2024 RACGP President Candidate Responses to AGPA Questions

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There are five candidates for RACGP president in 2024. They are:

Dr Palmyra De Banks, Dr Alan Bradley, Dr Michael Clements, Dr Monirul Haque & Dr Michael Wright.

The Australian GP Alliance put four questions relevant to Practice Owners to the candidates requesting written responses from them.

  1. Do you understand the costs involved in running a Practice?  Responses are here
  2. Do you think you can provide a vision for the future for General Practice if you don’t have experience in running a small business? Responses are here
  3. What is your plan to improve the viability of General Practices? Responses are here
  4. What is your plan to help prospective Practice owners? Responses are here

The Australian model of GP owned private general practice has been responsible for our international reputation as an efficient and highly effective primary health care service. The continuation of high quality primary healthcare in Australia is dependent on the continued viability of the Practices that provide the leadership and infrastructure that allows GPs to practice, and patients to access the healthcare system.

AGPA Question 4:What is your plan to help prospective Practice owners?

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Dr Palmyra De Banks:
Supporting prospective practice owners is crucial for the future of general practice. I plan to advocate for more accessible and practical business support and training for GPs, ensuring they are well-equipped to manage the financial and operational aspects of a practice. Additionally, I will promote mentorship programs that connect new practice owners with experienced operators who can provide guidance and support. My own experience in setting up clinics and managing a large network of practices has shown me the value of such support. I will also push for financial incentives and grants to assist in establishing practices, particularly in underserved areas.

Dr Alan Bradley:
I teach hundreds of GP registrars in my role as a medical educator. The majority aren’t interested in becoming practice owners. This needs to change, unless we want a GP landscape dominated even further by large multinational corporations.
We do that by listening and responding to the concerns of current practice owners, as well as by improving the viability of General Practice as a profession. As above: this involves not capitulating to scope creep, avoiding going down the NHS capitation path, and increasing the respect and attractiveness of general practice by achieving pay parity for GP registrars with their hospital colleagues.

Dr Michael Clements:
Firstly, it is by fiercely defending and advocating for the models of small business general practices in Parliament and pushing back on some of the narratives of the idea that GP system has ‘failed’ – it hasn’t failed it just hasn’t been funded. I have been a big fan and regular attender and presenter at the RACGP Practice Owners conferences, I feel like it is my tribe. These conferences have so much energy and the enthusiasm from potential practice owners is palpable so I think we need to extend that support and that energy through other aspects of RACGP work. We need a culture and a community of support throughout the entire college for practice ownership and owners.

Dr Monirul Haque:
Share the knowledge and support each other on overcoming the barriers. I would support the prospective Practice owners by organising a Practice Owner Mentor and share best practices.

Dr Michael Wright:
Through my work with the RACGP Expert Committee and with Avant, I’ve been providing active support for prospective owners in setting up practices, and presented at multiple RACGP and Practice Owners conferences about practice financing and viability issues. This promotion will continue under my Presidency. I think the main attractor to encouraging interest in practice ownership  will come through better evidence of financial viability (I’m currently leading a research project out of UNSW that is looking at this), and a stronger narrative about general practice being a great profession and having a strong future.  The real evidence of success will come from increased interest in practice ownership (reported in Health and the Nation and in member sentiment).  I look forward to working with AGPA members to achieve this plan.

AGPA Question 3: What is your plan to improve the viability of General Practices?

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Dr Palmyra De Banks:
Improving the viability of general practices requires a multifaceted approach. My plan includes advocating for significant increases in MBS rebates, including increased item numbers scope, to better reflect the true cost of care; addressing workforce shortages by promoting general practice as a rewarding career; and reducing the administrative burdens that take time away from patient care. My experience in managing a large network of clinics gives me a practical understanding of the challenges faced by practice owners, and I am committed to working closely with them to develop and implement strategies that enhance financial sustainability and ensure the long-term viability of general practices.

Dr Alan Bradley:
My plan involves strident advocacy about the upcoming Scope of Practice Review, of avoiding the slide into capitation via MyMedicare and blended funding models, and of ensuring that no doctor who decides to train as a GP is required to take a pay cut and lose their entitlements to do so. For more, please see my website: https://www.dralanbradley.com.au/racgp-presidential-candidate-2024

Dr Michael Clements:
We need to protect fee for service and private fee setting as a core component of our primary care model and support our practices and members breaking free from the Medicare tether whenever possible. At the same time we need to acknowledge some practices and practitioners will want to engage with the government funding models, particularly for vulnerable communities and use blended payment models and bulk-billing, so we also need to advocate for increased rebates, increased overall funding and bundled payments that are actually workable within a small business. We must also push to reduce red tape and time consuming madness such as the authority line.

Dr Monirul Haque:
I have few ideas. Firstly by including the Family Medicine with General Practice,  it will increase the scope of work we GPs do. Secondly to address the shortage of Doctors, I would work towards for creating opportunity for the overseas trained doctors to get trained in the metropolitan cities for the first two years before going in the rural areas. Thirdly, work towards increasing the Medicare rebate for chronic, complex and challenging medical problems. Fourth- more fund for GP registrar and supervisors equivalent to hospital registrars and supervisors.

Dr Michael Wright:
My platform outlines a series of measures to increase funding for general practice including 1) targeted MBS funding  increases for high needs patient and the GPs looking after them, 2) increasing WIP and removing WIP caps and more capacity payments to support practice strengthening in areas such as care coordination and governance, 3) regulatory changes to allow practice team time to be included within consultation time.  I will also commit to strong and successful advocacy in funding and workforce reform as the key accountability for my term as President. I will also share a more positive narrative about the potential of general practice, a push for us to expand our scope and use technology to improve our standing, financial viability and capacity to lead the health system

AGPA Question 2: Do you think you can provide a vision for the future for General Practice if you don’t have experience in running a small business?

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Dr Palmyra De Banks:
I have significant experience in both clinical practice and business management, having established clinics in the UK and currently overseeing a large network of 19 clinics in Victoria and 80 clinics nationally. This extensive background equips me with a unique perspective on the challenges and opportunities within general practice. My vision for the future is informed by this experience and focuses on creating a sustainable, patient-centred model of care that supports both practitioners and patients. I am committed to leveraging my experience to advocate for policies that benefit the entire general practice community.

Dr Alan Bradley:
I have experience running a small business – I ran a successful tutoring company while working as a resident doctor. However, I think a vision of the future of General Practice is much broader than the experience of small business owners. That’s why I think having more representation on the RACGP board – of GPs who are not practice owners – will improve discussion at board meetings and lead to overall better outcomes for General Practice in Australia.

Dr Michael Clements:
I joined RACGP and AMA Councils at the same time I opened my practice as I wanted more business intelligence on understanding how I needed to shape my business to evolving challenges. I moved up the chain within RACGP and want the top job now as I believe we need a practice owner who truly understands the implications of government policy on general practice at the coalface. My vision is for profitable and sustainable private practices to be the core providers of health care in the country and I know practice owners are ready to deliver with the right support.

Dr Monirul Haque:

I do believe, running a small business is important to understand the complexity of running a General Practice. Only then one can understand the pain points of the Fellow General Practice owners and help them with growing their business.

Dr Michael Wright:
Not impossible but experience in owning and running a practice has given me many skills which are still of value in my current practice where although I am an independent contractor all of our contractor GPs are keenly aware of viability issues.  My experiences as an owner, salaried and contractor gives me multiple perspectives to draw on.

AGPA Question 1: Do you understand the costs involved in running a Practice?

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Dr Palmyra De Banks :
Yes, I have a deep understanding of the costs and complexities involved in running a practice. Before emigrating to Australia, I was a owner and partner in a GP practice and set up my own clinic in the UK, where I learned firsthand about the financial, staffing, and operational challenges. Today, I directly oversee 19 clinics in Victoria and 80 clinics nationally, providing me with a broad and current perspective on the financial realities facing general practices. This experience allows me to appreciate the delicate balance required to maintain high standards of care while ensuring financial sustainability.

Dr Alan Bradley:
I do. Fortunately, even if I did not, the majority of the RACGP board are practice owners. Rest assured: the costs of running a practice will be well understood at RACGP Board meetings regardless of which candidate AGPA members vote for.

Dr Michael Clements :
I opened my first practice in 2015 in Townsville and I am now about to open my 5th in Charters Towers. I have been almost ruined by flood, struggled my way through Covid and I am now on the other side with a thriving number of practices and rural/remote outreach clinics, RACF and school clinics.  I have been kept awake at times wondering how to pay the staff and at times have been ready to give it all away but I am now very proud to have over 50 staff and doctors working with me on our vision. Owning practices is a core part of my identity as a meaningful contribution to my community.

Dr Monirul Haque:
As a practice owner myself, I do understand the cost and challenges of running a general practice business.

Dr Michael Wright:
I’m very aware of the costs in setting up and running a practice.  I was a practice owner for nearly a decade with my father in Queensland, before moving to and working in the UK as a contractor and salaried doctor, and then moving back to Australia.  In my role with RACGP as Chair of RACGP’s Reference Expert Committee for Funding and Health System Reform for nearly six years, I’ve collaborated with many practice owners and championed our Business Sustainability Focus, led the development of  the private billing toolkit, billing calculators and tools for GPs in setting up a private practice.  With additional education and training in health economics, I’m keenly aware of the economics of general practice and the need to create incentives for GPs and practice owners. I’ve also led the Health of the Nation survey to prioritise financial viability as a core focus.