8 October 2018

After two torrid years, it’s where to now for GPs?


Dr Bastian Seidel jumped into the spotlight first as the face of a campaign to defend GP funding and he vowed, on being elected RACGP president, to put general practice at the centre of political debate. 

As he departs the top job this week, handing over to Dr Harry Nespolon at the College’s annual conference on the Gold Coast, the Tasmanian rural GP can look back on a tumultuous two years of scraps and successes in which GP affairs were rarely out of the news. 

Before taking the leadership in 2016, Dr Seidel had a profile as national spokesperson for the RACGP’s #CoPayNoWay and #You’veBeenTargeted public campaigns, which set the scene for the infamous “Mediscare” campaign waged by federal Labor at the 2016 election. 

“In the lead-up to this election, we’ve talked a lot about general practice and the role of general practice and the problems that GPs face.  If you think about previous elections, that didn’t quite happen,” he told The Medical Republic after the poll that left the Coalition with a one-seat majority.

“That’s quite a shift within a very short timeframe, and I believe it is a direct result of the RACGP’s advocacy campaign that really started when the co-payment was floated two years ago.

“That’s what we want – to make general practice left, right and centre when we talk about health and health policy.”

While keeping up the pressure to end the Medicare rebate freeze, Dr Seidel stood up to government over its approach to what doctors had hoped would be a game-changing project to address chronic disease and advance the role of digital communications in primary care.  

Faced with a bare-bones version of its cherished “medical home” concept, the RACGP walked away from the scheme. As a result, the Health Care Homes trial now under way has a participation rate far reduced from original targets. 

But the tough battles were also internal. A new compulsory component of the QI&CPD program known as PLAN, unveiled in 2016 for the 2017-19 triennium, led to a backlash in which an undisclosed number of members quit the RACGP in favour of the rural-oriented ACRRM. 

Controversially, Dr Seidel said the reflective learning activity would head off a Medical Board push for stricter demands. But it seems that might have been premature. The revalidation scare seems to have abated and PLAN is now no longer obligatory. It will still exist in a modified form, an outcome that he had suggested might occur at the outset.  

Members also rebelled against a planned revamp of the RACGP’s governance structure in mid-2017, defeating a proposed shift to a smaller corporate-style board with powers to overrule the Council, sparking fears of a loss of influence for faculty groups at the top level.

But while many perceived this as a show of no confidence in the leadership, there was a upside. 

Chair Dr Tim Koh said the unprecedented participation – with more than 2300 members bothering to vote – was a “testament to the incredible passion and dedication we share for general practice and for our College”. 

Under Dr Seidel’s leadership, the college adopted electronic voting – which failed spectacularly at its first test on the occasion of the governance poll – and opened a Canberra office to be closer to the epicentre of political power.

In other important advances, he presided over the RACGP’s resumption of GP selection and training from AGPT and struck a landmark agreement with ACRRM to collaborate in developing a national system to create a new generation of rural generalist doctors. 

Personally, Dr Seidel was conspicuous at rallies for asylum seekers, and for speaking out on medicinal cannabis as a possible source of relief for patients. 

Of course, the big win for GPs was long in coming and miserly in the event, but it will go down that the five-year Medicare rebate freeze ended on Dr Seidel’s watch.

After critical coverage of controversies such as PLAN and instances where he claimed he had been misquoted, Dr Seidel retreated from his formerly voluble, generous attitude to the medical media. That was everyone’s loss.  

Last week, Dr Seidel was uncontactable, so we couldn’t ask the big question.  

Was it worth it?  The constant travel, the sniping from the press, the relentless arguing with politicians with one eye on the door, every yard hard won?  

We wonder… 

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10 months 13 days ago

Dr Seidel stood for values that are important to an academic and professional college. It is a challenge to implement and negotiate worthwhile changes in a period as short as two years without the risk of it being undone.