The reduction in recent years in applications for GP Registrar training positions is of great concern.
Even more problematic is that GP Registrars are relatively under-remunerated in their current arrangement and have trouble with transporting and accessing entitlements such as parental and annual and study leave. Simply increasing the base payment in the NTCER agreement dramatically would place a burden on practices that supervisors tell us will result in drying up of places available.
One suggested solution is to move from a low base payment plus fee for service percentage to a salary from a central employer agency – which could be government or training body or something else. This would tidy up the issue of transfer of entitlements but may come with other problems such as removal of incentive to see enough patients to cover practice fixed costs and divided lines of authority, where the trainee works for the practice but is paid from outside. A small number of trainees may lose money under a salaried arrangement and we need to see the data to know how to respond to that concern.
The common denominator here is the need for more money to be injected into GP training through the most efficient mechanism possible. What that mechanism is should be determined by an expert group without delay and the AMA WA is capable of organising and coordinating such a discussion.
Another potential complication is what effect the MBS review will have on the fee for service components and other practice incentive payments, so this needs to be watched carefully from the training perspective as well. I have had close involvement with responses to the MBS review and will continue to advocate strongly for data rather than anecdote as the basis for reforms.
AMA WA should lead a conversation about GP Registrar payments with all stakeholders and be impatient unless a solution that rewards registrars, enables training, and remains efficient is implemented quickly.
See more discussion here : Ausdoc article on GP Salaries