Scope of practice: one review to rule them all

3 minute read

As the old Canberra adage goes, governments rarely do inquiries if they aren’t already certain of the outcome.

RACGP president Dr Nicole Higgins often wakes up at 2am in a cold sweat thinking about the government’s scope of practice review.  

“How sad is that?” she told RACGP Practice Owners Conference delegates at the weekend.  

The scope of practice review is just one of 14 different government reviews to have been spurred by the 2023 Strengthening Medicare Taskforce report, but it’s a doozy.  

“We know this is the really important one, because every other review is dovetailing back into scope of practice,” Dr Higgins said. 

Some of the initiatives proposed in its second issues paper included removing requirements for GPs to do certain referrals and effectively open up the MBS and PBS to all allied health professions. 

The skills matrix included in the paper offers as big a clue as any as to what’s going on in the minds of reviewers.  

“We’ve got the primary care workforce – allied health, nurses, GPs, nurse practitioners and midwives – on one axis and then on the other axis we’ve got tasks,” Dr Higgins said. 

“The skills matrix has been divided into ‘these are the tasks, and if you can do this task [then you’re equal]’. 

“It’s looking at the activity but it’s not looking at the training or the outcomes.” 

Given its title, “unleashing the potential of our health workforce”, it’s hard not to wonder whether the results are a foregone conclusion.  

It’s a possibility the college is very aware of. 

“Fourteen different reviews is a hell of a lot of work,” Dr Higgins said.  

“[Governments] don’t do this unless they know that there are outcomes that have already been partly predetermined.” 

Dr Higgins acknowledged that the incoming changes to the profession were likely going to be “uncomfortable” for many GPs.  

But with some sort of change resulting from the review an inevitability, the challenge facing the college is to limit how drastic that change will be.  

As satisfying as it may be, throwing all the toys out of the pram and refusing to engage with the process is not an option. 

“If we don’t present the solutions, we’ll have them imposed on us,” the RACGP president said.  

“We’re all businesspeople here, and we understand that the value proposition we must demonstrate is why general practice is the foundation of the healthcare system.”  

The RACGP’s Practice Owners Conference 2024 was held at the Cairns Convention Centre in Queensland between 24 and 26 May.  

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