Cash bonuses for registrars welcome but awkward

The peak GP training bodies reckon state-based incentives will be a flash in the pan.

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The new trend of state governments offering cash bonuses to junior doctors going into general practice could do more harm than good, leaders from both GP Registrars Australia and GP Supervision Australia say.

It comes after recent mainstream media reports that Victoria’s one-off $30,000 payments to first-year GP registrars had drained rural NSW towns of trainees.

Queensland announced a similar program in June but upped the ante by offering $40,000 to doctors who chose general practice, distributed over the course of their fellowship.

Theoretically, the cash payments help soften the landing for junior doctors moving off a hospital salary and into fee-for-service GP work.

In reality, it’s been a bit thorny.

“If you’ve got two registrars at the same practice and one’s been able to access an incentive payment like [the $30,000], it changes the morale,” GPSA CEO Carla Taylor told The Medical Republic.

“It changes the flavour and is a little bit awkward, as you can imagine, for people in that sort of close environment.”

Ms Taylor said there was also widespread scepticism about whether state-level investments would last, given that general practice is traditionally a Commonwealth burden.

“If there’s not enough money in the kitty, then you’re getting people’s hopes up for something that’s going to be short term … it’s just another cliff for registrars,” she said.

GPRA president Dr Karyn Matterson was of a similar opinion.

“What makes a registrar that joins training this year any more worthy than a registrar who joined training last year and is ineligible?” Dr Matterson said.

“It creates dissatisfaction and bad blood within the system, and it’s not genuine reform – we don’t want Band-Aids, we want action to happen.”

While cash might help registrars out in the short run, it’s just one of a range of investments open to states.

“New South Wales has invested a lot in the single employer model, and I would be very surprised if they put more money on the table for another scheme that doesn’t support what that they appear to want to do,” Dr Matterson said.

“We can’t confirm that, but all we know is what’s in the environment there.”

From a purely ethical and moral perspective, Dr Matterson said, the last thing that GP training needs is for states to start a game of one-upmanship.

“Buying resources and draining the poorest states is certainly not a position that GPRA supports,” she said.