An outspoken Melbourne GP is calling for the RACGP to heed its members’ attitudes on voluntary patient enrolment.
Melbourne GP and Australian Society of General Practice president Dr Chris Irwin is once again calling on the college to survey members on MyMedicare, confident that most GPs will be against the voluntary enrolment scheme.
Dr Irwin’s letter and Change.org petition comes as Health Minister Mark Butler makes further overtures toward widening the scope of practice of allied health practitioners.
In a speech at the Whitlam Institute on Friday, Mr Butler alluded to “a self-interested cabal of doctors’ groups” – namely the AMA and long-since-defunct General Practitioner’s Society – that had successfully campaigned against the Community Health Program in the mid-70s.
Now, he said, was the time to strengthen Medicare by fostering the kind of multidisciplinary team-based care that Gough Whitlam had envisioned for the Community Health Program half a century ago.
“Professor Mark Cormack’s Unleashing the Potential of our Health Workforce Review will find the opportunities for everyone in our highly educated health workforce to provide every ounce of care that they can,” said Mr Butler.
It’s a prospect that RACGP president Dr Nicole Higgins is well aware of.
Speaking at a webinar in September, she said she had gone from a MyMedicare sceptic to believing it would be “one of the most important drivers for general practice going forward”.
“I’m going to be a little bit crude … if we don’t [register our patients], somebody else will,” she said.
“I think it’s really important that we make sure that we bring our patients with us in general practice and provide that continuity of care.
“Because if we don’t, the system will fragment and there are going to be other options about how that care gets delivered, potentially through the reforms that are coming.”
It’s this idea – that general practice needs voluntary registration to help it stay in control – that caught Dr Irwin’s attention and inspired his open letter.
“I completely disagree with the long-held RACGP view that the best way to ameliorate harm caused by government is to be complicit with it,” he wrote.
Being “complicit” in instituting a system with block payments, Dr Irwin argued, will instead encourage practices to allow nurses and pharmacists to perform what would typically be GP roles.
“To briefly summarise – without effective control over the process (and the fact the president is urging us to be complicit or be replaced shows we have zero control), the outcome of capitation will be an ongoing fee for service freeze in real terms as items are not kept up with inflation, with increasing paperwork and hoops for an increasingly sidelined and demoralised general practice as government focuses on its aims of cost containment, increased bureaucratic control and data mining,” Dr Irwin wrote.
While he commended Dr Higgins for her work and advocacy as college president, Dr Irwin also wrote that he felt the outcome of the last RACGP election “would have been different if voters had known Dr Higgins would be endorsing MyMedicare to this extent”.
Dr Irwin lost to Dr Higgins at the 2022 RACGP election, despite winning the primary vote by about 200 votes.
The letter concludes by calling on the college to survey members on whether they support MyMedicare.
This is the second time this year that Dr Irwin has called for the college to do so; on his first attempt, in May, he received around 300 signatures.
