Many GPs are still assessing the impact of the means-tested fee hike. Here we break it down

In an email to members explaining upcoming membership fee increases, RACGP president Dr Nicole Higgins referenced Monty Python in answer to the question she’s often asked: ‘What does the RACGP do for me?’

“It reminds me of The Life of Brian ‘What have the Romans done for us?’ A hell of a lot,” Dr Higgins wrote, while pointing to the College’s work educating, developing submissions, advocating for GPs and setting the standards for quality care.

But not everyone was amused.

Dr Higgins said the College is changing its fee structure “to ensure the financial viability of the college.”

The RACGP announced a new means-tested fee structure which will significantly increase the amount that most members pay, and likely hit part-timers and hence women hardest. Membership fees will also be indexed by 4.2%, in line with CPI.

Under the existing structure, only 39% of members are paying full fees. There are 16 also different fee categories, which will be reduced to nine.

What’s changing? Means-tested membership fees

GPs will be asked to self-declare whether or not they earn $100,000 or more from all revenue sources before tax. Those who do will now have to pay the full fees, which will be $1567. The declaration is based on an honesty system and does not require any kind of formal verification.

There is no longer a separate category for part time GPs; only a concession fee for those whose pre-tax income from all revenue sources is less than $100,000.

Under the current system, GPs who work more than 20 hours a week pay $1503 each year, while those working less than 20 hours a week pay $978, and those who aren’t currently active in clinical general practice pay $604.

In an FAQ on their site, the RACGP explains that the $100,000 threshold “was chosen because it represents approximately the median income for a 3-day-per-week GP.”

There are also still discounted membership fees for GPs who:
• live overseas
• are aged 70 or over
• are in training
• are International Medical Graduates
• are members of certain international colleges and live and work outside of Australia.
• permanently retired GPs and ‘pre-vocational’ students, residents or interns will get free membership

However, in some cases even those who fall into the discounted categories will be paying significantly more under the new system. For example, the fees for GPs in training are increasing by 42%, according to an analysis by the Medical Republic.

Exactly how much you can expect to pay will depend on the category; you can find the updated list and fees here.

How will the RACGP police the means-testing?

As for whether members will have to provide proof of income, an FAQ on the RACGP website says they “will be asked to declare that the information they have provided is true, correct and complete in all particulars,” and acknowledge that providing “false, incomplete or misleading information when applying for or updating their membership may constitute a breach of the RACGP Members Code of Conduct which attracts sanctions including the possibility of loss of membership.”

How is the College justifying the change?

The RACGP said the services they’re delivering cost more than the revenue they collect, and blamed, in part, the complicated subscription categories and associated admin, and the fact that only 39% of members pay full fees. That will no doubt rise exponentially if the criteria for full fees is primarily a pre-tax income of $100,000 that includes all sources of revenue.

“We’re making RACGP membership simpler and fairer,” reads the RACGP’s tagline explaining the new membership categories.

But many doctors will beg to differ.

Healthed has polled over 1200 GPs and while many are still taking stock of the situation, the majority of those who understood how the changes will impact them were concerned. For example 56% of that group concluded that their fees are going to rise. As for the cause of the RACGP’s financial woes, 40% of GPs blamed mismanagement and incompetence, while an equal number blamed circumstances beyond the College’s control such as COVID and macro-economic uncertainty. And only 15% of respondents were clearly supportive of a mean-tested fee.

As one GP summed it up when ask for their take: “The question of why the means tested membership fee is likely to go down in the same annals of history as PLAN, it’s a bit like that scene from Monty Python’s Holy Grail, where the peasant is introduced to King Arthur (read here “means tested membership fee system) and the peasant rather unexpectedly replies “Well I didn’t vote for you”.