Round table communique

Statement from the GP trainees’ Round Table discussion on employment arrangements

A round table discussion was hosted by General Practice Registrars Australia (GPRA) on 12 September 2020. This was a watershed moment whereby General Practice trainee representatives from across Australia, representing the diversity of general practice (GP) and rural generalist (RG) training programs and breadth of settings and locations in which this training is undertaken, joined to discuss long-standing problems with general practice trainee employment and to begin exploring potential solutions.

The following is a summary of the discussion which took place between the panellists and participants who attended this round table. View the Statement from the GP trainees’ Round Table discussion on employment arrangements (pdf).

In a media statement, GPRA President Dr Sama Balasubramanian said: “Nothing about us, without us—no changes to GP trainee employment and training should be decided without the full and direct participation of GP trainees.”

“This Round Table aimed to directly involve GP trainees in defining key problems and considering potential solutions. Agreeing on the common issues and continuing these multi-party Round Table discussions in the coming months provides a unique opportunity to find solutions at a time when significant reforms to the GP training program are continuing to progress,” Dr Balasubramanian says.

“GPRA calls on GP training sector colleagues, Government representatives and other stakeholders to work together for real, tangible and effective changes to achieve a fairer and more equitable solution to GP trainee employment and training conditions in Australia. Such change will facilitate better healthcare outcomes to our communities, who deserve the high-quality, patient-centred general practice care that the future of our profession promises,” Dr Balasubramanian says.

 

The following is a brief summary, provided by GPRA, of the Statement from the GP trainees’ Round Table discussion on employment arrangements. Please read the full statement to see each item discussed in depth.

The main, overarching issues with general practice training and trainee employment identified and discussed were:

  • the current base rates of pay are unacceptably low;
  • power imbalances in the employment of the GP trainee by a small to medium-sized private business;
  • issues with access to and portability of leave entitlements;
  • power imbalances with placement arrangements and employment negotiations;
  • inadequacies with dispute resolution.

Within the main issues, the following detail was noted:

  • The suboptimal training and employment conditions of GP trainees is affecting the wider community and discouraging doctors from becoming GPs.
  • The NTCER is not fit-for-purpose and should not, in its present form, continue to be the document which outlines the employment for GP registrars.
  • As a GP trainee’s training experience is linked to their employment (in particular their MBS billings), there is discordance in the competing interests of providing a quality training experience while ensuring a financially sustainable GP practice. 
  • Hospital-based trainee counterparts typically experience better employment conditions (such as access to parental leave entitlements) and undergo specialty training programs that are not tied to their financial stability.
  • GP trainees should be fairly remunerated for the work they undertake (including procedural work, VMO work, and out-of-hours work undertaken in a hospital setting).
  • The locus for resolving the employment issues for GP trainees should not lie with GP supervisors or training practices. 

The following was noted as basic principles as any change to the current system is considered:

  • A one-size-fits-all approach to GP training or employment arrangements during training is not supported. 
  • Measures need to be taken to enable more doctors to enter rural and remote general practice and rural generalism. 
  • Employment models should not disadvantage or disincentivise rural and remote GP and RG trainees. 
  • The training location or training pathway should not disadvantage any GP trainee in terms of the support, benefits, and resources offered.
  • Community-based general practices, as small to medium private business, cannot and should not be expected to provide the gap of funding required, particularly for entitlements such as portability of leave and paid parental leave. 
  • All GP trainees need to be well supported and adequately supervised during their training experience. 

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The NTCER covers the terms and conditions of GP Registrars' employment.