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.