Reform announced in Tasmania last Friday that allows GP Registrars to be employed by the state health system, rather than needing to change employers once every few months, is one of the reforms wanted to resolve the GP crisis in New England.
The reform, known as the single employer model, has been trialed in the Murrumbidgee area of New South Wales with great success since 2020. NSW Regional Health Minister Bronnie Taylor is supportive of the program being expanded across the state.
Currently, GP registrars will have between 3-5 employers throughout their studies across a range of health care services including hospitals, primary care practices and community health centres. Because of the change in employers, the registrar loses entitlements that accrue with length of service and live with a level of insecurity that is challenging for people at the beginning of their careers.
By implementing a single employer model, GP trainees will be employed by the state health system on a contract of up to four years, providing them with a similar salary and entitlements – such as annual leave, sick leave and other benefits – to doctors working in a hospital setting. The better wages and conditions for doctors working within the hospital system has been clearly identified as a cause of GP shortage.
Tasmania has now rolled this model out across the state.
Announcing the initiative in Tasmania, Prime Minister Anthony Albanese acknowledged the importance of GPs to the health system, describing it as an honourable profession.
“The reason why primary healthcare is so important and GPs are so important is that if you get that knowledge of care between a doctor and their patient it’s more than just a transaction, it’s a relationship for life.”
“It’s a relationship which is about making sure that health issues are diagnosed early, that intervention happens as soon as possible.”
“And, of course, we know that if that happens, it will cost less because we’ll have less people who have acute health issues,” the Prime Minister said.
Tasmanian Premier and Health Minister Jeremy Rockliff said the $13 million jointly funded pilot would help attract more GPs in training doctors to rural and regional areas, with the aim of boosting retention in these areas to assist more people to receive the right care, in the right place, at the right time.
“Our government has long been advocating to trial a Single Employer Model for GP registrars, including rural generalists, to make rural practice more attractive for doctors and we now look forward to making it happen,” he said.
The Australian Medical Association (AMA) has welcomed the move. AMA President Professor Steve Robson said the AMA has been a strong advocate for a single employer model to provide GP trainees with wages and conditions comparable with doctors training in other specialty areas in public hospitals.
“The AMA at both state and federal levels had been negotiating with both governments to make the initiative a reality, with the single employer model having been developed by the AMA over several years and a key ask of the AMA’s plan to Modernise Medicare campaign.” Professor Robson said.
“The reality is doctors considering entering the GP training program need to grapple with the prospect of a significant cut in wages once they leave the public hospital system, estimated to be around $25k per year, as well as inferior access to personal leave, annual leave, long service leave, and parental leave.”
“This is one of the key reasons the Australian General Practice Training Program fails to fill many of its training places each year,” Professor Robson said.
“The single employer model overcomes this problem, with the state government continuing to employ GP trainees while they undertake their general practice training — ensuring that they get equitable pay and conditions.”
The model was identified by leading local GP Dr Maree Puxty as a good solution for the New England’s GP crisis, which has intensified with the recent departure of 8 GPs.
A potential obstacle to implementing the system here is the stubborn insistence of NSW Health, and Minister for Regional Health Bronnie Taylor, that the New England’s health fortunes should be lumped in with the Hunter and managed out of Newcastle. While Ms Taylor has advocated for the system to be adopted by Hunter New England Health, the decision and administration (including decisions about how many doctors will be placed in each community) will ultimately be in the hands of bureaucrats hundreds of kilometres from here. Multiple calls, including a large petition by local MP Adam Marshall, for the health district to be split, have been dismissed.
Federal Health Minister Mark Butler said they have committed federal funding for 10 more pilots and that they want to see this reform rolled out across the country.