Dr Alan Bradley
RACGP President Candidate Statement
The future of general practice looks dire. The social contract of the GP as the centre of the healthcare system is breaking down. The Federal Government’s current “Scope of Practice” review, which will be released imminently, is a direct attack on the profession. It is beyond overdue for us to forcefully start fighting back.
The next two years will be absolutely critical in this fight.
We just have to look at our UK colleagues to see where this road takes us: The takeover of primary care by non-doctors, such as Physician Associates and Nurse Practitioners. GPs struggling to find work, as clinics are incentivised to use non-GPs working “top of scope”. GPs being demonised in the press, losing the respect and confidence of the public.
And all of this enabled by the British Royal College of GPs.
We can’t go down that path. It’s bad for patients. It’s bad for the health system. It’s bad for GPs.
The push from politicians is for accessibility at the expense of quality healthcare.
Without strong activism from our college, we will have:
- More pharmacists prescribing antibiotics, antihypertensives, metformin, and statins; like they are currently doing in Queensland
- The widespread introduction of Physician Associates, as envisioned in the May 2024 Queensland Health Clinical Governance Guideline
- More Urgent Care Clinics, being increasingly staffed by non-doctors
- Free-for-all access to secondary care without needing a GP referral
- An influx of overseas doctors working as GPs, who will not be accredited by the college
- Nurse practitioners in primary care seeing undifferentiated patients independently
Due to unnecessary referrals and lower standards of training, we’ll be left with a healthcare system which is both less efficient and more expensive. And GPs will be left to pick up the pieces in this fragmented system: a future as a risk sponge for other professions.
MyMedicare registration is the thin end of the wedge for this, and our college has been sleepwalking into this disaster – too busy pushing the government’s agenda on 60-day dispensing when they should have been protecting our profession.
Pharmacists are getting an extra $3 billion in funding this year, while we get new time restrictions on item 23.
We shouldn’t need to pack and stack care plans, or wait for some dietician to send a fax back to us, to be well paid for the services we provide.
Like the NHS, MyMedicare will introduce KPIs and block funding for certain conditions which will lead to more tick-box exercises and fragmentation of care.
87% of current medical students have figured this out, saying that they have no intention of pursuing General Practice as a career. Of the 36 medical students I currently teach, only two say they would ‘consider’ doing General Practice. They would rather get paid more in hospitals as unaccredited registrars and be eligible for long service leave, parental leave and sick leave. Who can blame them, when GP registrars can earn less than a graduate nurse.
The real solution to Australia’s healthcare problem is to have more good GPs. And the way to get that? Pay us what we’re worth!
This isn’t new – the RACGP has produced glossy materials such as the 2015 “Vision for General Practice” and the 2022 “General Practice Crisis Summit White Paper” which describe the issues.
The problem is not a lack of understanding, it is a lack of effective advocacy.
The Medicare rebate for item 23 in July 2014 was $37.05; in July 2024 it’s $42.85. Just keeping up with inflation, the rebate should be $47.34 today.
That means, four elections and a pandemic later, the rebate has gone backwards by $4.49.
We need to organise and present a united front against these attacks, and we need to do it yesterday. The college’s recently announced Advocacy Plan is a belated step in the right direction. We need to throw our weight around more, and be willing to fight like a union to protect GPs.
Restore respect to our GP profession
Full rebate restoration after a decade of cuts
Achieve parity in GP remuneration compared to other specialties
Adequate funding to teach registrars and medical students
Ensure no doctor takes a pay cut to train as a GP
Fight against scope creep of pharmacists, nurse practitioners, other ‘healthcare assistants’
The death spiral of General Practice in Australia has begun.
We need a president of RACGP who is going to take the fight to the government to protect our profession and our patients.
I intend to work as a GP here for the next 30 years, so you can be sure I will fight to save our profession.
Send a message to the college with your vote.
Dr Alan Bradley
MBBS, DCH, FRACGP, GradDipClinEd