The humble flea has a role to play in reforming Medicare, says this candidate for the RACGP top job.
Associate Professor Charlotte Hespe believes that to understand the mess general practice is in currently, it’s helpful to look backwards.
The Sydney-based GP is also chair of the RACGP NSW/ACT faculty, and head of general practice and primary care research at the University of Notre Dame.
“Medicare is actually a system that’s designed to be a ‘sick care’ system, and that’s probably one of the problems we’re facing at the moment,” she says. “It was an amazing transformation of healthcare service when it was designed back in the 1970s.
“But the problem it was designed to solve was actually about access for sick care – and that’s the system that we got. And as Einstein would say, we cannot solve the problems that we’re facing with the same thinking that we used when we created them.
“So, unless we actually redesign our system to become a healthcare system, then it’s doomed to fail.”
The RACGP needs a strong leader at the helm if the college is to navigate its way out of the crisis – especially when the college is dealing with government, Professor Hespe says.
“I don’t think we’ve managed that relationship terribly well,” she says. “We’ve had a tendency to be a little bit subservient, and I think we’ve accepted advice to not cause too much disruption and not to be too noisy, when I actually think now is not the time to be subservient.
“Thankfully, [Health Minister] Mark Butler appears to realise there is a problem, but we need to be fleas in his doggy coat so he can’t forget about us.”
So how does she intend to marshal her army of fleas? “My vision for the RACGP is absolutely about the college being respected by all of us – as being our professional home, the place that listens and helps us get the right things done. With 43,000 people, you’re not always going to meet everybody’s needs, but we need to understand the things that we can do and how we prioritise them and the most important at the moment is sustainability.”
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