The answer is ‘probably not’. Here’s why.
The mass resignation of psychiatrists in NSW has captured public sympathy and attention, but the decentralised nature of general practice makes it difficult to recreate collective action on a primary care level.
While there are similarities in the struggles faced by both specialties – the 203 resigning psychiatrists say they’re fed up with comparatively low remuneration and consistent under-resourcing (sound familiar?) – the avenues for GPs to take action are more limited.
As a group of GPs found out in 2022, it is very difficult for general practice to unionise due to the fact that many GPs own clinics and are therefore seen as employers rather than employees.
AMA-affiliated union Australian Salaried Medical Officers’ Federation, on the other hand, is only open to salaried doctors, a label that does not apply to most GPs.
If GPs were able to unionise, the next major stumbling block is that protected industrial action is only protected during a period in which workers are in the process of bargaining for an enterprise agreement.
While some practices and practice groups do have enterprise agreements in place, the bulk of GP anger tends to be directed at Medicare.
There is no enterprise agreement between GPs and Medicare, leaving nothing for GPs to strike over.
With protected industrial action a somewhat moot point, GPs could still mass resign without union involvement.
Technically, that’s what the psychiatrists in NSW are doing, after the state Industrial Relations Commission ordered ASMOF NSW in December “not to organise, incite or encourage the psychiatrists to resign”.
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“The psychiatrists are the ones who are resigning,” ASMOF NSW acting executive director Ian Lisser told The Medical Republic earlier this week.
“This is not industrial action. This is staff saying, ‘that’s it, we’ve had it’.”
Even if general practice was to go down this route and effectively stage a coordinated stop-work event, it would be individual small businesses – again, many of which are owned by GPs – that would bear the financial burden of that action.
When the psychiatrist resignations come into effect next week it will be NSW Health left holding the proverbial bag, not other psychiatrists and small business owners.
To recap: if Medicare reform is the goal, then unionising is somewhat pointless, and a mass walkout would be actively harmful to GP businesses.
The most impactful remaining option is for GPs to abandon bulk billing entirely.
While that is already happening in an organic way, the closest it got to a coordinated effort was then-RACGP president Professor Karen Price urging “as many people as possible” to stop bulk billing at the 2021 Annual General Meeting.
Bulk billing is tipped to be a key battleground in the upcoming federal election, which is due within the next five months.
