The new year has brought a full policy agenda at regional and national levels with the policy team currently working on Medicare Reforms, the Scope of Practice review, a Maternity Care inquiry, Payroll tax advocacy, Rural Generalist Recognition and more.
ACRRM advocates on behalf of our members in a range of forums, collaborations, and partnerships.

The College regularly engages with policy development, review and reform agendas at national level. We provide written submissions, organisational delegations, consultations, private briefings and in-person evidence to a range of national reform agendas. 

Select Committee into reproductive, maternal and paediatric health services in Tasmania
ACRRM has provided feedback to the Tasmanian Select Committee this week. Building on a presentation given last year by ACRRM Regional Director of Training, Dr Sally Street. Our members report that Tasmania is the only state which currently does not formally use RGs in maternity, although there are many skilled RGs providing an extended range of reproductive health, maternity and paediatric health services across the state. Harnessing and utilising their RG workforce, would allow women and families to receive great care that is affordable, patient centred and close to home; and would ease the burden on the states secondary care services.

ACRRM has called for:

• Tasmanian support for the full implementation of the National Rural Generalist Pathway, including specialist recognition of Rural Generalist Medicine as an enabler to innovative workforce models and workforce capacity building across maternity and paediatric services. and 
•  Development of alternative models of care that support affordable access to maternity care services and support from Rural Generalists and other medical practitioners providing this care

National Medical Workforce Strategy Implementation
College President, Dr Dan Halliday and policy team staff met with the DoHAC team leading the implementation of the National Medical Workforce Strategy roll out in January. The College was given an update on progress and used the opportunity to emphasise key issues, including:

• The principle of value of practice and ensuring that rural doctors and rural general practices are funded in a manner that reflects the significant skills and high levels of professional responsibility associated with provision of care in rural and remote contexts including appropriate recognition of supervision services
• The need to continue to grow the Rural Generalist training pipeline
• The importance of specialist recognition of Rural Generalist Medicine, through the healthcare ecosystem
• The need to better encourage and support rural school students toward medical careers 
  
  

Working Better for Medicare Review – seeking member feedback
The Working Better for Medicare Review has been commissioned by the Commonwealth Health Minister, Mark Butler, and is led by Prof Sabina Knight, and Adjunct Prof Mick Reid. 

The review has a strong focus on rural and remote health, seeking to provide a wide-ranging look into how to distribute doctors and other health workers more equitably around the country.  Key areas to be covered include:

• Medicare’s role in locating the workforce
• Modified Monash Model
• District of Workforce Shortage, and
• Distribution Priority Area.

ACRRM is invited to provide a submission by 1 March 2024.  We would welcome any feedback you may have for the College submission, please direct to our team at policy@acrrm.org.au.

Scope of Practice Review
The Scope of Practice Review continues with the release of the first Issues Paper.  This paper focuses on health professionals who provide primary care and the associated evidence about benefits, risks, barriers and enablers to support them to work to their full scope of practice.

The Review team welcomes feedback from both individuals and organisations.  This can be provided through a written submission or by completing an online survey.  ACRRM will be making a submission.  Members are encouraged to contact the Policy team with any feedback to inform this submission, and the College also encourages members to participate individually.

ACRRM will continue to fully engage with this important review and keep members informed.

Payroll Tax Update
Until late 2022/2023 it was  generally accepted that medical practices were not liable for payroll tax, with doctors working under contracts, and payments made to those doctors not being categorised as wages. Several recent cases and revenue office rulings have made it clear that these very common contractual arrangements are captured by payroll tax legislation, unless an exemption applies. If a practice is not eligible for relief or exemption, it will be liable for the total amount of payroll tax, plus interest and penalties. 
Contractor arrangements have always potentially fallen within the payroll tax net, but recent State Revenue Office (SRO) rulings have confirmed that these arrangements are caught by the “relevant contracts” provisions in payroll tax legislation. 

• SROs in Qld, NSW and VIC have confirmed GP contractors are liable to payroll tax.
• Temporary relief has been announced for GPs in Qld and SA.
• The Qld ruling (updated in Sept 2023) makes it clear that direct payments to practitioners will fall outside the payroll tax net (meaning general practices need to rethink their payment arrangements with contracted GPs)

There are calls for the Victorian Government to urgently review Payroll tax arrangements and bring Victoria  in line with the recent Qld ruling.  ACRRM is monitoring the situation closely and will provide further information to members as it becomes available. The College also continues to advocate on this issue through both individual and joint representations with other Colleges.

Contact the Policy team
The Policy team values all members’ input on policy issues as they arise. Member input allows us to provide submissions and representations which are more powerful and more reflective of the realities of rural and remote practice on the frontline. 
Contact Policy@acrrm.org.au  if you would like to provide feedback on a particular issue or consultation.