On Sunday, the RACGP announced its five year advocacy plan to “improve patient outcomes and strengthen the voice of general practice,” calling for increased investment in GP among its top priorities – however a national Healthed poll with more than 1700 respondents suggests the majority of GPs think a purpose-built organisation may be better suited to the task.
Sixty-five percent of GPs think the profession would benefit from an organisation set up specifically to lobby on behalf of general practice, the survey found.
A substantial proportion – 38% of all those surveyed – said they’d be prepared to make a modest but regular donation to fund a dedicated lobbying body for GPs— with many pointing to the Pharmacy Guild as a powerful example of what could be achieved – and a force that needs to be counterbalanced.
“While ideally this would not be necessary, I think all the inappropriate new domains of pharmacy are due to their intense and well-funded lobbying to politicians,” one GP commented.
Among the 35% of GPs who do not think a lobbying body would benefit the profession – or the 62% who would not be willing to financially contribute — GPs tended to feel that advocacy should be done already by the College and AMA – and that the membership fees should cover the costs.
“The RACGP should be lobbying the govt for us, that’s what we pay them for.”
“This support should come from my annual payment to RACGP.”
While the most common reason GPs gave for not being prepared to contribute financially to a lobbying body was that College fees should cover it, many said they were struggling too much financially to add another expense.
“My income is barely enough to cover my expenses as I am working part-time.”
“I am only earning an average salary barely enough for expenses. Have not saved for retirement and lots of uncertainty about the future.”
Around 700 GPs elaborated on the reasons for their support, or lack thereof, for a dedicated lobbying body in comments in the survey. Lack of effectiveness of existing organisations, a need for GP specific lobbying focus, and pressure to counteract the Pharmacy Guild’s power and money, respectively, were most commonly cited by those in support of developing a GP-focused lobby group.
Here’s what GPs are saying:
Several GPs said they saw the College’s primary purpose as training and education, with a stand-alone organisation being better equipped to focus on advocacy, possibly with reduced administrative burden. Some felt the peak bodies had too much emphasis on keeping the government on-side, jeopardising their ability adequately represent general practice:
“At the moment there seems to be more collaboration with the government than lobbying.”
“RACGP has been sleeping with the government when Medicare came into force.”
“None of the esteemed colleges have ever had the guts or the foresight to prioritise their members’ needs first.”
“We need better representation and the RACGP and AMA haven’t really met that mark.”
“The RACGP is a training body and is not always effective at political lobbying.”
“It will allow the college to focus on standards.”
“The RACGP is ineffective and the AMA does not speak specifically for GP.”
“RACGP is a little dependent on a small voice of one person.”
A large number of GPs pointed to the Pharmacy Guild as an ideal role model for how GPs could lobby more effectively – with several noting that the success pharmacists, and in some cases nurses, have had in leveraging their power has heightened the need for GPs to counteract them:
“GP has no power — no say — while chemists and nurses want to take over the doctor’s role to manage patients.”
“We need an appropriate voice that is cognisant of current GP issues and can lobby as effectively as the Pharmacy Guild do.”
“The pharmaceutical board is taking the low hanging fruit and general practice is left with difficult and energy intensive work.”
“Just see how powerful and influential the pharmaceutical organisation is!”
“Need to counterbalance other powerful lobby groups, like the Pharmacy Guild.”
“Pharmacists have a powerful lobbying group, GPs don’t.”
“Well, maybe we could borrow the pharmacy guild lobbyists, they are pretty effective.”
Several respondents highlighted the need for GP-specific advocacy. GPs’ needs are unique within the broader health care system and GPs felt that they can not rely on other more general bodies to effectively reflect their specific needs:
“If we are lumped in with all the other specialties, our needs are diluted and dismissed by all the other specialties.”
“Need very specific knowledge of GP and its constraints.”
“Only GPs know GP problems.”
“We face difficulty getting our voices heard by the policy makers individually but with one unified voice we will have a bigger and better chance.”
“Together and united as a solid group of professional doctors is the only effective voice at any negotiating table. Otherwise, doctors are just like a handful of loose sand: will never amount to much.”
On the other hand, other GPs felt that adding another voice could potentially fragment the profession further:
“No, it should already be done by the AMA GP Group, the RACGP, and the ACRRM, all working together. Another group will simply be another group that the government will ignore.”
“RACGP already represents and advocates for GPs. Creating another organization could duplicate efforts, create confusion, and weaken a unified voice for the profession.”
“Too many groups, best for RACGP to be more proactive.”
“This approach has been attempted in the past – with no visible net benefit to GPs.”
“I think we are all so different that it would be impossible to do – unless there was a wealthy benefactor.”
“Another organisation charging GP a fee and not providing any value.”
One thing is for sure, this issue is not going to resolve itself. Healthed will be following up on this in coming months. Stay tuned for more insights.
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