Happy New Year!
Let me start with the good news: The stocks of general practice have never been higher in the 36 years I’ve been a GP – at least with our patients and the public; I’m not so sure about the politicians. Patients are thankful for the great work their GP did and continue to do during the COVID pandemic. Patients and the public understand that GPs are being squeezed financially like never before and appreciate what we do.
It's time for politicians to understand how our patients – and their voters – feel about this and act appropriately. Australia still has one of the best health systems in the world; when will we get the message through to our politicians that they need to stop looking implement aspects of the failing UK and the US systems?
Profession-led training
By the time you read this, the RACGP and ACRRM will again be leading general practice training in this country. JCU GP Training will continue (under a contract with the RACGP) to be responsible for delivering training in the northern and western parts of the state. The Federal Government has chosen not to continue funding GPTQ or other RTOs around the country. I want to thank GPTQ for the fabulous job it’s done over the last two decades. We’re lucky that many wonderfully talented and passionate people from GPTQ are continuing with the RACGP.
Payroll tax – the ‘sick tax’
Payroll tax remains a considerable threat to general practices in Queensland and across Australia. The tax is set at 4.7% in Queensland, which this exceeds the margin for most practices. The Medicare freeze and lack of indexation have brought us to the point where neither practices nor tenant doctors can absorb this additional cost. The payroll tax will affect all doctors and all patients in most states.
I’ve been meeting with the Queensland Revenue Office (QRO) and talking to the Treasurer’s office on a fortnightly basis over the last three months. We’ve made a strong case that the retrospective application of payroll tax could shut practices down. As a result of RACGP negotiations with QRO, the Commissioner wrote to the college stating that there would be no retrospective audits before this current financial year – a massive win for general practice!
The QRO also responded to our request for increased certainty over the application of payroll tax; and it responded with a
public ruling. The QRO should be congratulated for being transparent about the application of payroll tax to general practice and for not conducting retrospective audits. We now need the other states and territories to follow suit.
A couple of quick payroll tax facts:
- Payroll tax is harmonised across the states/territories. As a result, the approach in any one location necessarily affects how the tax is levied in every other.
- Payroll tax has a reversed onus of proof – anyone working for you is subject to payroll tax unless they meet one of the specific exemptions.
Nevertheless, the public ruling, the
optical superstore case in Victoria, and the
Thomas and Naaz case in New South Wales all represent a far more aggressive application of payroll tax to tenant doctors in general practices. The RACGP is meeting regularly with expert lawyers and accountants on this issue and taking advice. We’re actively looking at the best way through. One of the main options is to seek an exemption for general practice tenant doctors.
So, politicians need you to tell them that patients (their voters) will have to foot the bill for the payroll tax, and we’ll tell our patients why they’re paying extra.
I urge you to contact your local state MP and raise with them that:
- general practices do pay payroll tax and will continue to pay payroll on employees but cannot afford to have tenant doctors subject to payroll tax
- practices will need to pass on the cost of the additional tax, which for your voters means increased out-of-pocket costs and less bulk billing
- current payroll tax provisions undermine team-based care; the requirement for GPs to work entirely independently will reduce practice efficiency, which for your voters means reduced availability of GP appointments
- many smaller practices will, for the first time, cross the payroll tax threshold, and this will disproportionately affect rural practices, which for your voters means reduced availability of rural GPs.
Voluntary assisted dying
Voluntary assisted dying (VAD) started in Queensland on 1 January 2023. I’d particularly like to thank Prof. Harry Jacob, as the RACGP representative, for his challenging work over the last year working with the Queensland Government to develop GP VAD training modules and operational guidelines. The training modules, health practitioners handbook and other VAD resources are available at the
QLD Health VAD webpage. In other jurisdictions, up to 80% of VAD has occurred in the community. It was and remains essential that the voice of general practice is heard, including the right of conscientious objection.
Cheers,
Dr Bruce Willett
RACGP Queensland Chair and RACGP Vice-President