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Tuesday, 13 June 1989
Page: 3917


Senator PATTERSON(10.21) —I will remind the Minister of the question I asked because it is very important: Does the family medicine program use Health Insurance Commission payments as a tool to monitor and identify those practices whose case loads are such that they may not provide trainees with adequate general practice experience? I have received a copy of a sample of group trainee practitioners, acquired under freedom of information-I think it took 10 weeks-which showed a minimum number of consultations under a general category of approximately 8.5 a week and a maximum of 129 a week. I would begin to be concerned-and the Minister for Community Services and Health (Dr Blewett) ought to be concerned-if, as Minister, I were paying a family medicine program subsidy for a salary and a teaching allowance in respect of a general practitioner who was seeing eight patients a week. Those doctors would be better off in a casualty outpatients department seeing patients with cuts and bruises, coughs and colds and whatever else than seeing eight patients a week in a general practice. From my inquiries, it seems to me that all one needs to be a family medicine program supervisor is a vacant room-he must have a vacant brain as well, I think-to which the trainee can go. Not much else seems to be required.

There are objective ways of measuring the experience that trainees get. One is to look at the number of consultations and the amount of rebate that the trainee brings in. In some cases the trainee sees zilch, and in other cases he sees 129 patients a week. If a practice is as busy as that, I wonder what supervision is going on. It may be that we should look at the one in the middle where there is at least some time for the general practitioner to discuss with the trainee the patients that he has seen. That was the question I asked.

The other question that the Minister has avoided-I am sorry to harp on this-is: what were the details of the auditing and monitoring procedures for the so-called Independent Peer Review Organisation? I have received some material-I do not know where it came from, but it has been coming into my office unofficially at a rate of knots-concerning a committee that has three Royal Australian College of General Practitioners members, one medical person from another medical organisation recommended by the RACGP and one or two other medicos. According to the material, the committee can co-opt people but they do not have voting rights, a quorum will be formed by the RACGP members and the majority vote will have to be that of the RACGP members. The Minister calls it an Independent Peer Review Organisation. If the Minister cannot provide us with that document--


Senator Crowley —You can ask the Minister.


Senator PATTERSON —I am asking the Minister. I believe that that document ought to be made public so that when the Committee debates this matter we will have been able to look at the--


Senator Crowley —You don't ask these questions about the training of any other specialist group. What is so particular about GPs?


Senator PATTERSON —That is a very good question. Senator Crowley asks, `What is so special about general practitioners?'.


Senator Crowley —You don't interfere with surgical specialist training or any other specialist training.


The TEMPORARY CHAIRMAN (Senator Teague) —Order! There are too many interjections.


Senator PATTERSON —I will speak through you, Mr Temporary Chairman. Senator Crowley asked the question: why are we interfering with general practitioners? What a wonderful interjection! The question I am asking is: why is the Government interfering with the training of general practitioners? Why is the Government not concerned about what is happening in medical schools? Mr Temporary Chairman, this morning you discussed the decline in and the problems associated with higher education. I said in my speech that even medical schools are having problems organising rotations for clinical placements because they do not have the administrative staff to do so. If the Minister and any of his advisers sitting over there have had anything to do with tertiary institutions and rotations for clinical practice they would know that it is time consuming and difficult to organise students for country and city placements. There is not enough money to do it. Senator Crowley is asking why we are involved, why we are concerned. The Government has not interfered with the registration of obstetricians and gynaecologists, with the Royal Australasian College of Surgeons, or with the Australasian College for Emergency Medicine. The Government is now interfering with the registration of general practitioners. Senator Crowley has put the ball right back in the Government's court.