Frequently Asked Questions (FAQs)

Throughout the month, GPRA receives enquiries from GP registrars. Reading through previous enquiries can help clarify an issue, or answer your question.

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Part-time GP registrars and increases to the base rates of pay

Member question: As a part-time GPT1 registrar, does my base rate of pay change once I've completed six calendar months of GPT1 training, or six months full-time equivalent (FTE) training?

Read GPRA's answer

Your GP training term is determined by your RTO's assessment of your progression through the AGPT program and is dependent on both completion of 6 months full-time equivalent (FTE) accredited training and satisfactory progression of performance on educational tasks and assessments.

Your RTO will determine the amount of your part-time training that is actually counted towards accredited training. Most RTOs will pro-rata your progression through training so if you are working 0.75 FTE, your time as a GPT1 will simply be extended until you have completed six months of 1.0FTE total.

However (for example) some RTOs will only count 0.5 FTE of part-time training towards progression, even if you actually work (and are paid) 0.75 FTE.

The key point is that you progress from one GP training term to another (and with that, your base rate of pay will change) when your RTO assesses you as having met requirements, rather than just being a GP registrar for six calendar months.

Working as a contractor

Member question: Is possible to be a GP registrar employed as a contractor?

Read GPRA's answer

The following is legal advice GPRA has obtained regarding GP registrars being engaged as contractors:

“The relationship between registrars and the party that engages their services is one of employer-employee. This is because the salient features of an employer-employee relationship are evident in a registrar-practice relationship (or any combination thereof). Involvement in an apprentice or trainee situation also has a significant impact on whether an individual is viewed by the ATO as a contractor or an employee. Therefore, no matter if you operate as a contractor, or what a signed, legal document with your employer says, your legal relationship with your practice is employer-employee.”

While this issue has not been tested in a court of law, to our knowledge; however, the ATO is clear on the matter.

Therefore, GPRA strongly recommends that all registrars should be treated as employees, not contractors, as per NTCER cl. 4:

"It is a requirement of the NTCER that a registrar is engaged as an employee (see the ATO website). The NTCER gives rise to no other relationship between the parties, such as an independent contractor, partner or agent."

So all registrars should reasonably be engaged as employees. Practices must pay PAYG tax on wages, pay the superannuation guarantee, and provide paid annual leave and paid personal leave for the registrar. Both registrars and supervisors are protected in this arrangement for indemnity and Workcover insurance purposes.

Superannuation

Member question:  My practice isn’t paying me any superannuation, what do I do?

Read GPRA's answer

Firstly, while superannuation is part of a registrar’s remuneration, it is not income that is paid directly to the registrar, but rather the employer must pay this into the registrar’s nominated superannuation fund.

It is a legal requirement that the minimum superannuation paid into the registrar’s nominated super fund is the super guarantee, which is currently 9.5% of ordinary time earnings and must be paid at least four times a year, by the quarterly due dates. Visit the ATO website for more information.

For registrars this applies to base rate of pay and any percentage of billings/receipts, which are ordinary time earnings. Steps for reporting unpaid superannuation to the Australian Tax Office are described via these two links on the ATO website (link 1 and link 2).

Correct percentage of payment – paying back the difference

Member question:  I get paid base rate for 76 hours per fortnight as per the NTCER. At the end of the month 45% of my total billings for that month are calculated and the difference between this and the base rate that has already been paid to me for the month is my bonus.

When I recently took leave, my base rate pay for the month was actually a bit more than the 45% calculated on total billings at the end of the month. Does this mean I have to pay back the difference as my 45% for the month is less than the base rate payment made?

Read GPRA's answer

The NTCER (Schedule A) states that registrars are to be paid the higher of:
(a) base rate of pay or

(b) percentage of billings calculated over the cycle (which is a monthly interval in this case).

This essentially means that registrars are guaranteed to receive, as minimum remuneration, the base rate of pay. If your percentage of billings is less than the base rate paid over a cycle, then the base rate is the only remuneration you will receive for the cycle interval; furthermore, you do not have to pay back any difference.

SIPs and PIPs

Member question: What are PIP and SIP payments and do I receive a percentage of these payments?

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The Practice Incentives Program (PIP) is aimed at supporting general practice activities that encourage continuing improvements, quality care, enhanced capacity and improved access and health outcomes for patients.

Over recent times the PIP has included in excess of a dozen different incentives. Practices can apply for as many as they are eligible for, these incentives include: Quality Prescribing, Diabetes Management, Cervical Screening, Asthma Management, Indigenous Health, Teaching, GP Aged Care Access, eHealth, and now, After Hours.

In general, the PIP payments are made to the practice, not the individual practitioner (GP or GP registrar). According to the NTCER cl 13 "The registrar is not automatically entitled to receive any portion of PIP with the exception of anaesthetic PIP and obstetric PIP. The exact distribution of these payments should be mutually agreed (and noted in the employment agreement), and not disadvantage either the registrar or the employer."

While PIPs are made to the whole practice, the Service Incentive Payments (SIPs) are made to the individual provider of the service, who is working with a practice that is enrolled in the PIP.

SIP payments are typically associated with services such as completion of the diabetes annual cycle of care, completion of the asthma cycle of care, and with cervical screening performed on under screened women (no pap smear previous 4 years). For more information visit here.

SIPs and PIPs are normally paid quarterly via Medicare and, as per NTCER cl. 13, are "added to a registrar’s gross billings or receipts”.

Causes for the deduction of various practice costs

Member question: I am starting at a new practice and the contract they are offering includes clauses for the deduction of various practice costs including nurse fees and equipment maintenance before applying the percentage calculation. Is this in-line with the NTCER?

Read GPRA's answer

No.

The reason why a practice may be seeking to deduct practice costs or exclude certain item numbers for the purposes of percentage calculation (particularly when the practice nurse is doing the primary work) may be because this is consistent with their arrangements for their contractor GPs. However, this approach is not compliant with the NTCER, and should not be applied for GP registrar percentage calculations.

GP registrars are engaged by training practices as an employee. This is consistent with advice from the Australian Tax Office and the NTCER (clause 4) “gives rise to no other relationship between the [registrar and practice], such as independent contractor, partner or agent”.

The NTCER defines gross billings to: "include all fees generated by the registrar at the practice in which they are employed" (NTCER clause 1), and the registrar's "percentage" is calculated from "gross billings or receipts" (NTCER Schedule A). Therefore, all item numbers billed to the GP registrar should be included in their percentage billings calculation.

As employees, and according to the NTCER minimum, GP registrars receive a lower percentage (49.05% including superannuation) of the billings earned compared with contractor GPs (typically 65-70% or more). As such, the share of the registrar’s billings retained by the practice should contribute to the practice costs, including the practice nurse salary.

Finally, prima facie, this approach may also breach Section 324 of Fair Work Act in terms of criteria for permitted deductions from an employee's remuneration (including employee's wage/salary, incentive-based payments, bonuses, allowances).

Practice shutdowns and annual leave

Member question: My practice is shutting down over the Christmas and New Years holidays. While I am being paid my base rate of pay for the public holidays (as they are my normally rostered days of work), the practice manager has informed me that I will be required to take days of annual leave over the closure dates which are not considered public holidays. Is this in line with the NTCER?

Read GPRA's answer

Yes – this is in entirely consistent with the National Employment Standards (NES), which the are minimum standards applying to the employment of employees defined in the Fair Work Act, and on which the NTCER is based.

According to the NES, “an employer may require an … employee to take a period of paid annual leave, but only if the requirement is reasonable” (Fair Work Act cl. 94(5)).

A requirement to take annual leave would be considered reasonable if the employer’s enterprise is being shut down for a period such as between Christmas and New Year.

This means that if the practice shuts down for a holiday period (for example, Christmas or Easter) you may have to use your annual leave for this period. This is reasonable as there will be no clients, no staff and no work during the shutdown period.

Usually, the practice would have an appropriate policy on this and it would also be discussed with you well in advance, ideally up front during employment negotiations and documented your employment agreement prior to signing off.

If you have not accumulated enough annual leave to cover the practice’s shutdown period, then the NTCER allows for access to leave in advance of accrual, by negotiation (NTCER cl. 6.1), if this is within your maximum entitlement, otherwise leave without pay would be required.

No payslips provided

Member question: I am not getting a regular pay slip with my fortnightly pay and I think that I might have been underpaid. What do I do?

Read GPRA's answer

According to the Fair Work Act (section 536), pay slips have to be provided to an employee within 1 working day of payday, even if an employee is on leave. Details of the information that should be included on your payslip are here.

Once you obtain your payslip, you should be able to determine if you are being underpaid.

If you have been underpaid the Fair Work Ombudsman advises that this "needs to be fixed as soon as possible".

You should follow up with the practice manager and/or your supervisor to resolve this as soon as possible. Your RLO can also support you with this.

My employment agreement while awaiting Fellowship

Member question: I'm currently working as GP registrar and have four months to go on the employment agreement with my training practice. I have recently received my fellowship notification. What does this mean in terms of my current employment arrangement?

Read GPRA's answer

Receiving notice of attainment of fellowship from your medical college (ACRRM or RACGP) still requires subsequent actions from you to become formally vocationally registered. If this has not occurred then you may not be registered for your VR Medicare Provider Number.

Therefore, if you wish to continue to work in general practice and bill Medicare, you will need to be employed under registrar conditions to continue to use your registrar (3GA) Medicare Provider Number. This is done through an "Extension Awaiting Fellowship" arrangement, according to the AGPT Extension of Training Time Policy (category 5.2) and organised via your RTO, until such time as all VR paperwork is in place and you have received your new VR provider number.

In this circumstance, it would be entirely reasonable to renegotiate the terms and conditions of your employment during this "awaiting fellowship" period.

While still subject to the NTCER, you will no longer have supervision requirements and adjustments in your share and/or frequency of payment of percentage billings (and/or other terms and conditions) could be considered so as to be more aligned with what would be offered for consultant GPs. This is also consistent with provisions in the NTCER (section 2), in that the: “registrar and employer may negotiate terms and conditions different from those outlined [in the NTCER] by mutual agreement, provided they are no less favourable to the registrar”.

Once your vocational registration paperwork and subsequent Medicare Provider Number is in place then neither you nor your practice are subject to remaining under the conditions set out in the NTCER.

This situation is something practices and registrars should be mindful of when reaching this point of training. A respectful discussion/negotiation between the registrar and practice is highly recommended, well in advance, particularly if you intend on leaving the practice either prior to or once you are vocationally registered.

Billing accurately under Medicare

Member question: There was an error in my Medicare billings where there was an incorrect item claimed which gave a higher benefit than what should have been paid. Even though my practice retains 50.95% of my MBS earnings, according to the NTCER, my practice manager has told me that for this billing error I have to pay the full 100% of the repayment to Medicare. This seems unfair; is this correct?

Read GPRA's answer

Under the Health Insurance Act 1973 you're legally responsible for services billed to Medicare under your Medicare provider number or in your name.

You're responsible for incorrect claims regardless of who does the billing or receives the benefit. You will be responsible for the repayment of the full amount of the incorrect Medicare benefit that was paid.

Be sure to regularly check the services you provided against the services you have billed. The NTCER requires the employer to provide the registrar with billing or receipts information as appropriate. So, while the employer should enable you to access patient billings for review for any inadvertent breaches, there is no other obligation on their part. If you become aware of an incorrect payment and let Medicare know voluntarily, you may avoid an administrative penalty.

For more information visit this page on the Department of Health website.

My percentage of billings and superannuation

Member question: I have managed to negotiate a percentage of 50% billings, but my practice is taking super out of that percentage. Is this allowed?

Read GPRA's answer

It depends on what is stated in your employment agreement.

If your employment agreement states that the percentage of gross billings is "50% inclusive of 9.5% superannuation" then your salary is actually 45.66% of billings with 4.34% billings paid into your super. (This is slightly above the NTCER minimum, which is 44.79% billings as salary and 4.26% billings is the super contribution.)

However, if your agreement states that the percentage of gross billings is "50% plus 9.5% superannuation", then the superannuation contribution should not be deducted from your 50% billings rather 4.75% (i.e. 9.5% of 50%) of your total billings is paid into your superannuation fund on top of the 50% of your billings which forms your salary

Can my terms and conditions be changed AFTER I sign my employment agreement?

Member question: My practice manager said there was a mistake made in preparing my contract and has changed my pay rate after I signed the employment agreement and started working at the practice. Is this allowed?

Read GPRA's answer

GP registrars are not covered by an industrial award or registered agreement so their employment agreements are common law contracts of employment based on the minimum requirements in the NTCER. RTO accreditation standards require that training practices employ registrars in accordance with the NTCER.

Employers who seek to change the terms and conditions of employment contracts already in operation are entitled to negotiate changes that are agreeable to all parties; however, the employer cannot simply decide to unilaterally change a contract. The employee (i.e. the GP registrar) must agree to any changes to their contract – this should be done in writing - and cannot be coerced into accepting any changes.

Should my unused annual leave be deducted from my percentage billings?

Member question: I am just about to finish my term at my current training practice and will be moving to work at a different practice for my next term. I have one week (38hrs) of annual leave that I have accrued but not taken during my current term. My practice manager is going to deduct this from my percentage billings prior to paying my 13-week payment. Does this sound right?

Read GPRA's answer

When your period of employment ends you are entitled to be paid out for any accumulated annual leave that has not been taken during your employment with your training practice, as per Section 90(2) of the Fair Work Act (2009)

According to Schedule A of the NTCER: For the purposes of the percentage calculations, the cycle is inclusive of any periods of leave taken, including annual leave.

Therefore, as your 38hrs of accumulated leave has not been taken during the cycle it cannot be included in the percentage calculation, but rather it must be paid out separately.

On-call payments

Member question: I'm a registrar in a rural practice with frequent on-call shifts in the local rural hospital. My practice rolls both the on-call allowance and the billings from the rural hospital into the 13-week cycle. Is this correct?

Read GPRA's answer

According to clause 10.11 of the NTCER, a registrar may be rostered to be on-call. The NTCER states that this is considered to be “a normal part of general practice”. By clause 10.10, a registrar will be paid for on-call hours “as per ordinary hours”. In addition, if registrars are rostered to be “on-call” and other practitioners at the relevant practice receive an “on-call payment” (that is, an allowance for being on call, as distinct from a payment made for the performance of on-call work), the registrars must also receive that payment (clause 10.11).

Advice GPRA has obtained from legal counsel with expertise in IR law is that the payment of an “on-call allowance” is not in exchange for the performance of work. It is a payment made to compensate the practitioner for holding themselves ready to work outside of ordinary working hours. A doctor does not “bill” an on-call allowance. Therefore these allowances do not fall within the description in Schedule A of “billings or receipts” and so should be paid stand-alone. Furthermore, The NTCER provides a registrar should receive the same allowances as other doctors for being on call (clause 10.11) or, in the case of hospital work, a percentage of such allowances (clause 11.4), noting that this is distinct from payment for work performed when called-in.

Therefore, on-call billings can be included into the 13-week cycle but you should have also been paid at base-rate for the (after) hours when you actually performed work while on-call (as per clause 10.10). However, it is incorrect for the on-call allowance to also be rolled into the 13-week cycle - this should be a stand-alone payment.

The NTCER and superannuation

Member question: I was wondering if you could help me with a question I have regarding a statement in the NTCER on page 20, about Schedule A Remuneration.

Read GPRA's answer

Payment for ordinary hours for a registrar at the GPT1/PRRT1 level is calculated over a 3 monthly cycle and will be the higher of a) or b) below.

a) The base rate of pay for a full-time registrar is $74,215 ($1,427.21/week), plus the statutory rate of superannuation as determined by the Commonwealth, currently 9.5%

b) 49.05% comprising 44.79% of in-hours, after hours and on-call gross billings or receipts, plus the statutory rate of superannuation as determined by the Commonwealth, currently 9.5% (‘the percentage’)

I don't understand how this works in practice because 44.79% + 9.5% does not equal 49.05%.

If you check Schedule A of the NTCER: your percentage payment is at least "49.05% comprising 44.79% of in-hours, after hours and on-call gross billings or receipts, plus the statutory rate of superannuation as determined by the Commonwealth, currently 9.5% (i.e. 44.79% + 9.5% of 44.79% = 49.05%).

So 44.79% of your billings or receipts contribute your gross wages (provided this is higher than your base rate of pay across the billing cycle) and 4.26% (i.e. 9.5% of 44.79%) of your billings or receipts are paid into your superannuation account.

You can read the NTCER here.

Verbal agreements

Member question: When I started at my current training practice, I had a discussion with my supervisor about taking two weeks of annual leave after Easter. At that stage, they agreed to this request but now the practice manager says I can only take one week of leave because the practice is too busy. I have already made arrangement for a two-week family holiday; what can I do?

Read GPRA's answer

The NTCER, clause 6.1, states that “it is up to the employer and registrar to agree on when and for how long paid annual leave may be taken. However, the employer must not unreasonably refuse a registrar’s request to take paid annual leave.”

The difficulty, in this case, is that what was initially agreed for registrar’s leave was based on a verbal discussion.

While verbal agreements are effective and can be enforced as valid and legally binding, there is a downside. Verbal agreements are notoriously difficult to prove which makes the enforcement of a verbal agreement time consuming and challenging. Not only do you need to prove the verbal agreement exists but you also need to provide evidence regarding the actual terms of the agreement, which, in the absence of written documentary evidence, can boil down to one person’s word against the other.

In this case, if the registrar has a detailed record of all their discussions and negotiations with the practice, and copies of all correspondence, such as emails or letters regarding the leave request, then this will provide documentary evidence that there was an agreement and assist in resolving the matter with the practice. However, without any of this written evidence it will be very difficult for the registrar to prove there was an agreement as both parties will be relying on memory in a “he said / she said” scenario.

The key point for registrars:

  • Ensure that all items negotiated and agreed are put in writing, ideally in your employment agreement.
  • Carefully identify and address each of the terms and conditions of the agreement so both parties have the same understanding and intention. This helps to limit any misunderstandings and disputes further down the track, which paves the way for a more harmonious working relationship. It also provides an accurate record in case the other party fails to live up to his or her side of the agreement, in which case you may need to seek legal advice.

Public holidays

Member question: My practice manager has changed my roster so that my day off now coincides with a public holiday. Can they do this?

Read GPRA's answer

Public holidays form part of the National Employment Standards (NES).

The NES provides an entitlement for employees to be absent from work on a day that is a public holiday. According to the NTCER (clauses 4 & 5), registrars are engaged as employees and as such, should be paid their base rate of pay for the day when a public holiday falls, provided they normally work ordinary hours on that day of the week (NTCER clause 6.7,).

Furthermore, the Fair Work Ombudsman advises that an employee’s roster can’t be changed to avoid paying them for a public holiday.

BUT this does depend on the details in the registrar’s employment agreement. GPRA's advice is to ensure that your ordinary hours are agreed on prior to commencing a term and that this is itemised and detailed in your employment agreement. An employment agreement is legally binding, and so if rostering detail is specified then this becomes a contractual obligation on the practice and so cannot be altered without your written consent.

If your rostering details are not documented in your employment agreement and/or are only based on a verbal agreement, then alterations to your rostering in relation to public holidays can be difficult to substantiate. Also, clauses in employment agreements that allow for rostering changes subject to clinic requirements can ‘open the door’ for roster alterations for public holidays.

The key point for registrars is to:

  • Ensure that all items negotiated and agreed on in relation to your remuneration, working conditions and other terms and conditions (including rostering details)
  • that these items are documented in your employment agreement prior to commencing your training term.

Navigating your employment and training as a GP Registrar can be overwhelming. We can help.

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