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COMMUNITY AFFAIRS LEGISLATION COMMITTEE
02/06/2010
HEALTH AD AGEING PORTFOLIO
General Practice Education and Training Ltd

CHAIR —Welcome to the officers of the agency.

Senator FIERRAVANTI-WELLS —There is a lot in the hospital plan and the network documents relating to workforce. I am interested to know what part you will play in relation to those programs and where, specifically, you will be assisting and how you will be assisting in relation to delivering some of those workforce outcomes.

Mr Janssen —The annual intake for general practice trainees or registrars is increasing to 900 next year, and going up from there to 1,200 by 2013. Those registrars are distributed across Australia into training localities based on a range of workforce related needs factors. We look at the available data on the distribution of general practices. We look at data on areas of workforce shortage, available training capacity and a range of other factors that determine the distribution. The objective is to distribute the trainee workforce—who, as they go into practices, provide services—to respond to those needs. Under the contractual arrangements we have for distribution, no less than 50 per cent of all training across the program is required to take place in areas outside of the major capital cities—in RA2 to RA5 localities. So the program is very much focused on addressing workforce requirements for the general practice community needs.

Senator FIERRAVANTI-WELLS —In the budget statements it says:

As part of the National Health and Hospitals Network Agreement and to address the current shortage of GPs across Australia, the Government will increase prevocational placements from 380 in 2010 to 975 in the 2014 training year, and the available number of vocational training places from 700 in 2010 to 1,200 in the 2014 training year.

Is that what you have just mentioned?

Mr Janssen —I referred specifically to the distribution of general practice registrars—the vocational trainees—but we are taking a similar approach to the distribution of the additional placements in the prevocational program. These are doctors that have not yet chosen a specialty for training and, as a part of their prevocational experience, have an opportunity under this program—in increasing numbers now—to rotate into a general practice placement that is supervised for a short period.

Senator FIERRAVANTI-WELLS —So you do not actually do the training; you just organise and coordinate it.

Mr Janssen —We coordinate it and contract with regional training providers, and they in turn have relationships with general practices that are accredited to take trainees, registrars and prevocational doctors.

Senator FIERRAVANTI-WELLS —Were you consulted in relation to the assumptions that were made in relation to the hospitals network plan?

Mr Janssen —In relation to the distribution or the numbers of registrars, we are in continuous dialogue with the department over what we see as the numbers that could be accommodated coming into the system, the rate of growth that could be sustained and, overall, the final numbers. So, to that extent, yes, we are involved quite closely with the ultimate policy decisions that are made around the numbers. We certainly have input, and we are very pleased with the increases that have been announced. We believe they are sustainable in terms of creating the placements that are required going forward over the period of time.

Senator FIERRAVANTI-WELLS —It is a substantial jump if I look at page 55 onwards, given some of the difficulties that we have had. Without going into specifics, I think that the general anecdotal evidence is that there are difficulties in this area. I am interested to see the considerable jump there. It is more than a doubling and a half of general practice placements for prevocational doctors—380 to 975. That is a sizeable jump. Do you honestly think that that is going to be doable?

Mr Janssen —As part of our response to those decisions, we have undertaken an audit, firstly, of expected demand from junior doctors for these placements in the next year. That really is based on the number of junior doctors in the hospital system that will be released by their hospitals to undertake these terms. We have also, through our training providers, looked at potential training capacity—what is available there in terms of placements for them—both from practices that are already accredited for the purpose and from other ones that could be brought on between now and the beginning of next year to accommodate the growth. We think it is achievable. It is a real challenge for us, and we are working with some of the accreditation bodies in the various jurisdictions that accredit prevocational training places to streamline their processes. That is happening. The biggest growth area, in fact, will be in New South Wales—

Senator FIERRAVANTI-WELLS —I was about to ask about New South Wales.

Mr Janssen —which has not participated in the program in a significant way in the past. We are working very closely with the Department of Health there, the accreditation bodies and the providers to ensure that we can roll out the program.

Senator FIERRAVANTI-WELLS —I wonder if you could take that on notice and provide to me the basis of those assumptions. It does seem quite a sizeable jump. I would be interested to know the basis of those assumptions.

Mr Janssen —The assumptions behind?

Senator FIERRAVANTI-WELLS —The assumptions behind that. On page 655 of the yellow document there is ‘Program 1.1: Deliverables’ and ‘Minimum number of places available’ and for 2010 we are talking about 380 and then in 2011 we are talking about 910 and then 975 thereafter. So I would like to understand the assumptions that underlie those figures.

Mr Janssen —I think that would be a question better directed to the department that is actually responsible for the policy and ultimately the final figures that are put into the PBS.

Senator FIERRAVANTI-WELLS —So in terms of when you say it is achievable, the department makes the assumptions and says, ‘We want to deliver from 380 to 910,’ and then your job is to go out there and do it.

Mr Janssen —Exactly right, although we do have input, as I indicated earlier, on the broader question of what is a sustainable rate of growth in the various programs. But, as for the final figures, these are matters that have been determined within the relevant policy areas of the department.

Senator FIERRAVANTI-WELLS —And how much of that increase is actually New South Wales generated?

Mr Janssen —We are expecting at the end, when we get to 975 funded placements, around 30 to 35 per cent of those being located in New South Wales simply because that is where 30 to 35 per cent of the population and the doctors in fact are. So we are trying to move to a rational distribution of those places across Australia.

Senator FIERRAVANTI-WELLS —In terms of those regional training providers, you think that the structure is sufficient to be able to meet those needs out there?

Mr Janssen —On the basis of the audits that we have undertaken through those providers, the information is that we should be able to meet the demand for those places—the demand that is likely to be evidenced from the hospital doctors next year—and place them in practices that are accredited for the purpose.

Senator FIERRAVANTI-WELLS —What sort of working relationship do you have particularly with the regional medical schools? There are about nine of them around. Do you have a relationship with them? Do you do any work with them?

Mr Janssen —These are the rural medical ones?

Senator FIERRAVANTI-WELLS —Yes.

Mr Janssen —Yes, we do. We have a number of interactions with them. The university medical schools are in fact on our board; they have a nominee on the board. One of our advisory committees—particularly the one around this program, prevocational training—has a nominee from a rural clinical school, in this case out of Western Australia, so there is an interaction and, importantly, there are interactions at the regional level between our training providers and the local medical schools and the rural clinical schools.

CHAIR —That concludes our questions as to outcome 5, Primary care. As always there will be significant questions on notice. We will now move to outcome 9, Private health.

 [6.01 pm]