All DoHAC eyes are on the international stage and the RACGP digs in its heels.
The RACGP has reiterated its strong objection to physician assistants in general practice and is urging Australia not to incorporate the UK’s “policy failures”.
Members of the British Medical Association’s General Practitioners Committee in the UK have voted to stop the hiring of physician associates and to phase out existing roles within general practice.
The committee concluded that PAs were “inadequately trained to manage undifferentiated patients” and called for an “immediate moratorium” of their interactions with such patients.
Chair of the BMA’s GPC Dr Katie Bramall-Stainer said she recognised that the issue was “challenging” and “politically heightened”.
“At the heart of it is patient safety, which needs to be prioritised, alongside acknowledging the responsibilities of employing practices and welfare of existing employees,” she said.
“It’s no secret that we desperately need more staff in general practice, but we need be sure that staff who see patients are suitably trained and competent to see them unsupervised.
“Workload is inextricably linked to the recruitment and retention of the workforce, so additional roles should not generate more work for already-stretched GPs.”
The BMA said that PAs in general practice should be given the opportunity to retrain in more suitable roles within the NHS, as their role within general practice was “fundamentally unsafe”.
Closer to home, just last month Queensland Health closed its statewide consultation on the role of physician assistants in the workforce, after a proposal to expand PAs at some Queensland hospitals attracted outrage online.
The state’s health minister Shannon Fentiman’s office told The Medical Republic that they had not yet been briefed on the outcome of the consultation.
Speaking to TMR, RACGP president Dr Nicole Higgins said that the college “strongly, strongly object” to PAs in general practice.
“There’s no role for physicians’ assistants in Australian general practice,” she said.
“Our concern with PAs [in general practice] is that we have non-doctors with basic level medical training who aren’t qualified to diagnose and manage undifferentiated illness, which is a very different situation to hospitals where you’ve got strict clinical governance, guardrails, protocols and procedures.”
Dr Higgins said the college had made it very clear that there was no space for PAs in Australian general practice but was disappointed to be consulted so late in the game.
“The failure to consult with general practice until very late in the piece demonstrates the state government’s poor health literacy on how general practice works in Australia,” she said.
“GPs are trained very differently to PAs, who only get basic level medical training.
“Doctors are trained in undifferentiated illness and clinical reasoning, which is very different to the protocol-based training that PAs receive in Australia.”
Dr Higgins said Australia already had medical assistants in general practice, who support GPs under supervision and are delegated duties in a way that’s safe.
“Substitution is not a workforce solution,” she said.
“If we learn nothing else from UK, we have all the best health systems in the world, let’s not incorporate their policy failures.”
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The Department of Health and Aged Care told TMR that it would continue to keep an eye on the international environment.
“Physician assistant is not a registered profession under the National Registration and Accreditation Scheme (National Scheme) in Australia,” a department spokesperson told TMR.
“The adoption of new professions into Australia’s health system is largely driven by workforce and health service needs.
“Inclusion of a health profession under the National Scheme would need to be in accordance with the Inter-Governmental Agreement.
“In the meantime, the Commonwealth Department of Health and Aged Care will continue monitoring the use of physician assistants internationally with a focus on provision of safe and quality care.”
A spokesperson for Queensland Health – which currently employs seven PAs across Townsville, Sunshine Coast and Darling Downs Hospital and Health Services – said PAs were a valued part of their workforce.
“Physician assistants provide valuable support to doctors and other clinicians, working within their approved scope of practice,” they said.
“To ensure the highest standards of patient care, Queensland Health recently consulted with key stakeholders, including relevant associations, on the physician assistant clinical governance framework.
“We are currently reviewing this feedback to inform future decisions.”
This article was updated at 4.30pm on 22 October 2024 to include comments from Queensland Health.
