The RACGP has signed a deal to begin training doctors in Shenzhen, but should members have been consulted first?
The RACGP’s plan to help China train up half a million GPs over the next decade has been met with mixed reactions, with many critical of the College’s lack of consultation with members.
The College is staying tight-lipped on the details of the partnership, which is set to launch this year, but says that it will “assist with solutions to support the increased primary healthcare demands from a growing China”.
“The Shenzhen Municipal Community Health Association approached the RACGP to propose a partnership, under which the College will deliver education services and help establish primary healthcare training systems in the high-tech city,” according to an announcement in NewsGP.
China has committed to tripling the number of GPs in the country by 2030, and the RACGP’s new undertaking aims to educate GPs servicing Shenzhen, a city of 20 million people in southern China near Hong Kong.
However, comments by GPs on the College’s own website reflect a dissatisfaction with the lack of transparency and consultation over the move. There are also calls that resources and political will would be better spent improving the lot of Australian general practice before offering educational services overseas.
“It is very hard not to think ‘ivory tower’ greed, money and egos are the primary motivators in this new development,” one said. “It is most disappointing.”
The ongoing criticism that the RACGP makes major decisions without member consultation is a problem for an organisation that has so recently been plagued by concerns about its increasing corporatisation, according to Emeritus Professor Max Kamien, a recently retired Western Australian GP.
And it comes despite the College’s recently failed bid to change the governance structure in a way that many members feared would prioritise corporate interests over those of GPs.
Without member consultation on a move like this, it would just be “another corporate decision”, Professor Kamien said.
Nevertheless, he welcomed attempts to bring much-needed improvement to primary healthcare in China, a country where general practitioners are few and the hospital is often the first port of call.
Similarly, Sydney-based Adjunct Associate Professor Michael Fasher said that while the decision took him by surprise, it was “inconceivable” that the College would refuse a request such as this from China.
Professor Fasher also suggested that the lack of member consultation was not of concern, saying both the College and China “would reasonably expect the majority would say ‘of course’.”
China’s decision to emulate the Australian system was “a big vote of confidence in the whole health system”, according to Professor Geoff Mitchell, a University of Queensland’s professor of general practice and palliative care.
In the long run, it was likely that the money made for the College from a venture like this would “far exceed” that spent, he added.
While the College has a good track record of setting standards and curricula, moving from the Australian system and projects with our neighbours to helping train triple the number of Chinese GPs was a “quantum leap” in scale, Professor Mitchell said.
“It’s like being a good builder of individual houses and then suddenly getting a contract to build 100 houses at once,” he said. “Making sure that the standards remain uniformly high will be the challenge.
“Obviously primary care, in many respects, is generic, but it also has to be aware of the diseases and the conditions and social mores in which its run,” he said. “So it won’t be a fly-in, fly-out exercise. It would have to involve developing curricula and developing Chinese national expertise in running their own program eventually.”
Melbourne GP Dr Rolf Tsui said China had been collaborating with various Australian primary health stakeholders for years, and so there were “no surprises the Chinese are keen to adopt our model of primary care”.
This kind of a partnership could be “really valuable” to Australian primary care too, said Dr Melinda Choy, a registrar and GP academic who was visiting China for a teaching workshop around the time members from the College were also visiting.
“The scale of what [the Chinese government] wants to do is massive,” she said. “As they seek to expand, they’ll pour more and more resources into it.”
With this comes an opportunity for Australians to learn about innovations in technology or improvements to evidence-based practice in primary care.
“Ultimately, if you’re only in your own patch you’ll only ever be able to grow in that, but if you’re sharing and collaborating you may be mutually strengthened and developed.”
