1990
A tremendous effort is required of the college to implement the voluntary schemes of vocational training and vocational registration. Negotiation, discussing the issues, and writing and talking to doctors take up much of the college’s resources. The proposal meets opposition that is, frankly, misinformed, spurious and often politically motivated. It is at times difficult to discern genuine concern from fabricated, untruthful opposition. The Senate Select Committee recommends that the college should be totally responsible for the academic requirements of vocational registration. This calls for the completion of a continuing medical education/quality assurance program to retain accreditation for the vocational register.
The President again expresses concern at not being able to have a general practice point of view heard at the Committee of Presidents of Medical Colleges. He says that the college’s membership of the committee must remain in question and subject to review on a yearly basis.
30 April: The college delivers a surplus of $814 447, as compared to $456 196 in 1989.
The FMP receives increased funding to help meet the needs of vocational training with the introduction of vocational registration. At the beginning of the year, the component is reduced to 3 years.
There are courses in advanced training during the year in sports medicine, women’s health, manual medicine, geriatrics and anaesthetics. No further progress is made in the development of a training course in palliative care.
The Medical Education Committee takes on the task of liaising with other groups responsible for education within the college to develop a comprehensive program to evaluate continuing medical education/quality assurance for members so that they can meet the requirements to maintain their vocational registration. At the same time the Quality Assurance Committee develops a full time Quality Assurance Project Unit to give phone advice and develop information packages for doctors Australia wide. A research project, Process Evaluation of General Practice Care, is submitted for funding. At the same time, the unit conducts research into quality assurance and disseminates this knowledge. There is a high level of interest shown by many GPs to the QA program, a response that is not expected.
Dr Keith Bolden is appointed Visiting Professor.
The Practice Management Committee produces the Drugs of Addiction Record Book for use in general practice. The Services Division publishes the handbook Administration of Drugs of Addiction/Dependence.
May: The National Computer Committee holds the 6 th Computer Conference in Sydney. Each faculty is active in computer related activities, supported by the Computer Fellow.
A Working Party on Practice Economics works hard in liaising with government to improve rebates under the Medical Benefits Schedule.
At the instigation of the Research Committee, a research facilitator is appointed to assist with general practice research projects. The Research Unit continues its work on sleep disorders in the elderly, looking at whether cognitive function declines more rapidly in the elderly with sleep related breathing disorders; it also looks at the incidence and prevalence of depression in the elderly.
Australian Family Physician is the number one clinical journal in almost every aspect surveyed. Its monthly circulation reaches 19 600.
September: The Preventive and Community Medicine Committee launches its recommendations for minimal preventive care in general practice. Of particular concern to the committee is the criticism of the schedule of recommendations by the Department of Health and Community Services who misunderstand the intent of the college, which is to improve patient care rather than to increase income.
The Office Pathology Committee holds a seminar in Sydney. It continues discussions with the Royal College of Pathologists and the Australian Association of Clinical Biochemists about continuing quality assurance programs.
The Secretary-General expresses disappointment in the outcome of the deliberations of the Ad Hoc Committee of the AMA on the Care of the Aged, which fails to achieve recognition of the role of GPs in aged care.
NSW Faculty reports that, spurred on by vocational registration, educational courses, and particularly the Annual Revision Seminar, are attracting more participants than ever.
The Research Committee is involved in a cholesterol project.
The RDRN is active in educational programs, vocational training, and the provision of locums; it is also active in encouraging doctors to go into rural practice.
The Doctors Health Advisory Service’s activity trebles over the year.
Victoria Faculty reports a reduction in funding to the Victorian Academy of General Practice, with a consequential strain on educational funding falling back on the faculty.
Queensland Faculty notes an increase in its medical education and research activities. Its Medical Organisation Committee notes the threat to general practice posed by the emergence of a plethora of subspecialties of other colleges such as palliative care, geriatric care, and women’s health. Its Preventive and Community Medicine Committee is represented on the Queensland Domestic Violence Council and helps produce and distribute a booklet on domestic violence.
Western Australia Faculty establishes, with the HBF, a joint breast screening clinic – the first such GP based clinic in Australia. It produces a booklet in conjunction with the Health Department on domestic violence.
South Australia Faculty produces a second report, Review of General Practice in South Australia, which recommends that there should be postgraduate training under the guidance of the RACGP for all medical practitioners who work in unsupervised general practice.
28 September: The college’s 33 rd Annual General Meeting is held at the Observation City Resort Hotel, Scarborough. There is limited attendance again due to a pilots’ strike. Dr Anthony Buhagiar is inducted by Dr GR Gates as the 16 th President of the college.
The Faulding Prize is awarded to Dr I Rowe for his thesis ‘Medical Workforce Changes in Victoria 1977–84: Implications for General Practice’. There is no Rose-Hunt Award.
After 30 years of occupancy by the college, Bligh House is sold. The college’s needs outgrew its size, and it moves from the crowded, noisy Rocks area of Sydney under the Harbour Bridge to a more spacious area in Rozelle, where the college purchases a property at 39 Terry Street. The headquarters are moved there in December, before a final decision is made as to whether the headquarters should be in Canberra, Sydney or Melbourne.
1991
The NSW Faculty moves from St Leonards to North Ryde.
Membership increases quickly by almost 10% to almost 7500.
30 April: The college records a surplus of $987 641 from revenue of $6 963 638. Membership stands at 7487.
The Accreditation Committee produces an Accreditation Manual, recommending that, where possible, general practice supervisors should be Fellows of the college. All training practices are required to have a college record system or similar, a recall system, health for nontransient patients and a health screening protocol.
The Medical Organisation Committee’s Working Party on Practice Economics and the Practice Management Committee are involved in the college’s response to the Federal Government’s National Health Strategy (the Macklin Inquiry) because of its long term significance for general practice.
The Working Party on Practice Economics is instrumental in the introduction of new items for nursing homes and hospital visits with greatly increased fees.
The Quality Assurance Committee reports that in April, with less than half of the triennium completed, 45% of general practitioners have completed an option.
The Research Committee produces the National General Practice Research Data Bank. From July, a full time research facilitator is employed by the college.
The Board of Examiners, comprising all college censors, examination panel chairmen, segment coordinators and co-opted members, is created.
The Services Division conducts an inter-practice comparison involving 225 practices with 600 doctors. A Members Directory is distributed free to members.
The Archives Committee seeks advice from various expert sources in archives management. It makes a decision to separate college archives from a historical library, a museum (including gifts to the college), faculty memorabilia and the college library. It seeks college space for storing the archives properly so that they can be accessed. Lastly, it seeks to employ a trained archivist.
The CHECK program is made a Quality Assurance option. A desktop publishing system is purchased to produce the program. Australian Family Physician continues on its innovative path as a journal for general practice and achieves outstanding results in readership surveys. In 1990–91 there is a financial turnaround when council allows the Publications Management Committee to manage its income and expenditure.
The NSW Faculty and FMP have outgrown their accommodation in St Leonards after 5 years and shift to a site at Macquarie Hospital in North Ryde that provides better parking facilities.
The Research Unit oversees research projects on recognition of depression and dementia in the elderly; intervention on prescribing hypnosedatives; drug and alcohol resource and education; and nutrition in the elderly.
A standing review group is formed with the AMA and the Federal Government to begin discussions to oversee all aspects of vocational registration. All faculties report that vocational registration is becoming more widely accepted, and that an increasing number of applicants are applying for it.
26 September: The 34 th Annual General Meeting is held at Wrest Point Casino, Hobart, in the presence of the Governor, Sir Phillip Bennett. The WA Conolly Oration is delivered by Professor M Charlesworth. It is entitled ‘Medical Ethics, Ethicians, General Practitioners, Politicians and the Community’.
The Rose-Hunt Medal is awarded to Dr WE Fabb.
The Faulding Research Award is presented to Dr R Baxter for his study ‘Diabetes in an Elderly Population – Morbidity and Outcome: A Controlled Study’.
1992
By early 1992 the number of vocationally registered GPs has risen to 11 290 – a satisfactory number. Part time training with acceleration for FMP trainees is approved by the Board of Censors.
The Fellowship examination is held on two occasions for the first time.
The FMP establishes a Department of Program Evaluation. This department looks at areas such as hospital training, the characteristics of trainees entering the program, and external clinical teaching; it also undertakes a cohort study, which provides longitudinal data on trainee progress.
In the 14 months to 30 June, there is an operating surplus of $991 311.
The college is strengthened by the establishment of the Faculty of Rural Medicine, the implementation of a college wide computing system, the centralisation of accounting and membership records and the appointment of a Chief Executive Officer (administration).
The Accreditation Committee revises its manual Standards Required of General Practice Teaching Posts.
The Medical Organisation Committee develops policies on ‘The Delineation of Clinical Privileges – Access of Vocationally Registered General Practitioners to Hospitals’.
The Practice Management Committee writes several publications: Guidelines for Sterilisation/Disinfection in General Practice, Standards for Office Operative Procedures in General Practice and The Doctors’ Practice Management Handbook.
The Preventive and Community Medicine Committee publishes the booklet Preventive Medicine in General Practice. During the year the committee contributes to Federal Government initiatives such as the new cervical cancer screening policy, the National Program for Early Detection of Breast Cancer, the Role of Primary Health Care in Health promotion, the NHMRC Working Party on Assessment of Preventive Activities in the Health Care System, and the Macklin Report, ‘The Future of General Practice’.
The Quality Assurance and Continuing Education Committee of council is set up to subsume the activities of continuing medical education, quality assurance, courses' approval and courses of advanced training in one committee. The integration of the databases occurs, with over 11 000 GPs now identified as requiring some form of QA activity.
The Archives Committee develops a College Archives Policy; the council delegates to the Archives Committee the responsibility for implementing and supervising this policy. The archives, once classified, are deposited with the NSW State Library for safekeeping. The committee also embarks on a program of obtaining oral histories.
The General Practice and Primary Practice Research Unit continues with the projects ‘General practitioner recognition of dementia and depression in the elderly’; ‘Assessing the impact of educational intervention on prescribing of hypnosedative drugs in general practice settings’; ‘Drug and alcohol resource and educational network for general practitioners’; and ‘Nutrition in the elderly’.
The Services Division produces Sterilisation/Disinfection Guidelines for General Practitioners, Standards for Office Procedures for General Practitioners and Drugs and Elderly People. Edited by Dr EC Gawthorn, The RACGP Doctors Practice Management Handbook is produced by the Centre for Professional Development. In addition it publishes a Directory of Members, which includes special interests and languages spoken.
The Minister for Health allows radiological privileges to continue for GPs who have been currently using radiological procedures. It also includes an exemption for remote rural practitioners. This has a sunset clause until January 1993. The sunset clause is removed for practising GP radiologists when the college produces a system of CME and QA for them.
The General Practice Consultative Committee is established, comprising representatives of the RACGP, the AMA and the government, to discuss the document ‘The Future of General Practice: A Strategy for the Nineties and Beyond’.
At the Annual General Meeting, a special resolution is passed permitting the college to pay the President an annual presidential allowance to enable him or her to fulfil their duties.
24 September: Dr P Stone is installed as the 17 th President of the college at the Hilton Hotel, Melbourne. The Most Reverend Keith Rayner delivers the WA Conolly Oration. It is entitled ‘Euthanasia: Dilemma of a Community’.
The Rose-Hunt Award is presented to Professor N Carson.
The Faulding Award is presented to Dr R Strasser for his thesis ‘A Study of Attitudes of Rural General Practitioners to Country Practice and Training’.
The Faculty of Rural Medicine meets at the Annual Scientific Convention. At this meeting, significant discussions take place that clarify the relative positions of the faculty and the Rural Doctors Association. It is decided that the faculty will take over the portfolio of education and training previously held by the Rural Doctors Association, who will maintain their political portfolio. The idea of a Fellowship in Rural Medicine is canvassed at the meeting.
1993
Dr MD Bollen is appointed the fourth Secretary-General following the resignation of Dr KA Kinder.
Six hundred and seventy-nine candidates sit for the two examinations, compared to 416 the previous year. This is undoubtedly due to the introduction of the vocational register. The number of doctors on the register rises to 15 344.
The college annual subscription is set at $400.
Several Steering Groups are set up. The General Practice Working Group, a tripartite group made up of the RACGP, the AMA and the government, is given the task to investigate, develop and recommend proposals for general practice reform about which agreement can be reached. The Division Steering Group is responsible for facilitating the development of, and the allocating the funding for, divisions of general practice throughout Australia. The Interim Steering Group on Accreditation is greeted with suspicion – some fear it may be a way for the government to control the profession. This causes a rethink, and the development of the Standards for General Practice in consultation with GPs around Australia. The Evaluation Steering Group is set up to oversee evaluation of vocational registration and prioritise topics for research in general practice. The Information Management Working Party is set up to look at the information management needs of GPs. The Continuity of Care Working Party looks at linking patients to practices with better communication between GPs, hospitals and the consultants to whom they refer patients. Other working parties are the Reasons for Ordering WP, which looks at why investigations and pharmaceuticals are ordered, and a Workforce WP, which looks at how many GPs is enough.
Negotiations begin to purchase a building in Melbourne to house the FMP. The program now has 2469 trainees. The program evaluation continues on from the previous year, and studies the Basic and Advanced General Practice terms as well. Vocational registration and FMP Mark 111 are well established and provide better training, education and assessment than ever before.
NSW Faculty explores ways of involving practice nurses to optimise the delivery of primary medical and nursing care.
A clinical school is established at James Cook University, Townsville, funded jointly by the University of Queensland and the FMP.
3–5 June: The Information Management Committee holds the 7 th Computer Conference in Melbourne. Three hundred and eighty delegates take part in an interactive series of workshops, hands on software courses and medical systems demonstrations.
July: A strategic planning meeting of the Faculty of Rural Medicine is held to develop strategies based on a curriculum previously adopted for 1 and 5 year plans to guide the faculty in achieving its goal of maintaining an adequate and appropriately trained rural medical workforce.
The Personnel Committee puts forward 15 new policies governing employment within the college. They represent a significant achievement in developing appropriate conditions of service for the growing workforce of the college.
The Preventive and Community Medicine Committee produces the second edition of Guidelines of Preventive Activities in General Practice.
The Publications Committee reports that AFP is maintaining its position as Australia’s leading medical journal. The number of CHECK subscribers increases by 2300 on the previous year.
The Quality Assurance and Continuing Education department develops a new QA&CPD program for 1993–1995, with more than 14 000 GPs participating around Australia.
The Archives Committee, with the financial support of council, is able to employ an archivist.
The General Practice and Primary Care Research Unit, while continuing its previous research, begins research into ‘Consumers’ expectations of general practice’.
The Services Division publishes and distributes a handbook on palliative care called The Nitty Gritty Handbook.
The college records an operating surplus of $2 440 041, which is assisted by the surpluses in the Publications Division ($1 536 009), the Services Division ($316 135), the faculties ($143 220) and the FMP ($172 503).
At the 36 th Annual General Meeting at the Adelaide Town Hall, Dr William Scammell delivers the WA Conolly Oration. It is entitled ‘The Philosophy of Change’.
The Rose-Hunt Award is presented to Professor C Bridges-Webb.
The Faulding Prize is not awarded this year.
1994
The examination has more than 1000 candidates for the first time. The number sitting is 1067. This year a number of innovations are incorporated into the examination by the newly appointed Director of Assessment. Darwin hosts its first college examination.
There are 15 241 on the vocational register, fewer than the previous year. The Federal Court intervened in the process by allowing those applicants who were unsuccessful when applying to the college to appeal against rejection; and then, should that prove unsuccessful, to appeal to the Vocational Registration Appeal Committee. In other words, the standard for vocational registration was not that set by the college or the Vocational Registration Appeal Committee but that set by the Federal Court.
The college purchases and fits out College House, 1 Palmerston Crescent, South Melbourne, to house the National Headquarters of the FMP as well as council operations in Victoria. This year sees the beginning of the centralisation of the college administration in the College National Offices.
The burden of vocational registration and the requirements for quality assurance and continuing education is felt by all faculties and places great pressure on their resources.
The Victoria Faculty identifies an urban sector with an oversupply in the workforce and a rural sector with an undersupply; the rural sector is not yet able to provide the services required to fully meet community needs. Only commitment to quality care and services combined with a reduction of poor practice and greed will make communication and liaison easier in the years ahead and reduce the erosion of general practice.
West Australia Faculty holds an offshore conference in Penang, Malaysia.
The conditions of grant to the FMP are expanded to allow an additional period of elective training and/or leave of absence up to a period of 1 year only. Trainees selected in the Rural Training Stream are required to complete an additional year in an advanced rural skills training post.
The college purchases a property in Payneham Road, St Peters, Adelaide, to accommodate the RACGP Research and Health Promotion Unit. It continues its valuable work on sentinel practices, uptake of cervical smears, education on HIV, and the effect of omeprazole on gastro-oesophageal reflux disease.
Council establishes a Care of Older Persons Committee to put a greater focus on the care of older people. The committee aims to develop a budget, a work plan and state committees in order to develop policies and implement plans to improve the care of older people, particularly in nursing homes.
The Practice Management Committee updates the booklet General Practice Sterilisation and Disinfection Guidelines.
The Preventive and Community Medicine Committee produces the third edition of Guidelines for Preventive Activities in General Practice.
The Inter-practice Comparison Survey shows that many participants have discovered the real value of study for their quality assurance requirements and have benefited from the experience.
August: Following an AMA summit on general practice, the RACGP agrees to participate in a general practice forum in order to provide a common ground for general practice to seek agreement among members on strategies to negotiate with government.
The college records an operating surplus of $1 313 830 despite the fact that the Training Program records a deficit of $755 483.
15 September: Dr C Owen is inducted as the 18 th President of the college by Dr P Stone at the 37 th Annual General Meeting of the college at the Hyatt Hotel, Canberra. Professor R Smallwood delivers the WA Conolly Oration. It is entitled ‘The Skilled Doctor: in Defence of the Pursuit of Excellence’.
The Rose-Hunt Award is presented to Dr EJ North.
Dr D Mazza is presented with the Faulding Award for her thesis ‘An Analysis of the Relationship Between Psychotropic Drug Use by Women and a History of Physical Abuse’.
For the first time, two faculties have four councillors each. Queensland has the President, Treasurer, a faculty representative and a rural faculty representative; South Australia has the Chairman of Council, Censor-in-Chief, Honorary Secretary and a faculty representative. This leads to problems.
December: The Tasmania Faculty and Training Program move to a more spacious building that has been purchased by council.
1995
The benefits of vocational registration are apparent in the 1265 candidates sitting for the examination, more than a fourfold increase from 1991.
The Censor-in-Chief visits the United Arab Emirates. He finds that their medical system is quite different to that in Australia, but that its standard was nonetheless very high. He concludes that a number of administrative problems preclude further development of the examination there.
March: Friday Fax, a brief report of college activities, makes its first appearance. Council resolves to undertake a survey of members four times a year to identify members’ areas of concern and interest, as well as changes of opinion.
31 May: The Computerised College Information System (COLIN) is launched.
The Queensland Faculty purchases a building at 201 Logan Road, Buranda, Brisbane, allowing the faculty and the Training Program to be accommodated together for the first time.
The NSW Faculty establishes a panel of expert witnesses to provide expert medicolegal advice to members.
The censors, having previously recommended a Fellowship in Rural Medicine, withdraw their support, despite the support of a large majority of the faculties. In its place they recommend a Graduate Diploma in Rural General Practice after the satisfactory completion of the fourth advanced rural skills training year. This engenders considerable ill feeling among the rural members of the college. This, combined with the perception that rural training initiatives are not proceeding with sufficient speed, leads to a motion of no confidence in the Training Program being passed by the Board of the Faculty of Rural Medicine. The Rural Doctors Association announces a plebiscite to ask country doctors if they wish to continue their academic association with the college.
The General Practice Forum fails to achieve its original promise. In March, the college withdraws from the forum, as in its present form it appears that no progress can be made. A number of presidential task forces are established on role function and definition of general practice, special interest groups, Aboriginal health, and standards and accreditation.
The South Australia Faculty proceeds with renovations to most of the lower floor of College House.
August: The new Tasmania Faculty headquarters is opened by the President.
The Training Program only succeeds in having 400 training positions funded for this year’s entry to the program. More training positions are offered for underserviced areas such as northern Australia and fewer positions in relatively overserviced areas. A separate office is established in Townsville with a part time state director.
The Quality Assurance and Continuing Education Program enunciates specific objectives relative to effective and accessible education, being accountable to the community, and professional responsibility.
The 8 th Computer Conference is held in Sydney and concentrates on the potential of the computer on the doctor’s desk for improving patient care. Medical Computing Business Directory is released in June.
The development of standards and accreditation is fraught with political difficulties. Once standards and accreditation have been developed, the government wants to reward compliance and introduces the Better Practice Program. The college does not support the criteria that are currently used. The AMA and the college write to all GPs asking them to delay applying to enable them to negotiate acceptable and fair criteria. The government refuses to negotiate until September 1996. Council then can not support the criteria for a Better Practice Program but it is unable to see sufficient reason for GPs applying if they wish to do so.
The college records an operating surplus of $2 441 141 to 30 June, $209 586 of which is contributed by the Training Program.
The 38 th Annual General Meeting is held at the Hotel Conrad, Gold Coast. Associate Professor D Bennett delivers the WA Conolly Oration. It is entitled ‘Adolescent Health Care: Creative Responses for the 1990s’.
The FH Faulding Award is presented to Dr J Fraser for his thesis ‘The Implementation and Application of Information Technology to Improve Primary Health Care in Arnhem Land 1992–1994’.
There is no Rose-Hunt Award.
The college image is not improved by public disagreements between the President and the Secretary-General, nor at the Annual Scientific Convention, where a most damaging Emergency General Meeting is held and motions are passed which require council to reverse its position on the Better Practice Program and which preclude the college from entering into negotiations on fees. During Convocation a number of motions are accepted without notice, recommending to council a change in procedure and structure, including the setting up of an election for a new position of Vice-President and the abandonment of the appointment of the Censor-in-Chief by the recommendation of the censors and an election by the members. Council opts for an election by restricted electorate.
November: The Victorian Academy of General Practice is closed after the Victorian Government withdraws financial support.
1996
The President, in his Annual Report, says: ‘Sadly, there is little joy in the area of academic general practice unity. Alternative GP Training Pathways have solid support from a number of quarters; a second general practice college is in the development phase. Some factors leading to these situations were beyond the control of the College; others were not’. He concludes: ‘Finally, I express my thanks to those who have shared my dream and vision of a strong unified College leading Australian general practice into and through the challenges of the future’. An historic achievement is the finalisation of the Entry Standards for General Practice, which is published in July.
From January 1996 trainees become known as general practice registrars. The first Training Program Handbook is produced for the 1996 training year. A videoconferencing project to link registrars in rural Queensland with rural health training units and other general practice training sites is established.
The criteria for the Graduate Diploma in Rural General Practice and the Rural Fellowship are finalised. A reciprocal arrangement is entered into regarding qualifications with The Royal New Zealand College of General Practitioners.
A General Practice Strategy is developed in conjunction the AMA Council of General Practice. Negotiations begin with the Department of Health and Family Services to seek ways of implementing it.
A Therapeutics Unit is established to investigate and consider all aspects of therapeutics in general practice.
The Secretary-General reports that a major row has erupted because of council’s decision not to agree to a separate Rural Fellowship in addition to the FRACGP. The failure to reach a satisfactory outcome results in a protracted battle which makes the college appear to be constantly in disarray.
A small commercial office property is purchased in Darwin to house college and general practice activities.
The National Office at Rozelle is replaced with a much larger building on Parramatta Road at Forest Lodge to house all the activities of the college, including archives and meeting rooms; the new building has the potential to become the focus for general practice in Sydney.
A Corporate Development Department is established.
May: The Rural Faculty launches the Aboriginal Health Curriculum in Alice Springs. The curriculum has been developed by faculty staff in consultation with the Aboriginal people. The Joint Consultative Committee in Aboriginal Health continues its work with the National Association of Community Controlled Health Organisations and with the specialist colleges. A plebiscite by the Rural Doctors Association shows widespread discontent with the college in the bush and leads the RDAA to set about forming The Australian College of Rural and Remote Medicine. An interim body is formed in Adelaide in February. The Faculty Chairman remarks that this is a tragedy for any who believe that general practice is best served by a single, united voice. Council decides in May to change the name to the National Rural Faculty and to add the suffix ® to the FRACGP to indicate possession of the Graduate Diploma. Faculties express concern at the potential loss of valued rural members.
The Tasmania Faculty is deeply moved by the Port Arthur massacre and its members are very involved in helping the community recover.
The Victoria Faculty begins to search for possible alternative accommodation to Trawalla, which it has occupied for 20 years.
College council establishes a Research Program to enhance quality of health care through research and evaluation, to respond to the wishes and needs of members regarding research, to provide opportunities to members to participate in research, and to support educational opportunities for research. Reason, the research supplement to AFP, is published twice yearly.
CHECK program publishes its 300th issue.
The Visiting Professor is Professor S Westin from Trondheim, Norway.
The government is concerned at the perceived oversupply of GPs in urban areas. Consequently it limits entry to the Training Program to 400 places; a move that has to be seen in the context of the situation in rural areas, where there are marked shortages.
Council adopts an access policy for the archives. This gives council members and officers, as well as the Archives Committee, the ability to access the archives. Other people wishing to obtain access now have their names placed before the Archives Committee, who grant approval for specific purposes.
The General Practice and Primary Care Research Unit initiates the Therapeutics Resources and Educational Network for Doctors (TREND) to evaluate a system of quality assurance in therapeutics for GPs.
The college records an operating surplus of $1 669 417 for 1995–1996. This takes into account the Training Program’s loss of $110 977.
16 October: Dr PCJ Joseph is installed as nineteenth President by Dr CE Owen at the 39 th Annual General Meeting, which is held in Perth. Dr RL Perkin is the WA Conolly Orator. During the convention, Dr B Williams delivers a moving address entitled ‘City to Farm and Beyond: Encouraging GPs to Consider Rural Practice’.
Dr S Couzos is presented with the FH Faulding award for her thesis ‘Cervical Cancer Prevention’; a second award is presented to Dr B Reading for his thesis ‘A Reasonable Weight’.
There is no Rose-Hunt Award.
The Federal Government, concerned at the disparity in numbers between rural and urban practice and the ease of entry into general practice, introduces in its budget a restriction on the allocation of provider numbers. These will now only be allocated to those doctors who are in training or who have completed their training. The college takes the view that this would place general practice on a par with other medical disciplines. It wants an increase in training places. The restriction does not eventuate; nor does an increase in training places, due to great opposition within the profession at large. Where would all those who fail to qualify as a specialist go?
1997
The inauguration of The Australian College of Rural and Remote Medicine (ACCRM) takes place. Council accepts the advice of the Rural Faculty to recognise ACCRM as a body of expertise in rural medicine with which a formal consultative structure will be established in the interests of cooperation.
11 February: The ACT Faculty is created.
A report is released by a Senate inquiry recommending that legislation be introduced at state and federal levels to permit patient access to their medical records. Australian General Practice Accreditation Limited (AGPAL) is formed to undertake general practice accreditation in Australia using the RACGP Standards. A Joint Consultative Committee between the college and the college of psychiatry produces a report entitled ‘Primary Care Psychiatry – The Last Frontier’.
When Mr L Apolony’s contract expires as CEO (administration), a review of the senior administration is undertaken by the Graduate School of Management. It recommends that there should be a single CEO. Council appoints the Secretary-General as CEO with a number of assistant secretary-generals responsible for various departments.
The Board of Examiners, which comprises all college censors, faculty censors, examination panel chairmen, segment co-ordinators and co-opted members, is created.
The college initially provided support to the divisions. The RACGP respects the desire of the divisions of general practice to become independent local entities. The Secretary-General sees that the college will need to seek active dialogue with divisional organisations at both state and national levels to determine the relationships that might be beneficial to both organisations.
An e-mail facility is introduced to improve communication within the college; the college also establishes a website.
The Rural Faculty, after being left in smouldering ruins at the previous year’s convention, recovers to give rise to a group of state representatives who are determined to maintain a rural presence and voice within the RACGP nationally. The frustrations, disappointments and anger of the preceding 2 years are replaced by tentative optimism. The formation of The Australian College of Rural and Remote Medicine has provided a benchmark and body of expertise for the college to utilise.
The Victoria Faculty finds a new home in Hartwell that it is well pleased with. The building has more glass and more light and makes it easier to communicate than its previous home Trawalla.
West Australia becomes the first faculty to have a consumer representative on its Faculty Board as an observer. Her insight as a consumer is a very valuable. Feedback from consumer organisations is very positive.
The Training Program is working towards providing 1600 supervised GP terms per year, with the proportion in rural areas approaching 50%.
An Evaluation Reference Committee is established to produce an evaluation report discussing the 1993–1995 Triennium of Quality Assurance and Continuing Education. Over 5151 activities have been approved for points in the QA&CE Program since the start of the 1996–1998 triennium.
GPReview makes its appearance, reporting to members and other practitioners the ‘behind the scenes’ activities of the college, such as the college’s lobbying of government and other bodies on behalf of general practice.
August: The RACGP’s 9 th Computer Conference is held in Melbourne, with over 900 participants. It is the largest general practice informatics conference in the world.
Services Division produces the publications Correspondence Course for Medical Receptionists and Paediatric Emergency Care Handbook. It also conducts the Inter-practice Comparison Survey.
The college records an operating surplus of $363 504 to the year ending 30 June. This includes a surplus of $551 117 from the Training Program, but reflects a drop in income from the Publications Division of $905 926 – the first drop in 4 years.
Convocation recommends to council that registrar associates, a category created in 1985, should be granted full voting rights and a representative on council. Two past presidents point out that this would pose a problem as it allows for two categories of associate – one with voting rights and one without. Council endeavours to overcome this problem by making registrar associates ‘eligible associates’ with voting rights and a representative on council.
The 40th Annual General Meeting is held in Hobart. The WA Conolly Orator is Dr J Stevens.
The FH Faulding Fellowship is awarded to Dr G Kelly for his thesis ‘General Practitioners and Post-traumatic Stress Disorder’.
There is no Rose-Hunt Award.
December: The Honorary Treasurer resigns in December to take up a position as the CEO of The Royal New Zealand College of General Practitioners.
1998
The college reaches 10 000 members for the first time. By 30 June, there are 10 096 members.
The college puts its Strategic Plan into place after extensive consultation with members, council, the faculties and standing committees, including a presentation to the Convocation in Hobart the previous year. The plan enables the finances of the college to be more efficiently and effectively disbursed. To promote cohesion between the Sydney and Melbourne offices, the college begins having monthly meetings between the senior managers from both offices, cementing the senior management of the college into an effective team. Member services are also extended through the Strategic Plan.
The GP Forum has considerable success in achieving satisfactory remuneration for successful vaccination strategies.
The FRACGP examination becomes the largest GP examination in the world.
1 February: The Health Records and Privacy Act comes into force. This legislation allows complete access to patient records.
May: After irreconcilable differences with council over the course of the year, Dr Michael Bollen resigns as Secretary-General. He predicts that the next few years will be a watershed for the college. It will be a time of great further change.
Council takes on responsibility for a loan to the Queensland Faculty for the purchase of its property after the Queensland Faculty finds difficulty in meeting its other financial commitments. Council obtains more favourable conditions for the loan.
The Training Program’s educational resources are expanded by the introduction of the ‘Library Without Walls’, which provides online access to the National Resource Centre’s catalogue of texts, periodicals and other resource materials.
New initiatives in QA&CE include ‘Falls in the Elderly’ and ‘Keep Yourself Alive – a youth suicide program’. Ninety-five percent of recognised GPs have completed their QA&CE requirements for the 1996–1998 triennium by May.
May: The first edition of the Australian Medicines Handbook – a collaboration between the RACGP, The Pharmaceutical Society of Australia and The Australasian Society of Clinical and Experimental Pharmacologists and Toxicologists – is launched.
The college develops a quality assurance program for GPs who provide rebatable radiological services under Medicare in conjunction with The Royal Australasian College of Radiologists.
Research continues apace in diverse areas. After two and a half years, ‘Research in Hypertension Management’ is presented to the WONCA Conference in Dublin. State based Research Unit activities include ‘Prevention of Youth Suicide’, ‘Ross River Virus Identification and Management’ and ‘Preventive Health Seminars’ (Qld); ‘Dementia Guidelines Development’ and ‘Measure of Patient Health Outcomes’ (NSW); ‘Organisation of Practices: Role of Receptionists’, ‘Cardiovascular Disease Practice Assessment Option’, ‘Mental Health Evaluation Tool’ and ‘Cancer Education Evaluation Project’ (WA); ‘Role and Function of Practice Nurses’, ‘Exercise Physiology Services’, ‘Patient Participation Program’ and ‘Asthma Management Audit’ (SA); and ‘Australian Sentinel Practice Research Network’ (national). A research workshop is held in Sydney for registrars called ‘Improving Practice through Research’.
An Activity Pool of $90 000 is set up to enable standing committees to fund special activities through the Committee of National Chairmen.
The National Care of Older Persons Committee produces the third edition of Guidelines on the Medical Care of Older Persons in Residential Care.
The Preventive and Community Medicine Committee produces the Guide to the Implementation of Prevention in General Practice.
The RACGP records a modest surplus of $269 442, which includes a surplus of $88 145 for the Training Program and a further 50% reduction in the surplus of Publications Division to $814 728. The surplus is achieved through a refund of payroll tax which had been previously paid of $1 289 878.
15 October: Dr MRJ Kilmartin is installed as the 20th President of the college by Dr PCJ Joseph in Melbourne. The WA Conolly Oration is delivered by Emeritus Professor NE Carson.
The Faulding Fellowship is awarded to Dr I Cook for his thesis ‘Research on Paediatric Vaccination Practice’.
The Rose-Hunt award is jointly awarded for the first time to Professor PR Mudge and Professor C Silagy.
November: Mr G Mak is appointed Chief Executive Officer of the college.
1999
The new CEO, G Mak, writes in the Annual Report: ‘Having a governing body provides clear direction and strong motivation to any organisation. The President’s vision, shared and supported by the entire council, is making the task of reinvigorating The Royal Australian College of General Practitioners a realistic objective’. He details the sweeping changes that he is making in the organisation of the college. The President echoes those sentiments at the start of her annual message: ‘This year is one which I hope will be remembered for momentous positive change carried out with energy and enthusiasm.’
The college makes an agreement with the ACCRM to develop an integrated approach to general practice and training. It also makes a commitment to support an initiative by the Minister for Health and Aged Care to recruit overseas trained doctors to rural areas.
A new format for the college examination is introduced. The new examination still reflects general practice but contains new assessment tools. The long diagnostic interview is replaced by two short diagnostic interviews to more closely replicate the situation in general practice.
The college adopts a new strategic planning role and sets up a Strategic Planning Unit to assist it in coping with the various technological, political and social changes that are impacting on general practice. The real work of the college is done by the faculties and the standing committees; the restructuring of the head office is designed to give them practical strategic support for their work.
The college establishes four dedicated directorates focussing on areas of core business: professional leadership, standards, education, and research and development. It also it also sets up a planning directorate. This changes the administrative format, which has been predominantly reliant upon membership input, to a more centralised model.
As a result of the reorganisation, council decides to consolidate the majority of college functions in College House in Melbourne, leaving behind only the Research Directorate and the archives. This results in all staff at Forest Lodge electing to take redundancy, with the exception of the Executive Director of Human Resources. The move to South Melbourne means that virtually all staff who were employed at Forest Lodge have to be replaced by Melbourne based staff. This results in a huge loss of corporate knowledge; even the CEO had only had 7 months experience in the job.
May: The government introduces the concept of Enhanced Primary Care. In November, it introduces 21 new items to the Medicare Benefits Schedule to promote Enhanced Primary Care.
A new training package is negotiated with the commonwealth. This necessitates changes to the operational policies and procedures, including a change to the COLIN database. A joint venture agreement is entered into with the ACCRM, the central purpose of which is to support a single, integrated approach to education and training for rural general practice. A major review of the Training Program is undertaken by external consultants, which leads to a strategic plan for the next 3 years.
All faculties report difficulty in relating to the new national college structure. It appears that their role has changed, but they are not sure where they fit in. The Committee of Faculty Chairmen opine that faculties and sub-faculties often have a different perspective on the needs and opinions of members to that of council.
Standing committees continue to work efficiently and to complete projects. Sadly, this year sees the demise of the Inter-practice Comparison Survey. The standing committees are faced with the challenge of relocating the National Office from Sydney to Melbourne and the subsequent loss of valued support staff, who take with them a great deal of wisdom and expertise.
There is no report from the Training Program. It produces a history of the program by Sally Wilde called 25 Years Under the Microscope. It is noted in the financial statements that the program review cost $194 707.
The college records an operating deficit of $2 555 418, the first deficit in the history of the college. The deficit is a result of losses sustained as follows: Training Program, $873 621; legal fees, $70 000; legal settlement, $425 000; relocation, $533 277; and the aforementioned cost of the review of the Training Program.
26 October: The 42 nd Annual General Meeting is held in Adelaide. Dr DA Game delivers WA Conolly oration. At the same meeting, the new, easier to use college website is launched.
Dr E Banks is presented with the Rose-Hunt Award.
The FH Faulding Award is presented to Dr SH Naidu for her thesis ‘Women’s Experience with the Initial Stages of Cervical Screening: their Knowledge, Understanding and Anxiety’.