Despite recent efforts, GPs want a more aggressive advocate in Canberra

Eight out of 10 GPs say the RACGP should be more proactive in lobbying for general practice, a Healthed survey of more than 2300 GPs has found.

And not just a bit more proactive — 58% of respondents would like the College to be much more aggressive in pushing for the needs of GPs.

College claims it is already doing more

RACGP president Dr Nicole Higgins told Healthed that while the College historically worked more behind the scenes to advocate for the profession, their role has become increasingly overt.

“Over the last decade, and especially since COVID-19, we’re doing more of our advocacy for GPs in public,” Dr Higgins said. “We’ve ramped up our visibility in the media enormously over that time by building a reputation as an organisation that strongly advocates for not just GPs, but all patients.”

As examples, she cited Medicare rebates, the fight against payroll tax, tripling the bulk billing incentive, 60-day prescribing—and billions in funding for GPs in the 2023 budget.

“We’re again ramping up our advocacy ahead of the 2024 Federal Budget and the RACGP will lead a delegation of over 20 GPs to Canberra in March to meet with politicians across the political spectrum about our budget submission,” Dr Higgins said.

Dr Mukesh Haikerwal, himself a longtime advocate, deputy chair of the Australian General Practice Alliance, and past president of the AMA, vouched for that.

“The RACGP has actually upped its ante in the advocacy space,” Dr Haikerwal said, noting that the AGPA had recently partnered with the RACGP and the Primary Care Business Council to pressure the Victorian government on payroll tax.

“You’ll see more of that happening, of the groups coming together,” he added.

Afraid of biting the hand that feeds them?

However, Dr Haikerwal pointed out that the College’s reliance on government funding for training programs in the past, and again now, has sometimes left them walking a fine line, with their advocacy intensifying when other agencies were running the training.

Perth GP Dr Joe Kosterich agreed the College’s financial interests in keeping the government onside created a conflict, and was less circumspect about their resultant ability to lobby for GPs.

“The RACGP has never effectively lobbied for GPs and the contrast with the Pharmacy Guild could not be more stark,” Dr Kosterich said.

“They’re typically on the side of the government, not the side of the GPs, and partly that’s because it’s to their financial advantage to be so as an entity,” he continued.

“But put the finances to one side for a minute. The College unfortunately, for at least 35 years since I’ve seen major government impositions, has never stood up for GPs.

And so I don’t think they’re about to start now… When was the last time the college actually came out swinging on behalf of GPs?”

So what is the solution?

Some surveyed GPs called for a union. “The big gap in general practice is that we don’t have a union to protect us and lobby for our rights,” said one. Others asserted that independent advocacy is needed. “The RACGP doesn’t always work in the interests of its members, so really doctors should independently lobby the Government for support,” another said.

Dr Haikerwal argues that ultimately individuals need to step up to effect change.

“Everybody wants advocacy by everybody else, and there is a time where individuals are going to have to do some heavy lifting themselves, whether it’s through letter writing or talking to media, whether it’s to go through the local MP,” Dr Haikerwal said. “There is an absolute imperative on every doctor to ask, what am I going to do?”

For her part, RACGP President Dr Higgins encouraged people to get in touch.

“Any RACGP members who would like to know more about our advocacy priorities or initiatives, or who would like to get involved, can contact me directly at president@racgp.org.au or visit the advocacy section of our website,” she said.

What your colleagues are saying

“They have forgotten that they represent GPs. They are ‘in bed’ with the government.”

“General practice will be obsolete if the RACGP and AMA don’t lobby enough for it.”

“Stop AHPRA dictating training programs for GPs, and like the pharmacy guild and specialist colleges, stand up to stupid bureaucrats and stop government bullying, denigration and doctor bashing of GPs, so young doctors can have fulfilling and remunerated career in general practice…”

“RACGP must review Department of Health policies before they get out; too often GPs and the RACGP itself are surprised by what complicated and troubling health policy changes are made without consultation.”

“I think there is an active lobby group doing what they can. We simply need more students getting into med schools to match the needs of growing populations; I cannot understand why it is so hard to get into medicine here when there is a shocking lack of GPs…”

“We need a union as the College has not stood up for quality, well-funded private non corporate general practice in the 20+ years I have been a GP.”

“I don’t see where lobbying politicians will have any benefit in a broken system that is too short of GPs, with medical students more interested in making money than caring for people.”