When the GP college president and vice-president headed West to listen to members, they discovered innovation and determination.
While Robyn Kruk is yet to submit her final report into regulatory settings for overseas practitioners, her interim report has already set the wheels of change in motion.
Ahpra in April flagged it would play its part in cutting red tape and costs to help alleviate nationwide health-care workforce shortages.
In August, the RACGP announced it would simplify its processes for IMGs to get more GPs into communities that need them sooner. The college has committed to make its assessment and accreditation processes easier for applicants, while maintaining safety and quality.
RACGP President Dr Nicole Higgins said IMGs were an important part of Australia’s general practice workforce and the college was considering measures including simplifying assessments and reducing the minimum time for IMG training.
“However, we are warning strongly against Ms Kruk’s recommendation that comparability assessments – which determine if a specialist IMG is competent and safe to practise in Australia – are transitioned to the Australian Medical Council,” she said.
“The inquiry into the ‘Dr Death’ case at Bundaberg Base Hospital made clear the risks to patient safety when specialist colleges don’t have responsibility for assessing specialist IMGs. We cannot risk this happening again.
“Also, training and comparability assessments must consider where IMGs work, because practising in a rural area is very different to an urban area. Rural doctors need to have the right skills and ability to work independently because there is often less support available. They also need cultural safety training.
“We largely support the report’s other recommendations, including a single portal for applications, the removal of labour market testing for employers sponsoring visas for priority practitioners, broadening age exemptions for permanent skilled visas to include key practitioners, and continued workforce support and demand modelling.”
The RACGP statement comes hard on the heels of a visit to WA by Dr Higgins and college vice-president Dr Bruce Willett, where she and WA faculty chair Dr Ramya Raman visited GPs working in the Geraldton region to hear firsthand their specific needs.
Speaking to Medical Forum at its conclusion, Dr Raman said the visit reinforced the college’s position on comparability assessments.
“Candidates must be able to competently and safely practice anywhere within Australia, and that includes rural and remote areas,” she said. “There are certain locations which are much further away from support – for both patient and doctor (and their families). The college plays a role in ensuring that support.”
In Geraldton, the college delegation visited two local GP practices as well the Rural Clinical School.
“We had some really useful conversations with local GP teams especially around strategies that they had adopted through COVID, including negotiating bloc funding from the local health service to provide after-hours care and aged care, which reduced the number of presentations to hospital,” Dr Raman said.
“Their model of care showed how we can improve health outcomes and reduce hospital admissions by turning our dial to general practice and primary care. It’s a small example, but it’s a very cost-efficient solution at a local level.
“And these stories are very powerful because without us going to Geraldton and speaking with GP teams, we may never have heard about them.
“These are the sort of solutions we want our health policy makers to listen to. If we can show how GPs are at the centre of some of these local solutions for health service provision, it will have an enormous impact on our health system.”
Dr Raman said workforce was the most critical need for the Geraldton teams.
“There are some very committed general practitioners and physicians and, and of course medical students who are coming through the pipeline, but the issue is just not a shortage of GPs,” she said. “It’s also practice nurses and allied health support within the practices.
“We need to make rural practice attractive, but it’s also about ensuring families have support, and that means schools for doctors’ children, work for their partners, and suitable housing. These are the elements that ensure a doctor will stay on.
“It was also heartening to hear from medical students who were in Geraldton, particularly those who originally came from a rural area, say they were renewing their term for another year because they enjoyed the teaching and the medicine.
“That was very reassuring because it’s a sign that they would most likely return when they are qualified. It was also incredibly valuable for Nicole and Bruce to see how well our Rural Clinical School integrates into communities. WA’s RCS, which embeds all three universities, is unique.”
Before they returned East, Dr Higgins and Dr Willett met urban doctors and several member functions, and also visited the team at Debarl Yerrigan in East Perth, which is taking on GP registrars.