GPET is no longer. The Department of Health takes over its responsibilities to achieve administrative efficiencies. Australian Doctor magazine reported: “The Abbott government predicts it will save $115.4 million over four years by a package of cuts that includes abolishing GPET, slashing regional training providers and scrapping the Prevocational General Practice Placements Scheme.”

The current situation can be summarised in one word: Chaos.

The power vacuum

Former chair of GPET Professor Simon Willcock predicted a while back that the axing of the organisation would create a ‘power vacuum at the heart of GP training’. The responsibility for the training program now lies with the Department of Health, but the question remains how well things have been thought through.

It appears GP registrars wanted to get rid of GPET. Shortly after the election of the current government they made suggestions to replace GPET in a ‘draft’ sent to a government policy advisor. Australian Doctor magazine obtained a leaked copy, which “(…) warned of escalating costs facing the government in dealing with the expanding number of options for GP training.”

GP supervisors are now concerned that big corporates will take over the training program, because they “(…) operate with an efficiency that concentrates on urban training to maximise patient throughput, rather than the development of quality general  practitioners.”

What the AMA, RACGP and ACRRM say

AMA president Professor Owler said:

“Abolishing GPET takes away professional control and leadership of GP training. And we believe that the Department of Health does not have the necessary experience to run GP training. The Budget reforms will dismantle the existing GP training infrastructure that has taken many years to put in place.

In the meantime the two GP colleges, RACGP and their rural counterpart ACRRM, have proposed a new framework for the training program. The AMA was not happy about the fact that the colleges kept their plans behind closed doors, but supports a college-led training program as this would be consistent with other medical specialist training programs.

The soap continues: The two colleges were to meet federal health minister Peter Dutton last week, but the get-together was cancelled at the last minute. This promted RACGP president Dr Frank Jones to express his disappointment:

“(The colleges) are extremely disappointed that a meeting scheduled to discuss general practice training with the Federal Minister for Health, The Hon. Peter Dutton MP, was cancelled yesterday. On behalf of the RACGP, I have stressed the critical and urgent need for reassurance regarding the future governance of a general practice training program and will endeavour to reschedule this meeting before Christmas.

It is unknown if Peter had to cancel because of the flu. If that’s the case I hope he has an empathetic doctor – and he’d better ask for a sick note too.

Here’s to hoping that regardless of the government’s administrative ‘efficiencies’, the quality of the Australian GP training will remain world-class.

Thanks to Karin Calford for the topic suggestion.

7 thoughts on “Chaos alert: GP training in tatters?

  1. I think one thing is clear – if the Corporates get a hold of GP training then we all – from grassroots frontline GPs through to the heads of AMA, ACRRM and RACGP (as well as other Colleges) need to disown the training program. And trainee doctors should vote with their feet – their options are now either to be cashcows for corporates…or city specialists. I know which I would advise them

    Liked by 2 people

  2. Many forget the shambolic beginnings of the regional training programs 13 years ago, the confusion, posturing, infighting and disruption to training. The RACGP had lost its “Silverware” as a new young college was trying to define itself through AMC accreditation. Distrust would be an understatement. GPET defined an administrative process and over saw the packaging of training units (Registrars) to various RTPs. With hindsight and lots of innovation and enthusiasm the good educators have moved on to a place where it seems educators at least are sanguine about the future. The last AGPT Conference recently held in Brisbane was not a mournful affair, there will be challenges and people were quite happy to meet them. GP Supervisors will continue as always steadfast in their role as the trainers of future GPS. Whether “Corporates” really are effective will still be judged at the endpoint RACGP or ACRRM examinations. To my mind this is not the end of the world, the Colleges may well have more influence than they had, the educators will still have jobs and General practice will survive. In many ways I think it best to ignore the machinations of Government and just get on with delivering quality care and GP training. I dont think it matters much that the Australian Government has decided to change course, they’ve done it before and they will do it again.

    Liked by 2 people

      • Imagine, if you will, a newly minted accountant or manager. They need an MBA or CPA to progress to the next stage of their career and the next stage of responsibility. Who pays? Who gets paid?

        I agree with Ewen. Training will go on, and I hope to provide some of this at Partridge Street General Practice. I will do my best (as I’m sure all GP Supervisors will) and will innovate as required.

        The only constant is change.

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      • Having seen the news today I do think young clinicians with huge HEX debts will question a career in primary care. So may be it will be moot the change in training structure. The Corporate model has been attacked, GP incomes forecast to drop by between 15% and 45% if you can believe the back of the matchbox calculations I have heard quoted this afternoon, so maybe the few of us left will have jobs for life.

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