Dear Colleagues

This is a follow up to the pre-Christmas meeting that discussed the future of the NRGPN and subsequent discussions about the evolving medical scene on a local, state and national level. There were no recommendations from the meeting but various options were discussed. This following is a personal opinion but others will no doubt contribute to this discussion. I see three possible paths for the NRGPN.

Firstly, the NRGPN can expand its current Board and continue as a representative organisation of North Coast GPs, continue to publish GPSpeak and to liaise with local medical groups, such as the PHN, Nordocs and others. My personal view is that this could be a worthwhile activity. As the PHN’s role continues to change it is no longer a direct supporter of general practice. Under this assessment of the current situation the NRGPN is the only organisation focused on local GP issues.

Secondly, the NRGPN could close and cease all its activities and donate its assets in cash and kind to a similar organisation. Currently these assets constitute a little over half a million dollars.

There was little enthusiasm at the recent meeting to give the money to the NCPHN or UCRH since these groups have significant government funding already.

Some participants felt that preserving NRGPN as a member of the NCPHN was still a worthwhile activity. As a founding member of the NCPHN we have some influence on the composition of the Board of the NCPHN. I would however note that the duty of a Board Director is to the company and not to any one or group of shareholders.  

The last option was to alter the NRGPN constitution to include all doctors in the area. Additionally the footprint could be extended to that of the Northern NSW LHD. In practice the new boundaries would include the Tweed and Grafton.

This change would essentially give the Nordocs Facebook group the underlying infrastructure of a registered charity and a deductible gift recipient. This organisation could have as its focus providing education for North Coast doctors, and improving communication and relationships between North Coast GPs and specialists.

It is unclear if the current NRGPN membership sees value in maintaining the organisation. The NRGPN’s main activity is publishing GPSpeak and although the magazine is relatively well regarded in the area, it is not clear that it represents the consensus views of practising general practitioners. Getting a consensus view from medical professionals has always been difficult, and this was equally true when the organisation was funded. However, “herding the cats” is much harder when you don’t have any milk.

Under the expanded Nordocs option, the larger organisation would be able to tap into other resources that are available through hospitals. It would be important for GPs to still have some influence on the organisation’s direction. Setting up the representative structure for all speciality groups will be crucial to the success of the organisation.

Whatever course is ultimately recommended, there was general agreement that we should be working harder at cultivating our medical community in our area. There is value in having closer personal relationships with our colleagues across the various specialties and across the footprint. This can be done through educational events, social events and perhaps even online communication.

It was acknowledged that this was progressively more difficult as the footprint increased in size and given the location of the current participants confining activities to the Ballina-Lismore-Casino corridor seemed the most practical in the short term.

Since the meeting there has been further discussion about the funding available from State and Federal governments for professional education.

The NCPHN held a meeting just before Christmas to outline the process an organisation would undertake to tender for some of the funds for education from the pool of $730,000 it has for primary care workforce development across its footprint (the Tweed to Port Macquarie).

Again as a personal opinion and from past experience, I believe it will be hard for small local medical organisations to fund and succeed with a tendering application of this nature. Government tenderers prefer to deal with large organisations. In the medical education arena these bodies are often already funded through other government streams.

It can be argued that is not appropriate for these organisations to set the agenda for medical education and ignore the views of the profession itself.

On the State hospital front I note the work that Sue Velovski has been doing for quite a number of years in developing the regional training hub. I understand that the hub is seeking funding for medical practitioner training (and the administrative infrastructure that this would entail) and that it could encompass pathways for both primary and secondary care careers for hospital residents.

The next step for the NRGPN will be to vote at an Extraordinary General Meeting on a resolution to close the NRGPN. If this vote is successful it will then need to decide to which organisation it will pass its assets. Formal winding up of the organisation would not take place until December 2019.

A date for this Extraordinary General Meeting of the NRGPN is yet to be set.