Matters Arising

An editorial in the General Practice Issue (MJA, 17 July 2000) called for leadership and vision to guide Australian general practice

MJA 2000; 173: 669

The introduction of vocational registration in 1989 signalled the start of a new era. This was followed by the General Practice Strategy Review and funding commitments from government in the 1992-93 Budget. As a result of these initiatives and the gradual acceptance of practice accreditation, general practice is now recognised by all clinical Colleges as a true specialty.

Your editorial, however, points out the contrast between these achievements and the despondency evident among so many general practitioners. In the face of chronic underfunding by government, the initial enthusiasm appears to have been difficult to maintain. While our leaders have been swept up by enthusiastic visions for the future, GPs are more cynical about the process.

The profession has committed itself to change, but government has not been seen to back the changes with appropriate financial resources. The relative value study,² so eagerly awaited by some, will doubtless join countless other government reports gathering dust in Canberra archives. The vast differential between the earnings of GPs and their other specialist colleagues will remain, despite the espoused recognition of general practice as the lynch-pin of a healthy community.

You point to some of the ongoing opportunities for general practice, and acknowledge in part that many of these will be difficult to achieve while the autonomy and financial independence of general practice is threatened. Corporatisation must be taken seriously, and the College is dealing with this concern by developing a profession-owned model.

The future lies in innovation. The process of change must continue, and the College has recently proposed a new definition of general practice, which is currently being circulated for consultation and consideration by the profession. We must embrace the IT revolution, become more efficient and take control of territory in danger of being lost to the corporates. Only then can general practice regain its rightful position in the Australian healthcare system.

The relative value study is only a first step, but investment in strategies to underpin general practice must also be advanced. If funding can be increased, the General Practice Memorandum of Understanding, signed last year by the peak general practice representative bodies, has the potential to deliver much more. For the first time in many years the profession has the opportunity to modify its own destiny in a novel manner.

Our leaders must continue to advocate strongly for the independence of general practice and lobby for the required resources. They must also embrace the concerns of GPs themselves, and not become so carried away with enthusiasm for change that they get too far ahead of the pack.

General practice needs strong leadership to achieve its full potential, and the RACGP, with its total commitment to the specialty and to GP registrars -- the GPs of the future -- is the best-equipped body to provide that leadership. It is my aim, as President for the next two years, to seek to re-establish the College in that role.

Paul J H Hemming
President, Royal Australian College of General Practitioners
1 Palmerston Crescent, South Melbourne, VIC 3350
paul.hemmingATracgp.org.au

1. Van Der Weyden MB. Australian general practice: the need for leaders and vision [editorial]. Med J Aust 2000; 173: 60-61.
2. Hays R, Piterman L. Education and training for general practitioners. General practice in Australia: 2000. Canberra: Commonwealth Department of Health and Aged Care, May 2000: 377.

©MJA 2000
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