College under fire over revamp plan

The RACGP says its governance reform is welcome and necessary, but not everyone agrees

---

Doctors are preparing to speak out against a planned constitutional reform that will strip strategic decision-making powers from the RACGP’s state-based faculties and interest groups and give control to a smaller, skills-based board.

Ahead of an extraordinary general meeting on May 30 to vote on the proposed restructure, at least one state faculty has declared a lack of confidence in the way the College has presented the case for the changes and asked for the decision to be deferred.

The controversial plan centres on the creation of a seven-member skills-based executive board that will sit above the RACGP Council and serve as the “ultimate decision-making body”, according to the board’s proposed charter.

The board, including three directors with expertise in financial, legal and managerial matters, would oversee the RACGP’s activities as a not-for-profit corporation.

The Council would continue to preside over clinical and professional matters.

Council Chair Dr Tim Koh has assured members that the new board would have a “mandated
GP majority”.

The GP directors would include the College president, Council chair and vice-president, and at least one of the three skills-based directors. The seventh seat would be filled by the chair of the Finance, Audit and Risk Management (FARM) Committee, currently not a GP.

Proponents say that relieving Council members of business-related affairs – and their current directorial responsibility to maintain board unity – will free them to engage in more critical thinking and focus on representing members.

“I think that’s the whole idea, to encourage a bit more constructive dissent,” RACGP President Dr Bastian Seidel said in a recent interview with The Medical Republic.

Dr Seidel also said he believed recruiting of non-GP directors, as opposed to GPs with financial or other special skills, would also help ensure diversity of thinking.

“Modern organisations really focus a lot on diversity – not only diversity of demographic, gender and background, but also diversity of professional background and diversity of thinking styles. What we should avoid, I think, is a group-think approach.”

While there’s no argument with the need to update and reflect corporate best practice, a number of senior doctors are not convinced the proposed model is the best fit for a membership-based organisation.

One point of contention is that the board – duty bound to serve the interests of the corporate body and with control of strategy and budget issues – could simply shut down argument in the event of a clash with Council, which is to retain its clinical and professional decision-making role.

“I think it’s completely artificial to suggest that all the clinical and academic decision-making will happen at Council and the board will just follow through, because fundamentally it’s all about budgets,” one concerned GP told The Medical Republic.

Dissenters also say that the current constitution already allows for up to one-third of Council members to be appointed as “co-opted” non-GP directors to bring professional skills, although only two – the current FARM chair, Martin Walsh, and former Victoria Police boss Christine Nixon – now fill such roles.

They argue that the smaller board would have a reduced pool of expertise, and a possibly lower level of experience, given the likely high turnover of the GP representatives.

They also fear disengagement with members as the state faculties, registrars, doctors with indigenous backgrounds and the censor-in-chief would no longer have a voice at
board level.

In making the case for change, the College has not offered specific examples of dysfunction in the RACGP’s current governance arrangement.

Rather, it says the restructure is overdue in view of the organisation’s size – more than 35,000 members and nearly $60 million in annual turnover – and the proposal reflects member feedback after a convocation item in 2013 calling for a governance review.

Dr Koh said members had made it clear during three years of consultations that they wanted a more nimble and responsive organisation.

Conflicts between the board and Council would be unlikely, because the president, the vice-president and the chair would sit on both and provide feedback to each side, he said.

“The chair and the vice-president are selected by the Council, so they can actually recall them and ask them to cease in the position if there is a massive conflict, an irreconcilable conflict.”

The College has promised to pose a “no” case on its website.

Dr Koh said more information related to the proposed changes would be made available.

“For us, this has been a three-year journey.  There have been innumerable meetings just trying to take in that feedback, and it’s really important that we listen to the whole membership,” Dr Koh said.