Gulp: the RACGP has changed … a lot

7 minute read

That we even got to the launch of a new GP training regime crisis-free is nothing short of a management miracle.

If another week of payroll tax doom, Nine Network newspaper doctor-bashing and general economic carnage is getting you down, then here’s a light on the GP hill to possibly brighten up your Saturday a little.

This coming Wednesday, the RACGP will launch, on time, its new GP training regime.

Notably, ACRRM sort of already has its new training regime running, which is another good news story, but the logistics of what the RACGP faced to get its portion of the training network up were especially horrific.

That the college even got to a launch remotely close to deadline on something so fraught with pitfalls and political controversy, without at least a couple of major fails and drama, might turn out to be one of the more compelling management transformation stories in corporate Australia for a long time.

It begs the thought: what’s going on at the RACGP these days given most of the last decade it presented as a significantly insular and dysfunctional organisation?

Before I get to that, it’s worth noting a few of the logistical, management and political challenges the college has had to navigate to get to Wednesday’s official start, keeping in mind that both the college and ACRRM were never in favour ever of disbanding the RTOs  as they were forced to do eventually by the Department of Health and Aged Care only a year ago.

  • Nine independently governed and funded regional training organisations, some with more than 20 years of built-up experience, skills and history, some operating in extremely remote regions with highly complex local issues at hand, and nearly all with very different skill bases, networks and operating cultures, had to be disbanded entirely and absorbed into one brand new and centrally run organisation with a single line of management.
  • Because of negotiating delays in developing the contract with government, the RACGP had to employ, and successfully onboard 700 employees, in what really was less than three months, starting in October last year with them sending out letters seeking expressions of interest. (All 700 by the way have new networked laptops loaded with all the systems to talk and work with the college centrally when needed).
  • Before they even got to this giant goal, they had to do all the vital pre-work to set up such a big new organisation including: developing a new management structure, with all its protocols and procedures; implementing a new governance and legal framework; and developing and implementing several new technology platforms to run smoothly with both internal and major organisations like Services Australia.
  • Manage the expectations and personal issues of the current crop of GPs in training, in various years of their training, and those new students moving into training this year.
  • And more…

When we wrote about this challenge on the part of the college, just on a year ago, one commentator compared it to trying to build a new and complex jet airline on a runway as its engines were being throttled up for its first take-off (GP Training: who’s flying this thing).

I also wrote that Paul Wappett, the then relatively new college CEO, was akin to Denzel Washington trying to stop that runaway train during that snow storm in a mountain wilderness, in that runaway train movie (How, why and when GP training will run off the rails).

In short, it couldn’t be done without at least some loss of life and likely significant loss.

In this respect I also wrote this:

“Dismantling every one of them [RTOs] and trying to put it all back together again in the space of nine or even 18 months is a business management transformation project that would be beyond a dream team of the world’s greatest business managers of all time.”

And …

“Given the current state of RACGP management experience and capability, no amount of consulting firm contracts and assistance is likely to result in any magical solution to what is, on paper so far at least, an impossible business problem.”

You can look at what I wrote through two lenses: I had no clue what I was talking about, or, Paul Wappett is some sort of management genius.

My take after the fact is that it’s somewhere in the middle.

Regardless of how wrong I may have gotten things, on paper, so far, this is a business transformation which is bigger than any we’ve seen in many years in Australia, is so far going off without many hitches, and if it keeps going well might one day rank as one of the major business transformations of any business group in the private or public in a long time in this country.

I’m pointing this out to suggest broadly that this is not the college of even a couple of years ago (and crossing my fingers that some bright spark from Egon Zehnder or Korn Ferry isn’t reading it, which might result in Wappett being made an offer he couldn’t refuse in the not too distant future).

The college has changed, and it looks like it’s not done changing.

Wappett is obviously a part of that change, but it’s not just Wappett.

Someone had to employ him and it was probably obvious when they interviewed him that he was a change agent of some sort.

The organisation is changing itself.

This is not to say that things still can’t go dramatically wrong with the training implementation – there’s a long way to go after launch on Wednesday – but even getting to launch without much fuss is a big achievement for all those involved.

As stated, the college never wanted to disband the RTOs, preferring a model which kept as much continuity in their regional management and structure as possible. This would have given the college a lot more time to plan and organise.

But with the Department of Health and Aged Care having forced the college’s hand, the college took the very brave decision to bite off more than anyone realistically thought they could chew, and start chewing like crazy.

The downside was massive. Lots of dead bodies from a reputation and management perspective.

But the upside of the changes if they could be achieved was not insignificant either.

The nine regional RTOs were for obvious reasons a very inefficient setup for the country and in some respects for the registrars in training as well.

They were all differently governed, creating a lot of duplication, and the variation in quality of management and delivery of services was significant.

Centralising under the college, if it could be done well, had a lot to offer all stakeholders: registrars, the government, supervisors and practices who were prepared to train.

Centralising that into the major organisation that determined the training curriculum and ran the people who delivered the care and training of registrars, should have upside in not just efficiency, but potentially in continuity of care of trainees and even quality.

Almost certainly, where the RTOs were operating at peak performance regionally, that sort of care and quality will be hard to produce by a bigger centralised group. But overall this new setup might end up lifting the average a lot and that should be better for everyone.

Wappett told TMR this week that a real focus in the transformation has been keeping things local and keeping top of mind that the college had been given the remit to be a steward of training, not the owner or boss of it.

In this respect he described the labour setup as 10% centralised management, 10% cross-functional services such as IT and HR out of head office, with 40% regional and 40% on the ground local in terms of workforce.

So in essence, 80% of the new organisation is distributed to the regions or local areas.

Fingers crossed that this so far amazing transformation keeps on track and delivers as the college is planning (and Wappett isn’t poached by some wealthy corporate in the near term).

And that this is just the beginning of all sorts of new ways of doing things from our largest GP college.

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