ACRRM has provided a submission for consideration in the GP Incentives Review final advice, that is to be provided to the Minister before the end of the year. Thank you to the many members who provided valuable feedback for incorporation into the paper together with advice from the College Council. 

The submission included 11 recommendations and made the following key points: 

• ACRRM supports reform to general practice funding models that enable team care to optimally deliver services in rural and remote areas. Key among these should be Rural Generalist(RG) models that integrate care and maximise the range of accessible services. 
• The Review Briefing does not include detail or assurance of the quantum of funding that will be available to RGs, GPs and practices going forward, or the timeframes and plans for implementation. The proposals entail transformative change and the stakes are high. Reforms must proceed with care and with the capacity to course correct if problems arise, particularly for the already tenuous access to medical care experienced by people in rural, remote and First Nations communities. 
• Key risks of adverse outcomes that would facilitate rural communities to lose doctors and services include: 
  
  • The GP incentives payments architecture may support non-medical primary care at the expense of a GP workforce, particularly in rural and remote areas. 
  • The Workforce Incentive Payments (WIP) (when directed to practices), may not go to incentivising rural doctors or their advanced specialised skills, potentially triggering further workforce shortages. Likewise, rural loading (when directed to practices), may be retained as profit by urban-based entities and not go toward the delivery of rural and remote services.
  • Rural and remote practices may fail due to an inability to adjust to change within timeframes, and/or disparities between the loss of current sources of revenue and the capacity to receive new funding. 

• To achieve positive outcomes the implemented framework should: 
  
  
  • Have a key outcome to sustain and strengthen the GP workforce, recognising that rural, remote and First Nations people deserve access to a doctor who provides continuity of relationship and reasonable access to in-person interactions.  
  • Recognise that incentivising GP care in rural and remote contexts needs to extend to provision of advanced specialised skills services.  
  • Ensure practice incentives are contingent on providing patients with access to a GP (applying a context appropriate model). 
• Importantly, the current WIP payments to doctors should be maintained in the short term, and assurance given that they will be preserved in a manner that will continue to directly support rural doctors and advanced rural skills in the future. 

ACRRM will continue to advocate on these issues and keep members abreast of developments. Please contact the ACRRM policy team if you have any questions at policy@acrrm.org.au.