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.