3 July 2018

What Dr Nespolon’s win might mean for the RACGP

General Practice RACGP

At a big meeting of GPs held a month or so back I was worded up by a few “in the know” to make sure I spoke to one particular doctor present as he was going to be the next RACGP president.

The doctor being referred to was not Dr Harry Nespolon. Those in the know were not “in the know” as things turn out. Democracy hey. Hard to pick these days.

THis morning DrNrspolon was confirmed as President-elect of the college.

What happened? Dr Nespolon was supposed to be a left-field candidate who was never going to have enough profile or support to make it. He was seen by some as just a little too outspoken.

Maybe what occurred reflected what seems to be happening in democracies all over the world at the moment. The “people” want better than they’ve been getting in the past. So they vote for those they think might achieve “real change”.

This is what Dr Nespolon seemed to be offering, through a campaign that was a little more robust around the key issues faced by the RACGP.

“The campaign was about change, and I’d like to think that I got the issues right in this respect,” Dr Nespolon told The Medical Republic this morning.

“GPs are rightly unhappy about the way things are going and they want real change,” he said.

“There needs to be a cultural change within the college. It needs to move away from being an autocratic organisation to an organisation that does really care for its members.

“We are always talking about the college and the members. They should be one entity.”

The key indicator Dr Nespolon may really be going to take a different approach came at the beginning of last week when he sent a message to a substantial portion of college members asking them to tell him what they wanted so he could develop the most appropriate strategy platform.

“I have decided to take an evidence-based approach to understanding your needs and concerns so I can carefully develop a policy strategy”, Dr Nespolon said in his message.

“I am looking to understand what issues are personally important to you. If I do become the RACGP president, these will become the most important issues”, he said, and asked them to take a quick survey to help him.

The response was huge, with more than 400 GPs responding to his questions and adding comments from which Dr Nespolon says he gleaned a lot of feeling for what members were after.

He sent a follow-up email yesterday with the results and promised to pursue the top five identified issues with vigour.

The issues weren’t that controversial.

They were GP funding, GP mental health and wellbeing, changing AHPRA complaints procedures, making PLAN non compulsory, and getting GP training right.

But the fact Dr Nespolon actually asked members what they wanted may have triggered a change in voter intentions.

Dr Nespolon also cleverly put a link to the voting on this last email. Never hurts to have technology on your side.

This left-field approach may also explain a doubling of the GPs voting this year, up from approximately 2000 last election to more than 4000 this time, according to some sources.

Dr Nespolon says one issue that came out of his survey was that many members weren’t even aware the voting was happening. One member told Dr Nespolon this was the first time in 10 years that the RACGP had explained to him that, as an associate member, he wasn’t even allowed to vote.

As Dr Nespolon’s survey indicates, highest on his agenda is GP pay. He doesn’t think either the AMA or the RACGP have done enough to fix the rebate situation, saying that “The Compact” (with federal Health Minister Greg Hunt)  felt like both organisations might be suffering a little from “economic capture”.

Signalling there might be some more agitation on the rebate front with the government, Dr Nespolon told TMR: “The government was always going to unfreeze before the last election, so it’s hard to see why we signed up to The Compact.

“The timetable on rebates is still too slow. It’s not acceptable.”

When asked if he felt he could achieve systemic change given the short, single-term tenure given to college presidents, Dr Nespolon said that he felt he could, but that certainly the tenure presented some difficulties.

He said a key issue was that a good president might develop excellent relationships in key areas where change could be affected, such as Canberra, but then have to move on.

And perhaps this was something the members might want to think about in how the organisation achieves long-term change.

Dr Nespolon said although it was not a priority issue, it might be that future presidents get a shot at a second term, but only through a vote.

“That way the members get to keep a good president, and get rid of a poor one,” he said.

Dr Nespolon is well known for his views on PLAN, which he and the other candidates had campaigned around either abolishing or making non mandatory.

Dr Nespolon was probably the most outspoken candidate on this issue.

Although he acknowledged that any change to PLAN required a vote of the RACGP board, not a “captain’s call”, he told The Medical Republic it would be very strange for the board not to act because all the candidates had run on a platform of changing PLAN, and it seemed very clearly to be the will of the members to change it.

“It is said that PLAN was a necessity to head off revalidation, but I’m not sure that many members buy this reason any more,” Dr Nespolon said.

Regarding the upcoming handover of GP training back to the college, Dr Nespolon feels strongly the management of such training should be put at arm’s length from the day-to-day business of the college.

“People really care about the training program. It’s not that sexy, but GPs as a profession are very concerned to see that our new GPs are trained effectively. One solution might be to have this managed through a fully owned subsidiary company that can be separated to the degree needed to be more effective,” he said.

As to the issue of CPD and the college being both the major governance body and earning significant revenue from the provision of CPD, Dr Nespolon said the issues were complex and he wanted to get across them more before commenting.

In closing our interview, as if to reinforce his point on member participation, Dr Nespolon asked us politely to include the link to his original survey, just in case anyone still wanted to contribute their thoughts as he prepares takes up the reins.

That link is HERE if you’d like to give your thoughts directly to Dr Nespolon.

Dr Nespolon’s summary email of the first results of the survey is reproduced below.

Dear Colleague Thank you to the many hundreds of GPs who replied to the survey that I circulated last week. The insights that your responses provided helped me understand not only the key issues but also which issues were high on the priority list of the GP community.  The “Top 5” issues found in the survey closely match the issues that I identified before the campaign in my discussions with colleagues and my own professional life as a GP. These are GP funding, GP mental health and wellbeing, the Medical Board/AHPRA complaints process, PLAN, and the future of GP training.  These priorities will be the focus of my work if you choose to elect me. Following is more information on how I plan to tackle these issues on your behalf:

1. GP Funding – The Most Important Issue

Not surprisingly the number one issue, with almost 80% of GPs rating funding as very important. Briefly, the way that I will start to deal with this is as follows: The gap and the rebate – no longer connected First, by working to remove the unnecessary rule that prevents charging a gap and direct billing the government for the rest. In our survey, 90% of GPs said that this is an issue that the RACGP should actively pursue – and I will pursue it with maximum commitment!  Non-Fee for Service – more clarity and explanation needed Second, almost 50% of doctors were unsure whether these should be supported, whichever model is trialled. I would seek to ensure that all the options are fully explored by the College, fully explained to the GP community and that the reward would compensate general practice for the risk.

2.  GP Mental Health and Well Being

I was impressed that the GP community made this their second most prominent issue. This warrants direct action by developing programs to directly deal with GP Mental Health with multifaceted initiatives to address stress and burnout as well as more silent issues such as depression and substance abuse.  Importantly, by dealing with the issues highlighted in this survey – improving funding, better complaints handling procedures and unnecessary red tape activities such as PLAN, to name a few – some of the key stressors in GPs lives can be reduced!

3.  AHPRA – It must change to be supported by the profession

Medical Board (AHPRA) complaints procedures are a major issue with approximately 80% rating these issues as important to them. I will use my position to improve the way that AHPRA treats doctors.

4.  Making PLAN non-compulsory

Almost all respondents (90%) wanted to remove PLAN or make voluntary, I feel the same and will work towards this goal for the next triennium.

5.  Let us get the GP training program right this time.

This issue is close to my heart, and it was great to see that it was the 5th most prominent issue for GPs. General Practice should be attractive to graduating doctors, the start of which is a great GP training experience. I do not want to see the training program being swallowed up the College bureaucracy.

6.  RACGP Membership needs to give more value

The principal reason why GPs joined the College was for the CPD requirements (76%), followed by the need to feel that they belong to a professional organisation (65%). Yet, it is concerning to me that only 20% rate the value of their membership with the College as good (18%) or excellent (2%). Only 35 per cent of members would recommend the College to a colleague! I will work to understand and change why these ratings are not as positive as they should be and how the value of College membership could be improved. A good start would be pursuing and being successful in dealing with these critical issues listed here.

7.  Voting for Change – Vote 1 Nespolon

Being a GP has never been more interesting and yet also more challenging.  I have extensive experience in general practice, as a clinician, mentor, and practice owner, as well my senior involvement in organisations such as GP Synergy and the federal AMA. I believe that I am the right choice to bring the College into better alignment with the needs and aspirations of its members and the demands on modern general practice and GPs.  So, please Vote 1, Dr Harry Nespolon (www.drharrynespolon.com). Click here to vote now – voting closes at 5pm today! Thank you for your time and participation. Kind regards, Dr Harry Nespolon RACGP Presidential Candidate drharrynespolon.com

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3 Comments on "What Dr Nespolon’s win might mean for the RACGP"

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Bengt Paven
Bengt Paven
9 months 17 days ago

Any chance of an OTD or a female (or both) for a change?

Joe Kosterich
9 months 17 days ago

This is a great result for general practice. The people have spoken and the powers that be in the RACGP need to understand that the new president has a mandate for reform. Congratulations Harry and best wishes for your success in implementing the policies that the members want.

9 months 18 days ago

Is anyone else absolutely NOT surprised that the one who clearly articulated that he would ditch the abomination known as the “PLAN” has been elected RACGP president?