25 March: Joseph S Collings writesan article entitled ‘General Practice in England Today – A Reconnaissance’, for The Lancet. The article sets out the perceived attributes and deficiencies of British general practice. Collings writes, ‘My observations have led me to write what is indeed a condemnation of general practice in its present form; but they have also led me to recognise the importance of general practice and the dangers of continuing to pretend that it is something which it is not. Instead of continuing a policy of compensating for its deficiencies, we should admit them honestly and try and correct them at their source’.
Discussions are held in London about forming a college of general practice. A steering committee is set up.
Dr WA Conolly writes to the British Medical Journal: ‘As an Australian who has been in general practice for more than 25 years, I would like to add my support to the formation of a College of General Practitioners. If this College is to be founded soundly and expeditiously, I trust the Steering Committee will give to those who practise in other parts of our great Commonwealth the opportunity to co-operate’.
19 November: Britain’s College of General Practice is founded.
1 January: General practitioners are invited to apply for membership of the new college. Australian GPs apply to become, and are admitted as, Foundation Members.
14 June: Dr HS Patterson writes to the Medical Journal of Australia stating that he believes that there is a need for a college of GPs in Australia.
A meeting takes place at the home of Dr Warburton in Pymble, New South Wales. Discussions at the meeting result in the formation of the NSW Faculty of the college on 30 October 1953. Dr WA Conolly is appointed chairman. For the time being, faculty headquarters are located at Cessnock, NSW, where Dr Conolly is in practice. Applications for membership are invited. By the end of the year, a number of GPs have become members.
23 March: The faculty accept the offer of the University of Sydney’s Postgraduate Committee in Medicine to establish faculty headquarters at 131 Macquarie Street, Sydney.
Discussions begin in Queensland about forming a faculty.
27 August: The inaugural meeting of the Queensland Faculty Board is held. Dr P Hopkins is elected Provost and Dr HS Patterson Chairman. The first office of the faculty is located at the Queensland branch of the British Medical Association (BMA).
24 September: The first Annual General Meeting of the NSW Faculty is held. Dr KCT Rawle is elected Provost.
Research committees are set up in each faculty.
30 April: The Queensland Faculty Board recommend that a combined meeting be held with the NSW Faculty Board to discuss the formation of an Australian council.
26 August: The combined meeting is held. Members from England, Tasmania and Western Australia also attend, and it is resolved to take the necessary steps to form an Australian council.
2 September: The first Annual Meeting of the Queensland Faculty is held.
19 November: The British college approves the formation of an Australian council at the request of the two Australian faculties. It donates 200 pounds sterling and office equipment to the council. The officers of the Australian Council are: Dr WA Conolly (Chairman), Dr HS Patterson (Deputy Chairman) and Dr HM Saxby (Honorary Secretary and Treasurer).
18 January: Western Australia Faculty is formed. The officers elected are Dr CW Anderson (Provost) and Dr HEH Ferguson (Chairman).
1 September: First issue of Annals of General Practice is published.
1 November: Victoria Faculty is formed. The officers are Dr RW Weaver (Provost) and Dr MO Kent-Hughes (Chairman). Faculty headquarters are at 132 Grey Street, East Melbourne.
The first research paper is published jointly by the NSW and Queensland faculties. It is entitled ‘Incidence of Eclampsia in General Practice’.
15 January: Editorial on general practice and research is published in the Australian and New Zealand General Practitioner, in which the editor notes the formation of the Victoria faculty. The editor goes on to suggest that the incidence of lobar pneumonia occurring in general practice may be a good research project for the new faculty, as GPs are the first ones to see most cases of this condition. The editorial then says that the conditions of entry to the college might cause a bias in the results of such an investigation. Because the college ought to be composed of ‘the elite of experienced and progressive general practitioners’, any investigation may give too rosy a picture of the position, the editor writes.
5 May: Tasmania Faculty is inaugurated from a practice group that has been meeting since 1953. Dr TC James is elected as Provost and Chairman.
A survey of members regarding the formation of an Australian college shows a positive response.
17 December: Memorandum of association is submitted under the NSW Companies Act.
4 February: Aus tralian college is incorporated under the NSW Companies Act. The memorandum and the articles of association are the result of work done by Dr HM Saxby.
8 February: South Australia Faculty is formed. Dr L Mallen is elected as Provost and Chairman. Faculty meetings are held at the BMA Offices, 80 Broughton Place, North Adelaide.
6 March: The Australian Council decides that it will dissolve on 30 June that year to allow The Australian College of General Practitioners to function from 1 July 1958. An interim council of the college is formed on the same day, with Dr WA Conolly as Chairman.
The interim council adopts provisional regulations prescribing the criteria and procedure for admission. Members have to have been graduated for 7 years and to have been in general practice for at least 5 years; they need to promise to undertake and continue approved postgraduate study while they remain in active practice. Admission of members and associates is, for the time being, by invitation.
Extant bylaws of the faculties of the British college are adopted until the faculties can create new bylaws to be adopted by the Australian college’s council.
The first headquarters are in a suite at 203 Macquarie Street, Sydney, occupied by Dr CWF Laidlaw, a college member. The NSW Faculty also moves its office to this location.
21 November: The first Annual General Meeting of the college is held at Macquarie Street. It is immediately adjourned until 20 March 1959 to allow the President of the British college, Dr ID Grant, to be present.
Dr WA Conolly is elected first President of the college; he also becomes an ex-officio Fellow – the college’s first Fellow.
Foundation Members number 874.
During the formative years of the faculties and the Australian Council, the members of the boards and the council pay their own travelling and hotel expenses. This involves considerable expense and time, not only for the members, but also for their families.
20 March: The adjourned first Annual General Meeting is held in the Great Hall of the University of Sydney. Dr ID Grant, President of The College of General Practitioners, gives the occasional oration. Dr JH Hunt (later Lord Hunt of Fawley), Dr W Pickles and Dr ID Grant of the British college have Honorary Fellowships conferred on them.
21 March Standing committees of council are appointed. These committees are as follows:
- Undergraduate education
- Postgraduate education
- Preventive medicine
Academic dress to be worn by Fellows and members is approved.
Deliberations continue on the design of the coat of arms.
30 June: Membership is now at 963.
Dr JG Radford lobbies hard to have the college represented on the National Health and Medical Research Council (NHMRC).
29 September: The second Annual General Meeting is held in the Great Hall of the Brisbane Grammar School. Dr JS Collings delivers the occasional oration entitled ‘A Balance Sheet of General Practice and a Budget for the Future’.
A survey of Australian general practice is undertaken by Dr CC Jungfer. In it he writes: ‘The first obligation of practitioners is to distinguish between those patients with symptoms of serious disease who are small in number and the majority who come with a wide range of conditions, many of them self limited, making certain at all times that an apparently simple complaint is not an expression of a more serious malady’. He makes a number of recommendations concerning increasing the number of GPs, and improving their training, education and distribution.
Council appoints Dr JG Radford as its representative on the National Health and NHMRC, a position he holds for the next 16 years.
Queensland Faculty holds its first Postgraduate May Weekend.
August: A conference on postgraduate education is held. The college makes an important contribution to the section of the conference concerned with general practice through Dr MO Kent-Hughes, Dr CC Jungfer and Dr JG Radford.
October: The third Annual General Meeting and the first Australian General Practitioners’ Convention are held at the Chevron Hotel, Melbourne. The Academic Session is held at the Wilson Hall of the University of Melbourne. Dr KM Foster of the British college delivers the occasional oration. It is entitled ‘Let Us Now Praise Famous Men’.
Fellowship is conferred on Dr HM Saxby for services rendered as Honorary Secretary of the college, on the recommendation of the Queensland Faculty. He becomes the college’s second Fellow.
A presidential gold chain is presented by Geigy Pty Ltd.
The Preventive Medicine Committee initiates statements on the diagnosis of infectious hepatitis and the use of gamma globulin. It also discusses better control of zoonoses, smoking, alcohol and rehabilitation as well as the practitioner’s role in marriage guidance and educating parents in managing childhood asthma and bronchitis. It promotes uniform immunisation and other preventive measures. The NHMRC accepts seven nominees of the college onto its Committee of Preventive Medicine in General Practice, which report to it through its Public Health Committee.
1 May: Bligh House, a Georgian house built in 1833 in the Rocks area of Sydney, is leased as the first permanent college headquarters after it was refurbished by the college and its owners, the Maritime Services Board. The NSW Faculty is also accommodated in the building, which had previously been a rooming house for derelict men. The original member of Alcoholics Anonymous once had a room there. Some of the first meetings of Alcoholics Anonymous in Sydney were held there in early 1945.
15 May: After council approves the form of the coat of arms, a grant of arms is given by the College of Arms. The patent that accompanied it is suitably mounted and displayed at the next Annual General Meeting. It now resides in College House, Melbourne.
October: A seminar on group practice put on by the Medical Education Committee is held in Adelaide.
Dr HS Patterson is inducted as the second President of the college at the fourth Annual General meeting, also in Adelaide. The general meeting is held in the Newland Memorial Hall at the AMA in Adelaide. Dr G McDonald gives the occasional oration entitled ‘Patients are People’.
The college becomes affiliated with the AMA at the AMA’s invitation. This frees the college from medicopolitical problems, allowing it to concentrate on its academic programs of education and research.
The Medical Recording Service is established by the Medical Education Committee of Council (MECC) as an educational tool, introducing prominent general practice educators through the use of recordings. Little progress is made at this time.
An appeal to members for a development and research foundation raises over 50 000 pounds by the following year.
Dr J Yeatman is awarded a Nuffield Travelling Fellowship to study general practice in Europe, Britain and North America.
The college donates a prize for the best essay by a fifth year medical student on the theme ‘Impressions of General Practice’. It is won by two students from Western Australia.
Dr Patterson records widespread opposition in the college to the idea of a college examination, an idea floated by the Medical Education Committee.
A College Educational Policy is formulated by the Medical Education Committee with a 5 year plan for recent graduates, a student term in general practice in the undergraduate course, and a Postgraduate Fellowship Plan.
A National Morbidity Survey is initiated by the Research Committee.
Dr HN Merrington is appointed Director of the Medical Recording Service and Dr GH Puddicombe Honorary Secretary. This service, which is subsidised by Smith, Kline and French, produces double sided recordings of notable visitors to Australia, as well as known Australian authorities in education, general practice, family medicine and other subjects. There is a modest subscription fee for members to receive the records; tapes are made available for loan to members.
October: The second General Practitioners Convention is held in Sydney in conjunction with the sixth Annual General Meeting at the Australian Jockey Club, Randwick.Dr CW Anderson is inducted as the third President at the Academic Session, which is held in the Great Hall of the University of Sydney.
A Practice Management Committee is established by the Victoria Faculty.
Dr NE Carson organises the first Practice Management Seminar at the Batman Inn.
A Medical Organisation Committee is established by the NSW Faculty.
Dr K Cullen receives the first doctorate of medicine ever awarded by the University of Western Australia.
Dr B Adsett is awarded a Nuffield Travelling Fellowship to study continuing and postgraduate education in Europe, Britain and North America.
The first Francis Hardy Faulding Memorial Research Award is granted to Dr TC Beard for his study ‘Eradication of Hydatid Disease in Tasmania’.
The Medical Education Committee urges that the next world conference on medical education be on vocational training in general practice. It holds a conference on continuing education.
At the annual Christmas party of the NSW Faculty, members donate over 1500 individual presents to be distributed to aged and invalid pensioners attending the local Citizens Welfare Centre at Millers Point.
Victoria Faculty begins to develop the concept of a 2 year rotating internship training program.
‘Project Family Medical Care’ is launched; eventually, 100 000 pounds is raised for education and research.
Secretarial work becomes too heavy for the Honorary Secretary, Dr Saxby, and an Assistant Honorary Secretary, Dr Radford, is appointed to ease the burden. An office executive assistant is also appointed.
Criteria for admission are strengthened to include a rotating internship for 2 years, 3 years approved training in general practice and a requirement to satisfy the Censor-in-Chief of proficiency in general practice.
The second Faulding Research Award is awarded to Dr PS Clarke for the study ‘The Serological (Schulz-Dale) Test for Carcinoma’.
Plans are made to appoint postgraduate Fellows in the faculties.
All faculties begin formulating and testing material that will be suitable for use in a college examination when it is established. A plebiscite of members agrees to the introduction of an examination.
The Tasmania prize is inaugurated for a research essay on ‘Quality Control in General Practice’. JM Last and N Andersen are awarded prizes. This is the first attempt to assess quality control in general practice.
Victoria Faculty develops local discussion groups and informal clinical meetings. It acquires new headquarters at 254 Albert Street, East Melbourne. Leased from the Melbourne Metropolitan Board of Works, the building is quite magnificent, with ample space. Efficient printing and photocopying departments are housed here.
The college’s vocational training plans and details of advanced training courses are completed, and the Medical Education Committee’s Educational Training Program is settled.
October: The NSW Faculty Board approves, in principle, the concept of grading professional privileges in hospitals.
May: The Geigy Seminar on Medical Teaching is held in May at Ridley College within the University of Melbourne. Forty-five college members attend by invitation. They undergo training in learning theory, teaching methods and evaluation. The hard task of implementing the College Educational Program now lies ahead. The form of a college examination is also discussed.
27 October: Dr CC Jungfer is invested as the fourth President at the eighth Annual General Meeting’s Academic Session in Adelaide. Dr CL Witten, President of The American Academy of General Practice, delivers the occasional oration entitled ‘Family Medicine – Truly a Needed Specialty’.
Dr HM Saxby retires after serving the college as Honorary Secretary and then Chairman of Council to move to a monastery in New Norcia, Western Australia.
At the third College Convention, Prof J Rising, of Kansas, USA, is a significant contributor to discussions on continuing education and also training for general practice. The new Postgraduate Fellows are also involved in this program.
Postgraduate Fellows have been appointed to faculties to visit members in their practices and carry out the following duties:
- To offer, in an advisory capacity, information to assist in their professional work and to assist with problems relating to their practice
- To organise educational facilities for postgraduate education and training as preceptors
- To inaugurate and supervise teaching in general practice
- To effectively liaise with appropriate educational and other professional bodies.
The object is to overcome the shortage of GPs, particularly in country areas. The initial appointees are:
- Dr WL Corlis (NSW)
- Dr WA Pryor (SA)
- Dr BN Adsett ( Queensland)
- Dr AS Fedderson (Victoria) (also for Tasmania, for 6 months only).
Queensland Research Committee reports on its obstetrical survey. The Preventive and Community Medicine Committee publish The Early Recognition and Treatment of Deafness in Children.
In South Australia, ‘Raywood’ educational weekends begin.
Victoria presents the results of surveys on circumcision, operative obstetrics and anaesthetics to the Annual Convention. Its Practice Management Committee classifies the content of practice management.
Western Australia undertakes a survey of GP postgraduate education.
All faculties report great advances in educational techniques.
The Medical Education Committee of council develops vocational training plans and advanced training courses.
The NSW Faculty issues a policy statement on the basic concept of grading professional privileges for the betterment of patient care, so that when in hospital, the patient can have continuing treatment from their own doctor – provided that the doctor agrees the rules of the hospital and satisfies the Credentials Committee as to their integrity, experience and proven competence.
After agreeing, the NSW Health Commission establishes a further barrier by requiring the approval of a Medical Appointments Advisory Committee.
This is completely at variance to what had been negotiated and understood. The faculty views this outcome with the utmost concern.
29 May–2 June: An examination seminar is held in Melbourne. Forty-five selected members attend and undertake trial tests and examination procedures to establish the format of the examination, using techniques not previously used for examination purposes in Australia. Those who are successful are deemed to have passed the college examination.
The Family Medical Care Education and Research Foundation is established. A Finance and Grants Advisory Committee is appointed to recommend the allocation of funds.
Dr DA Brown is awarded a Nuffield Travelling Fellowship to study evaluation procedures in general practice in Malaysia, Yugoslavia, East Germany, Britain, the USA and Canada.
The third Faulding Research Award is given to Dr C Bridges-Webb for his study ‘Anaesthetics in General Practice’.
A student attachment scheme is set up in NSW.
The first general practice term in an Australian university is established at the University of Tasmania. Dr P Gill is the supervisor of teaching.
The following Postgraduate Fellows are appointed: Dr RFF Harbison ( Victoria) and Dr NH Rutledge ( Tasmania). In Western Australia no appointment is made, as the Western Australia Branch of the AMA already appointed Dr J Bamford, a college member, to perform a function similar to that of a Postgraduate Fellow.
The Practice Management Committee of Council is formed. It formulates papers on the content, objectives, and educational objectives of practice management.
NSW Faculty conducts its first Teaching and Learning Seminar at Port Macquarie with input from the Educational Research Unit of the University of NSW. This results in a new approach to teaching and learning being pioneered.
A Rotating Residency Program begins that includes general practice rotations. It is organised by the Victorian Postgraduate Medical Committee.
NSW Faculty holds its second Teaching and Learning Seminar at Wagga involving Dr CC Jungfer and members of the Victoria Practice Management Committee. Exposure to group method, counselling techniques and educational principles are a feature.
The first open college examination is held. Over 300 candidates present themselves. The censors travel to each state to conduct the exam. Dr WE Fabb is appointed Examination Director. A Board of Examiners is established; its Chairman is the Chief Examiner.
The Research Committee of Council publishes research documents on the basis of research and a research digest. Dr IL Rowe, as Chairman of the Research Committee, undertakes a study tour to look at the research being carried out by the American Academy of General Practice, The College of Family Physicians of Canada and The Royal College of General Practitioners. He holds discussions with research leaders in these three organisations.
Dr GSC Mayrhofer receives the Faulding Research Award for research related to ‘Observations on Virus Disease in General Practice’.
College membership exceeds 2000.
10 October: Dr MO Kent-Hughes is invested as the fifth President of the college at the Annual General Meeting held in the Wilson Hall of the University of Melbourne. Prof RR Andrew is the occasional orator.
NSW Faculty completes six programs for the Medical School of the Air to facilitate distance learning.
Queensland Faculty members begin teaching undergraduates in their practices, while some give lectures to students in the Department of Social and Preventive Medicine at the University of Queensland. The Preventive and Community Medicine Committee recommend that the Guthrie test should be performed on all newborn babies before discharge from hospital. It holds its first Teaching Seminar.
The Nimmo Committee of Inquiry into the Medical Benefits Scheme finds that it is deficient and too complex. It recommends changes that would make the scheme more encompassing of patients’ needs to have their health costs reimbursed.
The college Executive meets with the Executive of the AMA to discuss the payment of GPs actively engaged in teaching, as well as vocational registration, smoking and health, and undergraduate medical education policy.
24 March: Her Majesty the Queen is pleased to grant the prefix ‘Royal’ to the Australian College of General Practitioners.
1 April: The Australian General Practice Morbidity and Prescribing Survey begins. It is the largest research project undertaken by the college so far. More than 1000 GPs contribute data on a part time basis to the project over 6 years. Many articles on the survey’s results are published in a number of journals. Researchers voluntarily contribute time to collate the material gathered.
A teaching seminar is held at Nedlands, Western Australia, to focus on the needs of GPs who are teaching medical students. Teaching methods and educational principles are discussed. The Western Australian faculty also begins country teaching tours, covering 2 weeks of visits to isolated areas of the state.
Dr JH Hunt (later Lord Hunt of Fawley) visits a number of faculties in Australia as President of The Royal College of General Practitioners.
The Combined Education Committee of the AMA and the royal colleges is established to exchange educational ideas about undergraduate and postgraduate training.
Discussions begin about the proposal to introduce a common fee that would see much higher rebates available for patients who see specialists than for patients who see GPs. The President reports that college representation on behalf of its members evokes opposition rather than cooperation from the AMA. This leads the President to comment that “a surprising number of our profession still believe that general practice is a thing of the past, and a dead end job for failures”.
The General Practitioner Convention in Brisbane highlights 12 important research projects that have originated within members’ practices; the projects cover a broad range of subjects including total patient care, content and morbidity, prevention, emergency, and obstetric, as well as other modalities of general practice.
Dr M Dunstone conducts the South Australian Obstetric Audit, which covers 10 000 consecutive confinements in South Australia.
The Medical Organisation Committee becomes a standing committee of council.
The NSW Teacher and Leadership Training seminars continue.
As a result of the Nimmo Inquiry, the government decides to introduce the concept of a common fee; as a consequence of this decision the Prime Minister announces that the cost of any consultation will be covered by the scheduled fee less an amount of $5.00. The college regards this as inequitable, proposing that this will encourage patients to consult specialists rather than their GP.
The NSW Faculty Teacher and Leadership Training seminars continue at their regular venue, the Everglades Motel in Leura. They become known as the ‘Leura Seminars’ until they finish in 1975.
A plebiscite of members overwhelmingly supports the college’s view that the fee proposals are inequitable.
22 March: Council decides to campaign to oppose the fee proposal on behalf of GPs, going against the AMA, which supports the proposal. It causes a schism between the two bodies that continues for some years.
April: Seventy-eight members and their wives travel to Aberdeen to participate in a joint meeting with The Royal College of General Practitioners at its Spring Meeting.
Dr F Farrar is appointed the first Executive Officer of the college.
The occasional oration at the Academic Session of the Annual General Meeting is designated the William Arnold Conolly Oration.
The first national Research Seminar is held in Melbourne to look at priorities and methodology in relation to population and morbidity studies; GP research units, clinical trials, evaluation, and community health and operational research are also studied. It is organised by Dr NH Rutledge, the part time Director of Research.
The Faculty of Medicine at the University of Queensland gives high priority to the establishment of a Chair of General Practice. The Queensland Preventive Medicine Committee holds a very successful seminar on family planning.
Tasmania Faculty holds talks with hospitals and government with a view to establishing a 2 year rotating residency period to train GPs.
In Victoria, a Department of Family Medicine is established at the Southern Memorial Hospital with faculty assistance. Its Research and Medical Education committees hold a seminar on GP obstetrics based on the research of Dr M Dunstone in South Australia.
Dr K Cullen receives the Faulding Research Award for the study ‘A Concept of Community Medicine’. Dr M Clarke receives a special award for research on ‘Streptococcal Infections’.
Dr N Andersen receives a Nuffield Travelling Fellowship to investigate research methods in general practice overseas; his destinations include the USA and Great Britain.
After serving as President Elect for 2 years (part of which was spent as Acting President during 1970), Dr M Kent-Hughes is on leave overseas when the turmoil created by the introduction of differential rebates increases in intensity.
15 October: Dr HN Merrington is formally invested as the sixth President of the college.
7 November: A meeting of representatives of the AMA and the four royal colleges in Australia reaches agreement on three points:
- The plans of the college to promote, reinforce and upgrade general practice should not be opposed by the other colleges
- Obstetrics should remain accepted as a valid component of general/family practice
- All should work for a more realistic undergraduate education.
Specialist Recognition Appeal committees are established, on which the college has a seat. The college repeatedly points out that when applicants fail to be recognised as a specialist that this does not automatically qualify them to be GPs.
Postgraduate Fellowships cease in all states due to lack of funds, except in NSW where funding is continued by the state government.
January: The Hornsby Vocational Training Scheme commences with seven junior residents. Under the direction of Dr A Himmelhoch it becomes a pilot study for the college’s vocational training ideas.
A Select Committee of the House of Representatives Inquiry into Pharmaceutical Benefits is set up to enquire into the validity of recent publicity which says that there is wastage and inappropriate prescribing of drugs under the National Health Scheme. The college is able to present, using the research data obtained from the National Morbidity Survey, that one-third of all disease contacts in general practice do not involve a prescription. It also shows that when medicine is prescribed it is done rationally. The college recommends that a prescriber’s journal could give reliable, unbiased information on pharmaceutical advances. As a result, the Australian Prescriber is produced.
The expense of council meetings becomes a concern. A seminar is held, and as a result the size of the council is reduced to the office bearers and one delegate from each faculty. Council will now meet quarterly.
It is recognised by the Combined Education Committee that graduates entering general practice need to be adequately trained and that this training should be properly recognised by vocational registration.
Dr K Kelly, who succeeded Dr Rutledge as Research Director in 1970, carries out a major survey of general practice. It includes the practice, investigations and procedures undertaken. He also conducts a study into the recruitment to general practice of graduates from 1965 from Australian medical schools. The study demonstrates the trend away from general practice, and especially rural practice and solo practice. There was a pursuit of postgraduate qualification, the study showed, not only by aspiring specialists but also by GPs. The study also looks at why doctors chose either general practice or a speciality.
The Faulding Research Award goes to Dr KR Heber for the study ‘Anti-ovulatory Steroids’.
21 May: In Queensland, the first Receptionists Seminar is held. It attracts almost 300 receptionists and is repeated in June. It is planned by the Practice Management Committee.
The Medical Education Committee holds a teaching seminar in September to improve GPs’ teaching skills in teaching medical students and other GPs.
October: Council decides to replace Annals of General Practice with Australian Family Physician (AFP), in keeping with trends in other countries. This new journal will have a different format and be published 10 times per year. Dr WE Fabb is appointed editor; JA Baker continues as managing editor. The first issue is to be produced in February 1972.
Dr FM Farrar’s position is reclassified to Secretary-General.
‘Medical Care in Western Sydney’ and ‘Community Attitudes to General Practice’ are published as research projects by members of the NSW Faculty Research Committee in collaboration with the School of Preventive and Social Medicine in Sydney.
14 December: The Australian Capital Territory Sub-Faculty is officially launched in Canberra, although it does not begin to function until 15 February 1973 with the adoption of the faculty bylaws. Dr D Craigie (Chairman) and Dr G Harris (Secretary/Treasurer) are the officers.
The Research Committee completes three studies: ‘Referral Habits of General Practitioners’, ‘Patient Satisfaction’, and ‘Expectant Fathers in the Labour Ward’.
The Victoria Faculty Research Committee also completes research projects on breast lumps, lignocaine in cardiac infarcts, family planning and factors determining family size, and evaluation of automated multiphasic health testing.
Dr F Johnston is appointed a Postgraduate Fellow in Western Australia. The Medical Education Committee begins the Medical Clinical Societies. The societies are multidisciplinary in composition; medical and medically related social issues are presented and discussed.
Accreditation of family practice teaching posts and hospital posts, as well as programs, begins.
The Mason Inquiry is held into the Schedule of Common Fees. The college submits that a GP consultation is not a stereotyped unit of service, and should be recognised for its complexity. As a result, four grades of consultation length are recognised in the schedule.
The President has fruitful and cooperative meetings with representatives of the Canadian and Singapore colleges.
The Preventive and Community Medicine Committee develops its concept of early childhood care, with regular examinations at 6 weeks, 15–18 months and 8 years of age. It also discusses the role of the GP in educating patients in family planning and human sexuality.
A practice management advisory service, medical record system and the first issue of Practice Management as a supplement to AFP are introduced by the Practice Management Committee.
A new 20 year lease on Bligh House is negotiated with the owners, on the understanding that the college will spend $20 000 on restoration and refurbishing. Roche Pharmaceuticals donates $5000 each year for 4 years for this to be accomplished. In the end, the total cost proves to be some $68 000 more, which the college finances.
5 October Dr JG Radford is inducted as the seventh President of the college at the Academic Session of the 15th Annual General Meeting in Melbourne. On this occasion, The Royal College of General Practitioners, through its President, Dr GI Watson, presents 12 silver medals to the Australian college commemorating two of its founding members: Lord Hunt of Fawley (the first Honorary Secretary) and Dr Fraser Rose. Designated the Rose-Hunt Award, it is to be awarded to any person who has rendered outstanding service in the promotion of the aims and objectives of the college. It can be awarded no more than once per year.
At this convention, the 5th International Meeting of Colleges and Academies of General Practice formally establishes the World Organisation of Family Doctors (WONCA) with Dr MO Kent-Hughes as its inaugural President. Dr DA Game is its inaugural Secretary/Treasurer, a position he will go on to hold until 1980, when he becomes President Elect.
The Practice Management Committee of council, at a meeting in Adelaide, reviews existing records in each state and develops a strategy to create a college health record.
Research continues unabated in all faculties on a wide range of subjects, enabling the college to reinforce its academic credentials.
March: Council decides, after a great deal of debate, that the aims of the AMA and the college are going in different directions. The college decides to disaffiliate with the AMA. Initially, the relationship was amicable but as the college matures, it feels that its affiliation would be more adequately served as an academic body by a closer association with bodies whose objectives are similar to its own. As a result, an invitation is received to join the Joint Advisory Committee of the three royal specialist colleges – the colleges of the physicians, the surgeons, and the obstetricians and gynaecologists. This committee produces, with the AMA, a joint statement known as the ‘Declaration of Singapore’ that is intended to be a guideline to government in any plans it might have for the revision of methods of providing medical services to the Australian people.
There is a period of turmoil in the relationship between the government and the profession. A meeting between the government, the AMA, the college and other bodies representing general practice rejects the government’s plan for its National Health Scheme. Two faculties oppose the rejection, and council does not endorse the rejection. As a result, the President offers his resignation, which the Chairman of Council refuses to accept. Council resolves that it will not be involved in any way in medical politics in the future. Council’s failure to endorse the rejection of the government proposal is portrayed as a betrayal of the profession by the General Practitioners Society of Australia.
The CHECK Program is launched. Developed by Dr WE Fabb, the CHECK program is designed to help GPs improve their clinical knowledge through study and evaluation at home.
The government requests that submissions for grants to be sent to the Hospitals and Health Services Commission, which it has recently established. The college submits 10 studies created by a number of members including Dr RFF Harbison, Dr WE Fabb, Dr GH Puddicombe and Dr FM Farrar; there is also a submission by Mr D Lamacraft, an expert in finance. The government selects study 10 as the most appropriate for its needs. In the study an academy is suggested. The government rejects the academy title; the ‘Family Medicine Program’ is adopted as the name. The government offers $1.1 million to initiate the program. College council has to be encouraged to accept the offer. The initial directors are: training – Dr RFF Harbison (Chairman); education – Dr WE Fabb; and administration – Mr D Lamacraft.
HRH Prince Philip Duke of Edinburgh, President of The Royal College of General Practitioners (PRCGP), gives the occasional oration at the Academic Session of the Annual General Meeting held at the Lakeside Hotel, Canberra. He says that he feels well qualified to be PRCGP because as a father he has the care of the welfare of his family. He makes a strong plea for GPs to continue providing the needed services to their patients. The President later admits Prince Philip to Honorary Fellowship of the college.
Dr J Coates wins the Faulding Research Award for his study ‘Neonatal Hypoglycaemia’.
The prototype for a medical record system for the college is developed and refined.
At an examination seminar in Canberra a behavioural system of rating is adopted to assess knowledge and skills in interpretation, problem solving and manual ability, as well as the attitude in consultation. A new physical examination is introduced. The examination is subsequently modified to include this change, and the long diagnostic interview is replaced by two short diagnostic interviews to more closely replicate the situation in general practice.
Chairs of Community Medicine (General Practice) are established at a number of universities; positions are advertised. The college has been stressing the importance of these departments for some time, and has made formal submissions to the Federal Government over the years. At last its representations are coming to fruition. The college has a number of members who have the research backgrounds and qualifications to fill these chairs.
The Western Australia Faculty moves to new offices at 28 Broadway, Nedlands.
A family practice club is formed by the NSW Faculty to advance undergraduate education for medical students at the University of NSW. It later includes students from the University of Sydney. Pfizer Pty Ltd assists financially. Country general practice attachments continue.
Dr WL Corlis resigns as Postgraduate Fellow.
Training courses in teaching general practice and skills such as family planning, counselling, research and other modalities continue in all faculties.
February: The President attends the first Conference of The New Zealand College of General Practitioners in Christchurch. The New Zealand college had recently been officially established by HRH Prince Philip. Prior to that there had been a New Zealand Council of the Royal College of General Practitioners similar to that in Australia. Thus begins a continuing and harmonious relationship with the New Zealand college.
Also in February, the Family Medicine Program (FMP) begins to take its first trainees. Prior to this the national office appointed national educators and acting state directors, and established a resource centre with a librarian and a video studio to produce educational resources. Equipment was purchased to utilise these resources. This was mainly accomplished by the acting state directors. State directors are appointed in all states and the ACT, together with state educators and ancillary staff. An Assistant State Director is appointed for North Queensland to decentralise the large state. Suitable premises are leased for administrative and teaching accommodation. Area coordinators are appointed as local educators and to undertake supervision closer to the teaching practices. By June 30, there are 238 trainees enrolled. Marysville teacher training courses are instituted for supervisors, educators, area coordinators and other members of the FMP team. As the funding authority, the commonwealth begins to question the college about the way in which funding is being spent. At the same time, the trainees and educators, though full of enthusiasm, are not able define an end point in training to aim at due to funding constraints that the commonwealth government has placed on the program.
The medicopolitical tumult of the previous difficult years subsides. President JG Radford writes, ‘The College’s decision to remain as an academic body had been a wise one and kept us out of arguments regarding the proposed Medibank. The Family Medicine Program progressed. We continued to work with our sister Colleges on the Joint Advisory Committee in areas concerning standards of health care’.
Council resolves that Fellowship of the college will be awarded to candidates who are successful at the college examination. All those who who achieved MRACGP (Membership) through passing the examination are upgraded to FRACGP (Fellowship).
By this time, departments of community medicine/practice have been established in all universities. College council, which has been stressing for some time the importance of these departments, is concerned about the nature of them. The college meets with Dr D Everingham, Minister for Health, to express its concerns. By the end of the year seven of the nine medical schools appoint chairs.
April: The Practice Management Committee, after developing a prototype health record for GPs, submits it to a joint seminar with the Hospitals and Health Services Commission in Canberra. It is revised following this seminar and subsequently published as the RACGP Health Record.
The Accreditation Committee becomes a standing committee of council. Difficulties are identified in the development of criteria for the accreditation of teaching positions not only in hospitals, but more importantly and with more difficulty in family practice teaching posts. Many of these difficulties are resolved at the upcoming July seminar.
July: A seminar in Sydney with wide ranging representation from faculties, standing committees and the FMP reviews the concepts and policies of vocational training for family practice, college assessment and periodic re-assessment, and the basic training program training in behavioural skills. It draws up a list of recommendations that are never fully implemented.
The college examination undergoes further changes. It is modified by the deletion of the case conference. Alternate segments are introduced, with a choice between case commentaries and an essay. Changes in the format of the practical examination take place. Assessment of competence is introduced.
3 October: Dr David Game is invested as the 8 th President of the college on at the Academic Session of the 17 th Annual General Meeting in Adelaide. Sir Mark Oliphant is the WA Conolly Orator.
The first Rose-Hunt Award is presented to Dr WA Conolly, the founding President of the college.
The Faulding Research Award goes to Dr RE Coolican for his study ‘Morbidity in an Australian Rural Practice’.
Council adopts a policy in respect to financing with monies received from government; it also develops a policy on community health centres.
Research in the faculties during this time includes, in NSW, ‘Infectious Hepatitis in Western Sydney’; in Queensland, ‘Workload of General Practitioners’ and ‘X-Ray Work of General Practitioners’; in Tasmania, ‘Asthma and Allergy’ and ‘Problem Family’; and in Victoria, ‘Urinary Diseases’.
January: The Ballarat Sub-Faculty holds its inaugural meeting. It has been planned since early 1974 with Victoria Faculty support.
February: The first scientific joint meeting with the Royal Australasian College of Physicians is held. The theme is ‘Care of the Cancer Patient’.
March: Council adopts a policy on continuing education and recertification that is relayed to the Joint Advisory Committee.
In the same month, council approves of the launching of a pilot study of the college medical record system. The study proves the worth of the system.
Also in March, council resolves that the Fellowship can be obtained by assessment as an alternative to the formal examination.
The President becomes Chairman of the Joint Advisory Committee; the college also holds the secretariat of the Committee.
The Western Australia Faculty holds a joint meeting with the nursing profession. The faculty supports the concept of further education for nurses but does not support the concept of an independently functioning nurse practitioner.
April: The Australian Government sends an official MedicalDelegation to China in April at the invitation of the Chinese Government. Our President is part of that delegation.He is the only practising medical practitioner and the only nongovernment representative in the delegation.
Also in April, Dr JRH Watson becomes the last President Elect to be elected by council. After his election, the regulations change. The term of the President Elect is shortened, and their election will now be determined by a vote of the whole membership.
July: Dr DA Game, the President, represents the college at the Jubilee Meeting of the South African Medical Association; he also attends a regional meeting of WONCA. The President has been the Secretary/Treasurer of WONCA since its inception and continues in these roles until he becomes WONCA President in 1983.
The FMP submits a budget for $7.125 million, which the commonwealth reduces to $5.5 million. This is regarded as discriminatory, as the Women’s Re-orientation Program is cut by more the 60%, yet the whole program is only cut by 23.5%. The council records that this constitutes excessive control of the program by the government. In this year, although trainees are increasing at a brisk rate, council is concerned that there has been no evaluation of their progress. The program is said to have educational expertise second to none in Australia. Already trainees are beginning to make an impact, although self directed learning without the advantage of a curriculum or learning plan creates some problems. The college addresses this issue.
16 July: The Illawarra Sub Faculty of the NSW Faculty is inaugurated.
Also in July, council accepts an official request from the Hong Kong Medical Association to assist in the establishment of a Hong Kong college of GPs. In December, the President and Dr RFF Harbison visit Hong Kong to assist.
August: ‘Convention ‘75’ is held at the Kuringai College of Advanced Education, Lindfield. The RACGP is host for the second Combined Meeting of the Colleges of General Practitioners of Australia, Singapore, Malaysia and New Zealand. A regional WONCA meeting and a Combined Council Meeting of the four colleges are held. As a result, considerable cooperation develops between the four colleges.
October: The Annual General Meeting is held in Perth for the first time.
Dr MO Kent-Hughes is presented with the second Rose-Hunt Award.
The FMP continues to expand and consolidate nationally and in the states. Mr D Lamacraft resigns and Mr G Howard is appointed as Business Manager.
The Victorian Academy of General Practice Ltd is established with funds provided by the Victorian Government on the recommendation of Dr E Wilder, the Director General of Health. Its board of management is comprised mainly of members of the Victoria Faculty Board. It operates as a distinct educational entity separate from the faculty.
Also in October, council accepts an offer by Beecham Research Laboratories to print and distribute an Australian version of the Manual of General Practice that has been developed from the New Zealand version.
January: DrMO Kent-Hughes dies. Council decides to recognise his contribution to the college and to general practice in general by establishing the MO Kent-Hughes Memorial Medal. It is to be awarded to the candidate with the highest mark in the college examination each year.
Also in January, Mrs ML Watson presents a gift to the college to have a visiting professor from overseas visit each faculty. Dr Donald Irvine, Honorary Treasurer of the RCGP, is the first college Visiting Professor.
March: The President Elect travels to the United Kingdom to hold discussions with the RCGP, and to observe its organisation and training program, because the Australian college is based on its structure.
The Commonwealth Auditor General raises several areas of concern, including whether the college is obtaining financial advantage from the FMP, using program resources improperly, and whether the National Coordinator of Educational Resources has been travelling excessively or travelling overseas. The program has been offset by an amount to cover the salaries of the directors while they travel overseas. The council refuses a request for the department to review the program and instead proposes an internal review of its own. There is a nationwide review of the FMP by the Chairman and Deputy Chairman of council because of the various tensions that have been arising within the college, and which have been exacerbated by the adaptation to the existence of the FMP. These have been dividing council as well as the college. Drs Jackson and Shaw recommend the appointment of a Board of Management to oversee the program. This leads to the resignation of Dr RFF Harbison as Chairman in August. Up until this time, the FMP, in addition to concentrating on trainees and their needs, has been supportive of Australian Medical Students Association. However, when it receives independent funding, the National Trainees Association is born and becomes a critical force in the program. An Interim Board of Management is appointed.
May: The college puts forward to the AMA and the Joint Advisory Committee a proposal that general practice should be recognised as a special discipline in medicine. This had been previously adopted as a policy document by council. At the same time it adopts a policy on honorary awards and appoints an Awards Committee.
August: Council adopts the proposition of electives by resolving that the ‘college should recognise the acquisition of special skills in elective areas and that such recognition should be given after appropriate training and assessment’.
On the 25 August, Dr JRH Watson is inducted as President at the Academic Session of the 19 th Annual General Meeting in Brisbane.
Dr K Fitch receives the Faulding Research Award for the study ‘Effect of Exercise on Asthma’.
Overseas visitors to the Queensland Faculty during this time include Professor PS Byrne of Manchester and Professor G Irwin of Belfast, both of whom are Professors of General Practice.
In Tasmania, a Clinical Research Unit is attached to the Bridgewater Health Centre.
Upon the death of a Foundation Member and former Provost of the Western Australia Faculty, the faculty sets up the Alfred Nailor Jacobs Prize in his memory. This gold medal is to be presented to the medical student submitting the best commentary concerning his or her attachment as a medical student to a general practice.
November: Australian Family Physician is rated as the top medical journal in Australia for overall readability and believability, educational value and relevance for the second year in a row. It is internationally recognised by being admitted to the Index Medicus.
Dr D Irvine of Ashington, Northumberland, becomes the college’s first Visiting Professor, visiting all faculties where meetings are held on training and education for general practice.
February: The college and the AMA participate in an investigation of the concept of peer review.
March: The President has a massive heart attack, which eventually requires open heart surgery. Dr DA Game, the immediate past President, becomes Acting President for the next 5 months.
The question of whether the faculties should have block grants to run the FMP or autonomy in running the program is defeated. Dr GRO Walpole is appointed as Chairman of the Program. At the next meeting of council, he resigns due to conflict with his appointment as Director of the Victorian Academy of General Practice. The Director of Education sets out educational policies for trainees. These include a syllabus, curriculum, educational principles and orientation activities. Evaluation of the program is also forecast. In the meantime, trainees are being attracted to the program and are gaining experience through their attachments to general practice; however often suitable hospital appointments relevant to general practice are more difficult to come by.
The Manual of General Practice, which has been heavily revised and rewritten for Australian practice by an editorial committee under the leadership of Dr E Gawthorn, is published.
5 May: After an initial meeting in February, the Newcastle/Hunter Valley Sub-Faculty is constituted. From its inauguration it is very active, with close ties to the new medical school in Newcastle.
The NSW Faculty Medical Education Committee continues to run the courses on human sexuality and human relationships that it began in 1976.
The NSW Faculty Research Committee completes two projects: ‘Emotional Illness and its Management in General Practice’ and ‘General Practitioners in Three Regions of NSW’, an analysis of services and attitudes undertaken by Drs A Chancellor and N Andersen.
A general practice club for medical students begins in Queensland. The club aims to stimulate participants’ interest in general practice through clinical discussion.
Victoria Faculty offices move to Trawalla, a nineteenth century mansion in Toorak purchased by the Victorian Government to house GP activities. It is a magnificent building. In addition to the faculty, it houses the Victorian Office of FMP, the Victorian Academy of General Practice and the Victorian Postgraduate Medical Foundation, all under one roof and in close proximity to each other. It is a unique venture and a hive of activity in education and training for general practice.
Western Australia conducts the first Australian Conference on the Family and Health, with the theme ‘The Changing Family Who Cares’, under the auspices of its Preventive and Community Committee. There are over 450 participants.
Dr PF Gill receives the Faulding Research Award for the study ‘Effect of Cadmium on Factory workers’.
Dr RFF Harbison receives the Rose-Hunt Award.
The first recorded convocation of the college is held at the Annual General Meeting in Hobart. It deals with the delineation of privileges in hospitals and the use of GP beds.
The Practice Management Committee initiates the marketing of the college record system. The council agrees, subject to its supervision by the Business Manager. It evaluates the record system. It publishes handbooks for the record system, receptionists and practice management. It also commissions a study into the role of computers in private general practice.
Dr RN Braun, a GP from Brunn an der Wild in Austria, becomes the college’s second Visiting Professor. Dr Braun has written extensively on diagnostic systems that he has developed. His is a most interesting method of classifying illness in the unorganised state in which it is often presented to the GP.
Dr WD Jackson becomes the first President Elect to be elected by a ballot of all members and to serve a shortened term of 6 months.
Dr FM Farrar resigns as Secretary-General.
The college commissions an organisational review from PA Management Consultants. Council decides at its meeting in March to proceed in an evolutionary manner to implement the recommendations in the report. A Finance Department is to be established under the control of a Finance Officer. The existing management structure of FMP will remain in place and be reviewed in 12 months in light of the recommendations for reorganisation contained in the consultants’ report.
May–July: Meetings of the medical educators in May and the state directors in June pass resolutions of no confidence in the Business Manager and in the Board of Management. Council, after condemning the behaviour of the medical educators, dismisses the Board of Management and the Business Manager at its July meeting. It places the FMP under the control of the Director of Education. In June, The Medical Education Committee convenes a meeting of medical educators. Representatives from medical education committees, university departments of general practice/community medicine, the FMP and the Victorian Academy of General Practice attend. Areas of commonality in education for general practice are explored.
Council sets up a Manpower Working Party consisting of members of the Research Committee and Medical Education Committee to produce a framework for manpower planning.
The Practice Management Committee organises the first Computer Conference to disseminate knowledge about the use of computers in general practice. It is held in Jolimont at the FMP National Office.
NSW Faculty holds the first medical receptionist seminar to try and improve practice managemant skills. The Newcastle and Hunter Valley Sub-Faculty is formally launched at a special dinner to celebrate the occasion.
Queensland Faculty holds a seminar on ‘Caring for Sick Children’ and continues with its Gold Coast and Sunshine Coast educational weekends.
Tasmania Faculty purchases Cliefden, a beautiful old neo-Georgian stone house in New Town to house its faculty and FMP offices.
Western Australia Faculty organises a successful ‘Illegal Drug Abuse Conference’ through its Preventive and Community Medicine Committee.
Victoria Faculty publishes the results of the first phase of the medical manpower study in Victoria in conjunction with Monash University.
Dr PWH Grieve is appointed as the college’s second Secretary-General.
25 October: Dr WD Jackson is installed as the tenth President in Sydney The William Arnold Conolly Orator is Sir Edward Hughes, whose subject is ‘Teaching Surgery’.
Dr HM Saxby receives the Rose-Hunt Award.
Dr JR Coates receives the Faulding Research Award for the study ‘1000 Successive Live Birth Labours’.
The Medical Education Committee sets up a sub-committee on rural practice. It recommends that a national conference be held to address the issue of rural practice. The conference, entitled ‘Country Towns, Country Doctors’, draws together doctors, health personnel and citizens from all over Australia. It embraces all communities, including indigenous participants. Although an initiative of the Medical Education Committee, it is executed with the cooperation and organisational help of the Victoria Faculty and the Victorian Academy of General Practice. The conference produces many useful recommendations and working parties as well as the report ‘ Rural Doctors’. The NSW Faculty presents a plan for rural registrar posts in country base hospitals.
A Presidential Working Party is formed to delineate future health care in Australia. Although a large amount of work goes into a briefing paper, it is not submitted to government.
The Joint Diploma in Obstetrics and Gynaecology is initiated with The Royal Australian College of Obstetrics and Gynaecology.
Rural registrar posts are made available in four NSW hospitals – Lismore, Dubbo, Orange and Wagga Wagga.
The NSW Postgraduate Fellow, Dr Neville Babbage, and the Chairman of MECC New South Wales, Dr Elizabeth Jane, attract funding from the NSW Health Department.
April: Cliefden is officially opened by the President as the headquarters of the Tasmania Faculty.
May: The President, in company with other members of council, is presentat the inaugural meeting of The Hong Kong College of General Practitioners.
Electives are designed for geriatrics and rehabilitation to be added to the existing electives for rural medicine and sports medicine.
The Medical Education Committee conducts a survey of members to ascertain what they want from the college. Council uses the findings to determine its priorities in planning.
Dr NA Andersen presents a summary of present state and future needs to the Research Committee. The development of the General Practice and Primary Care Research Unit is endorsed by council.
Council adopts a computer policy, outlining the college’s use of computers in financial and business applications, and their advantages in improving record management, and by extension, patient care.
The Family Medicine Program begins its evaluation. A Departmental Review is undertaken by the government to see if training for general practice is really necessary and who should fund it. This review is supposed to extend over the next 2 years. However, there is, even at this stage, evidence that training for general practice is beginning to have an impact. Special skills training posts are planned.
The Medical Organisation Committee is revived to give some relevance to the political input of the college. The NSW Faculty established one in the previous year because Mr Justice Macken had ruled that the college Fellowship was equivalent to other specialist qualifications in regards to the terms and conditions for public hospital appointments. The college is keen to set standards for general practice.
September: The Joint Colleges Conference in Manila enables the President and other representatives of the college to have fruitful exchanges with other regional colleges.
The WA Conolly Oration at the Annual General Meeting in Melbourne is given by Senator P Baume. It is entitled ‘ Liberty, Licence and Public Policy’.
Dr J Leavesly receives the Faulding Research Award for ‘A Study of Vasectomised Men and their Wives”.
October: The Telemed program is launched in Victoria in conjunction with, and with the cooperation of, Telecom. The program enables people to dial up and get a prerecorded message on subjects such as ‘Venereal Disease’ and ‘How to give up smoking’.
The rural training registrars posts, created in 1978, are no longer available. Similarly specialist skills training posts are not blossoming because specialists and hospitals are not just apathetic to the proposition – they are actually quite opposed to it.
The Formative Evaluation of the Family Medicine Program is published. This leads to individual trainee assessment and learning contracts with specific learning goals.
Scope for General Practice and Training for General Practice are produced in conjunction with the Medical Education Committee.
The Departmental Review continues into the FMP – diverting resources that would be better used to get on with the training of our future GPs.
The retraining program for practitioners who have been out of the workforce for some time proves valuable, particularly for women doctors.
Progressive trainee assessment begins; by 1983 it will have become an essential part of the program.
The Manpower Working Party proves productive.
The second Manual of General Practice is launched. C HECK goes international.Medical Records expand and Quality Assurance (QA) gains acceptance. Pilot programs for QA are initiated in NSW.
Dr I Tait of Aldeburgh, Suffolk, is the Visiting Professor. His particular interest is medical records. He stresses the importance of having a strong general practice training network as a basis for teaching general practice.
The Practice Management Committee releases the first edition of Computer Systems for General Practice.
12 August: Dr KW Shaw is inducted as the 11th President in Adelaide. Justice K Murray delivers the WA Conolly Oration, which is entitled ‘Divorce – the Untreated Cancer’. Dr DA Game receives the Rose-Hunt Award at the same meeting.
Dr J Murtagh receives the Faulding Research Award for the study ‘The Anatomy of a Rural Practice’.
Falling practice workloads, the increasing costs of taking a trainee and the failure of the government to increase funding lead to the possibility of the Training Practice Network collapsing. This is despite the Departmental Review being supportive of the FMP. This leads to another external review of the program, this time by Dr K Jones and Dr S Sax. This review finds that there needs to be a wider evaluation of vocational training for general practice, although it is supportive of the view that vocational training is necessary. A system of individual trainee assessment is initiated and developed. The net result is that funding for the program is made contingent upon another external review. In December, the Minister for Health appoints Dr T Hurley and Dr CJ Cummins to conduct a comprehensive review of the program. The terms of the review make it clear that future funding cannot be taken for granted. This review takes up a great deal of the program’s time, energy and resources. In South Australia, a specific stream of training for rural practice is initiated.
The Practice Management Committee develops and publishes Computerised Medical Record Systems – Proposed Minimum Standards.
A Joint Consultative Committee with the Royal Australian College of Obstetricians and Gynaecologists results in the creation of a Joint Diploma in Obstetrics.
The NSW Faculty establishes local learning groups (or GP forums) to promote continuing education in a decentralised way. This is an initiative of the NSW Postgraduate Fellow, Dr Neville Babbage, and the Chairman of the MEC NSW, Dr Elizabeth Jane.
The Newcastle and Hunter Valley Sub-Faculty conducts the Annual General Meeting in Newcastle. Professor David Maddison gives the WA Conolly Oration, entitled ‘Is Medicine an Academic Discipline?’
Dr HS Patterson is awarded the Rose Hunt Medal.
The Faulding Research Award goes to Dr R Beran for the study ‘Epilepsy – An Exercise in Needs Analysis.’
Council, at its first meeting after the AGM, introduces a 4 year term for any college office, with the exception of President, which is a 2 year term. This is to bring all offices into line with faculty representatives on council who have terms of 2 years with an option of a further 2 years.
The FMP had to turn to council for a good deal of support during the Hurley-Cummins review. This was forthcoming, although the previous autonomy of the program came in for a significant reassessment. Proposals for restructuring the program are developed and submitted to the Department of Health; they are largely adopted. Learning contracts are introduced; to formalise the end point of training, a Certificate of Satisfactory Completion of Training is introduced. Because council had been criticised during the Hurley-Cummins Review for inadequate supervision of the FMP, at the first meeting of the 25 th council it sets up the Family Medicine Committee of Council to advise on the FMP. There are no further government inquiries into the program. The grant has been held up until this time but is approved by the government 3 weeks later.
The General Practice and Primary Care Research Unit conducts a study on infant care in western Sydney; at the same time, it advises on an intervention to increase the detection of hypertension in general practice.
Dr RL Perkin of Toronto is the guest Visiting Professor and enlightens on the assessment processes in use by The Canadian Academy of Family Physicians.
18 October: Dr RT Finch is installed as the 12 th President of the college at the Annual General Meeting in Brisbane.
Dr HS Patterson gives the WA Conolly Oration, entitled ‘Handing on the Torch’.
Dr P Mudge is given the Faulding Research Award for the study ‘Clinical and Epidemiological Features of Epidemic Polyarthritis in Australia’. A second award is given to Dr GA Puris for ‘An Appraisal of Acupuncture in General Practice over 20 Months’.
Bachelor of Education units in medical education are formalised between Victoria Faculty and Latrobe University to promote teaching skills suitable for vocational training. The faculty also holds a 12 week training course for medical receptionists.
The Rose-Hunt Medal is not awarded for the first year since its inception.The Joint Diploma in Obstetrics and Gynaecology is initiated with The Royal Australian College of Obstetrics and Gynaecology after a period of negotiation lasting 2 years.
January: The Government of Bahrain requests assistance in the training of GPs. After complex negotiations regarding the payment of the trainers, Dr WE Fabb and Dr G Papworth are sent to assess the situation. Dr Papworth is then seconded for 2 years to undertake GP training there.
In the same month, planning begins for a research foundation, which is eventually established.
The President begins exploratory talks on developing an Aboriginal health package, which is taken up by all faculties. In other areas such as anaesthetics, paediatrics, obstetrics and geriatrics, joint discussions are held with other colleges. With the exception of obstetrics, GPs tend to be marginalised by other interested parties.
Convocation expresses concern at the diminishing hospital access of GPs. As a result a research project is set up to look at the problem – in particular the problem of urban GPs who are being pushed out of community hospitals. Although a Rural Health Elective Subcommittee is established and recommends special training in anaesthetics, obstetrics, and surgery, training posts prove difficult to obtain.
The Research Committee produces a series of research articles for AFP that are later incorporated into a handbook, Introduction into General Practice Research. It also recommends the establishment of an ethics committee.
A Workforce Working Party continues its research into workforce issues, placing the college at the forefront of the workforce debate.
The General Practice and Primary Care Research Unit conducts research into the sleep patterns of the elderly and their use of medication.
Work begins on the research project ‘Long Term Use and Prescribing of Psychotropic Drugs’.
The Preventive and Community Medicine Committee produces the handbooks Alternative Medicine and Home Safeguards for the Elderly. Advice on how to be Healthy is also published, and is used with a health promotion program that is taken up by many GPs. Other campaigns, such as a campaign to stop smoking and another to promote random breath testing, are instigated.
The Practice Management Committee conducts an inter-practice comparison survey in Victoria. It proves to be the forerunner of a very successful survey that runs for many years, giving valuable insight into the conduct of practices and their economic viability.
The Medical Organising Committee puts a lot of work into correcting misconceptions about fraud and overservicing, as well as addressing the problem of reduced hospital access for GPs.
The Queensland Faculty Headquarters is opened by the Minister for Health.
Dr D Game is elected as President of WONCA.
Dr PW Gill receives the Rose-Hunt Award.
The Faulding Awards are given to Dr RHS Gibbs for the study ‘Community Based Cardiac Rehabilitation Program’ and Dr ID Steven for ‘Methods of General Practice Assessment’. The WA Conolly Orator is Sir Ninian Steven, whose speech is entitled ‘A Layman’s Encounter with Plague and other Things’.
Talks held in Townsville about the formation of sub-faculties.
March: The President is informed from a reliable source that the FMP has been removed from the list of organisations to receive funding assistance from the government. There follows a period of intense lobbying, including a meeting with the Minister for Health, Dr N Blewett, who convinces Cabinet to restore funding for the program. The incident ensures that council becomes more involved in the management of the program. As a result, the commonwealth increases the funding by $1.1 million to $6.65 million. A joint meeting of the FMP and the Professors of General Practice is held in Perth.The National Trainees Association produces its hospital checklist to assist trainees in planning their hospital term goals.
May: The President and other members of the executive meet with the National Disaster Organisation in Canberra to discuss the role that GPs could play in the event of a national disaster.
More talks, this time in Darwin, are held about forming sub-faculties.
A submission to the Inquiry into Rights of Private Practice in Public Hospitals argues that there should be no change to GPs’ already limited rights of private practice in public hospitals.
The Research Unit begins studies on patients using benzodiazepines and antidepressants. It also conducts an unusual study on self care in patients who present with minor complaints.
In Western Australia the Faculty Preventive and Community Medicine Committee develops an Aboriginal Health Draft Policy Document.
The Practice Management Committee puts out three publications: The Organisation of General Practices, Handbook of Computers in General Practice and Design of Doctors Surgeries. It establishes the Telecommunications Advisory Group to advise on the evolving use of telecommunications and the Services Division to promote and market college services.
The fourth Computer Conference is held.
The Victoria Faculty produces What’s Wrong, a booklet on children’s illnesses, and another publication entitled The General Practitioner and Hospital Services.
West Australian Faculty establishes the Alan Barr Memorial Library of audiovisual material.
The college makes a submission to the Inquiry into the Rights of Private Practice in Public Hospitals, arguing that there should be no further restriction of GPs’ rights.
5 September: At the 27 th Annual General Meeting in Perth, Dr RT Finch invests Dr DP Finnegan as the 13th President of the College. The WA Conolly Oration is delivered by the Most Reverend Dr P Carnley, and is entitled ‘Miracles, Morals and Medicine’. There is again no award of the Rose-Hunt Medal; there is also no awarding of the Faulding Prize.
18 October: The North Queensland Sub-Faculty is formed.
College representatives meet with the Committee of Medical Fraud and Overservicing to help convince it that the problem is an uncritical examination of computer generated information. Later the college meets with the Medical Benefits Review Committee but are unable to persuade it to establish a work value study to find an alternative means of remuneration for the work done in general practice.
Peter Grieve, the college’s second Secretary-General, dies in office. The Honorary Secretary Dr AE Fisher acts in the role until the following year. Frank Farrar, the former Secretary-General, also dies.
Two medical educators were seconded to other organisations in the the previous 2 years. In 1985, the Commonwealth Director of Health expresses concern that in these circumstances the FMP requires more staff. He points out that more than 50% of the budget goes on administration instead of practices to train trainees. Council decides to retrench executive staff and their support staff to make more money available to the states for training practices and trainees. It makes the Manager of Finance and Administration the General Manager of the program. The first certificates for the Satisfactory Completion of Training are issued. A post of Trainee Research and Development Officer is created, enabling a trainee in their senior year to undertake such work.
Dr P Grantham, from Vancouver, is the Visiting Professor and induces a stimulus in the fields of public relations, sexual counselling and adolescent medicine.
A submission to the Joint Committee of Public Accounts recommends that the establishment and maintenance of high standards of performance and conduct in general practice can be achieved through:
- Mandatory vocational training for unsupervised general practice
- Mandatory vocational registration for unsupervised general practice
- A system of quality assurance based on peer review and continuing medical education.
The Accreditation Committee makes a decision to accredit individual disciplines within hospitals rather than accrediting the hospital as a whole. This increases the standard of training. It also agrees with the FMP on the criteria for the implementation of a GP mentor scheme.
The Research Committee takes over the Chairmanship of the Workforce Sub-Committee of the Combined Education Committee of the Clinical Colleges. It begins a new sleep study that looks at the relationship of sleep apnoea to dementia in the elderly.
The Preventive and Community Health Committee makes a submission on behalf of the college to the Better Health Commission. The submission includes the GP advocacy of a health promotion kit and emphasis on the general practice role in the care of children, the elderly, and drug and alcohol problems, as well as other aspects of the GP’s care.
The college also makes a submission to the Joint Committee on Public Accounts concerning maintaining high standards of professional performance through mandatory vocational registration for unsupervised general practice and a system of quality assurance based on peer review and continuing medical education.
The college publishes a survey conducted through the Practice Management Committee, Vision of General Practice in 1995, which looks at the future of general practice from many points of view.
The Communications Committee of Council is formed.
Dr F Mitchell, Provost of the Tasmania Faculty, writes these prophetic words his annual report: ‘If general practice is to survive as a fundamental part of our health system we have to be seen as being legitimately the authority on matters of health in the community. Make no mistake, this is being eroded on all sides by health bureaucracy, the paramedical profession, pharmacists, other specialties, academics, hospitals and practitioners of alternative medicine’.
Council accepts a recommendation of Convocation that all trainees in the FMP be able to apply for associate membership.
The Rose-Hunt Medal is awarded to Dr PWH Grieve.
Dr HS Patterson is awarded the second Life Fellowship of the college.
The WA Conolly Oration is delivered in Melbourne by Dr Bryan Gandevia. It is entitled ‘Medicine in Australia – the Poet’s View’. The WONCA Regional Meeting is held in conjunction with the Annual Scientific Convention. The joint event has the theme ‘Challenge ‘85’, and looks at the challenges facing GPs as they approach the year 2000. There is no Faulding Award.
April: Dr K Kinder is appointed the third Secretary-General of the college.
The FMP introduces distance learning for trainees through AUSSAT. This Clinical Home Evaluation of Knowledge Using the Phone goes by the acronym CHECKUP. The program also contributes to the college’s submission to the Inquiry into Medical Education and Medical Workforce. The function of the Family Medicine Program Committee of Council changes from an advisory role to a policy making and management role on behalf of council. The Australian Health Services Council Working Party on the Family Medicine Program recommends that the college set up a working party to examine the implications of mandatory training for general practice and submit a report to the Doherty Inquiry on medical education and medical workforce.
The college’s submission to the Better Health Commission recommends positive actions for GPs to become involved in health promotion. They include a health promotion kit developed by the NSW Faculty, and a central role for GPs in aged care, child care (including a patient held childhood health care record), and drug and alcohol prevention services. Other recommendations include periodic health examinations; community and domiciliary physiotherapy for the aged; meeting the accommodation needs of psychiatric and psychogeriatric patients; and a multidisciplinary team approach to health promotion programs.
The college also makes a submission to the Australian Health Services Council Working Party. It states that the college is in favour of vocational training for all disciplines, and that RACGP training is appropriate. The requirement to satisfactorily complete training is a prerequisite to achieve adequate standards of practice. The submission concedes that ideally such training should be mandatory. That state departments of health examine ways that educational facilities and resources could be increased for trainees and and GPs.
When preparing the previous budget, the college overestimated the increase in membership that would occur from granting associateship to trainees. Consequently, during the year it has to realise on its investments to balance the budget. Plans for the Medical Education Committee to play a greater and more professional role in continuing education in the college have to be put on hold.
The Accreditation Committee introduces the concept of provisional accreditation. This allows a supervisor and practice to be provisionally accredited to take trainees for two terms. The practice can then apply for full accreditation.
The Research Committee publishes an audit of GPs performing colonoscopies.
The Practice Management Committee carries out the second Inter-practice Comparison Survey. It shows that 22% of practices were nonviable. A Practice Management Advisory Service is established; council also sets up a Quality Care Committee to promote care in general practice. The Computer Committee is also established.
During the WONCA meeting in London, a college delegation holds discussions with the Medical Defence Union (UK) with a view to having a reduced rate for GPs. (A reduced rate would be granted in 1989.)
To promote quality care, the Quality Assurance Committee is established to formalise quality assurance programs.
Early in 1986, the NSW Faculty moves from Bligh House to a property in St Leonards that it leases with the state office of the FMP. The move brings them together for the first time and synergises the activities of the college in NSW.
The Tasmania Faculty institutes a breast check booth at the annual show to promote awareness of the need for screening; it also promotes the need for males 15–35 years of age to check their testes for lumps regularly. It produces a booklet, This is your College, which is distributed nationally.
Victoria Faculty forms an advisory panel to assist with coronial inquiries. It also institutes a community medicine prize for the top student in Community Medicine at the University of Melbourne.
20 October: Dr DP Finnegan installs Dr AE Fisher as the 14th President of the college in Adelaide.
Mrs Katherine West is the WA Conolly Orator. Her speech is entitled ‘General Practice – New Threats and Opportunities’.
Dr BS Alderson is awarded the Rose-Hunt Medal.
The Faulding Award is given to both Dr L Piterman for the study ‘Industrial Lower Injuries in Primary Care – A Five Year Retrospective Study’ and to Dr IL Rowe for ‘Doctor and Patient Evaluation of Automated Testing at the Shepherd Foundation’.
It becomes apparent to the Executive that the college is headed for a financial crisis due to an error in budget planning. The Executive intervenes and institutes cost cutting measures; it also realises on college investments to improve cash flow. This is fortuitous in view of the stock market situation in 1987. Having survived the crisis, the college adopts a policy of setting aside money for a building fund and maintaining an operational reserve.
Council institutes a Quality Care Campaign, with the President writing to all members personally and informing them that they would be required to undertake a number of quality assurance options between May 1987 and April 1989 to maintain their membership of the college. It is not supported by all faculties initially.
The Committee of Presidents of Clinical Colleges is formed, replacing the much smaller Joint Advisory Committee of the RACP, RACS, RACOG and RACGP. This means that the college’s voice is diminished from one voice in four to one voice in seventeen. Its influence in the decision making process is thereby lessened.
Early in 1987 Professor S Abrahamson, Associate Dean of Medical Education at the University of Southern California, reviews the FMP at the request of council. He makes eight recommendations to improve the program, all of which are put in place. The most important of the recommendations is that the FRACGP be the end point of training. The Executive takes over the executive role of the Family Medicine Committee of council by consulting with it together representatives of trainees and the Medical Education Committee.
May: The fifth Computer Conference is held in Melbourne. The first Computer Fellow is appointed. He works on the Monash University Computer Project and acts as a computer resource person for members of the college.The Inter-practice Comparison Study shows that 22% of general practices are nonviable. A working party is set up with other organisations such as the AMA to look into the problem.
Quality Assurance begins an evolutionary development. It begins with the accreditation of Quality Assurance options such as teaching medical students, completing CHECK Programs, doing research, and attending educational activities. At the same time a Quality Care program is publicised to enunciate the quality of care in general practice.
In the period between 1986 and 1988, the college holds the secretariat of the Joint Advisory Committee of the colleges of physicians, surgeons, obstetricians and gynaecologists, and general practitioners. The college President chairs these meetings. They are particularly helpful in clarifying common issues such as workforce, educational, and nursing issues; the reorganisation of the AMA; the accreditation of hospitals; gaining support for general practice; and submissions to the Doherty Inquiry into education and the medical workforce and education. The Joint Advisory Committee then meets with the AMA as a Conjoint Conference to put the clinical colleges’ view to the AMA. With the formation of the Committee of Presidents, it is decided, after a period of time, that the Joint Advisory Committee no longer needs to meet. The President questions the value of the Committee of Presidents to the college. Until the formation of this committee, the college had been in discussions with only three colleges and its views were respected. With the formation of the Committee of Presidents, sixteen colleges are now represented. An Education Sub-Committee is formed by the Committee of Presidents in which the college is not included, despite the fact that, through the FMP, it has more educational expertise than any other college.
The college makes a submission to the Inquiry into the Medical Workforce and Medical Education (the Doherty Inquiry). It makes a total of 63 recommendations regarding the undergraduate curriculum, vocational training, vocational registration, mandatory training for unsupervised general practice, recognition by the National Academic Specialist Qualifications Advisory Committee (NASQAC) of the FRACGP as an appropriate qualification for the specialty of general practice, appropriate training for rural general practice and workforce issues relating to general practice. This submission is primarily the work of the Medical Education Committee Working Party. The college receives a poor hearing from the committee, which contains no GPs and five physicians as the only medical members.
The censors introduce two major examination initiatives. The introduction of computerised diagnostic problems and the provision of detailed feedback to candidates on their performance in the examination improves the quality of the examination. The ninth conjoint examination with the Malaysian college coincides with the first conjoint examination with the Hong Kong college. Council also decides that any overseas candidate who is a member of the GP college in their own country can sit a conjoint examination in their own country. All trainees have undergone formative assessment but, with the adoption of Abrahamson report, are now required to undertake summative assessment.
The Combined Education Committee of the clinical colleges disbands and its function is taken over by the Committee of Presidents. This is disadvantageous to the RACGP because it takes away the interchange between the educators of the clinical colleges.
Council delegates the Research Committee to take responsibility for the future direction of research in the FMP. A part time director of research is appointed to oversee the program and to report to council through the Research Committee. The director of the research unit supervises three GPs doing research into the management of obesity in general practice.
A national medical computing newsletter is set up by the Practice Management Committee to update members on medical computing. It publishes Computers as Medical Tools.
The Office Pathology Committee is set up to promote the practice of office pathology to enhance the care of patients.
The Rose Hunt medal is awarded to Dr WL Corlis. Life Fellowships are conferred on Drs CW Anderson and HE Ferguson.
The Faulding Award goes to Dr L Kennedy for the study ‘Genital Epithelial Carcinoma as a Sexually Transmitted Disease: A case for current male screening and treatment’.
The WA Conolly Oration is delivered by Prof S Leeder. It is entitled ‘The Estimation and Modification of Risk in General Practice’.
The Regional WONCA Conference in Hong Kong follows immediately after the college’s Annual General Meeting. At the meeting of the Hong Kong college, the President confers the first conjoint diplomata on members of the Hong Kong college who have passed the conjoint examination. After the Hong Kong meeting the President, with members of council, visits Beijing and holds meetings with the Chinese Medical Association.
The NSW Faculty ceases operating from 43 Lower Fort Street, Sydney, and relocates to 48 Albany Street, St Leonards.
The college commissions a report from Dr Paul Fitzgerald to advise it on how to introduce mandatory training and vocational registration for general practice. His advice is that it would best be done at a federal level through representations at a political and departmental level. The issue of general practice remuneration, which council links to standards standards of practice, is of concern. Dr B Aldrich of Buckmaster Hawkey produces a comprehensive report which suggests linking the college’s public image with its representations to government.
May: The President visits Canada to attend the Annual Scientific Assembly and Convocation of the Canadian college in Montreal; he goes on to Kingston, Jamaica, for the inaugural meeting of The Caribbean College of Family Physicians. At the same time, the President Elect visits New Zealand for its college’s Annual Meeting in Queenstown.
The college adopts a policy on vocational registration. It decides that from January 1992, the Fellowship will only be awarded after appropriate training and assessment.
Dr Jacqueline Wakefield is appointed Visiting Professor.
Rural Doctors are in dispute with the NSW Department of Health over the provision of services to country practitioners. It is a protracted dispute. The issues are locums and financial, educational and general support for doctors and their families in smaller country towns. The college establishes the Rural Doctors Resource Network (RDRN), which helps to resolve the dispute. The NSW Postgraduate Fellow, Dr Elizabeth Jane, is instrumental in attracting the funding for the RDRN, and represents the college on the Management Committee for the next 10 years.
Australian Family Physician, which has become a well established academic journal over the years, introduces letters to the editor, an ‘any questions’ service and GP news to expand its role and readership. It is ranked as first among the medical journals that GPs prefer to read.
The Preventive Medicine Committee produces an advisory questionnaire for teenagers entitled Growing Up Healthy.
The Practice Management Committee issues Standards for Computerised Medical Record Systems. It begins pressing for the legalisation of computer generated prescriptions; the clarification of the legal position relative to computer stored patient notes; and the establishment of a general practice computing research and development advisory committee.
Work continues on the development of descriptors for what a GP does in a consultation. This is designed to show the level of complexity in, and difference between, consultations.
The Communications Committee is set up to improve the public image of the college. It works closely with the Quality Care Committee. This committee sets seven quality assurance options to be undertaken by all college members, beginning in 1989. At the same time, it decides to appoint a research/education officer to support the quality assurance program.
The Tasmania Faculty begins a campaign with the Department of Health to encourage women to examine their breasts for breast lumps and to encourage men between 15–35 years of age to examine their testes regularly for lumps.
The Rose-Hunt Medal is awarded to Dr EC Gawthorn.
Life Fellowships are conferred on Drs HN Merrington and JG Radford.
There is no Faulding Award this year.
8 September: Dr GR Gates is installed as the 15 th President of the college at the Annual General meeting on the Gold Coast. The WA Conolly Oration is given by Professor R Doherty. It is entitled ‘The Cloudy Crystal Ball – Australian Medical Workforce in 2020’.
During the convention, a joint meeting is held with The Royal College of General Practitioners. The British royal college gives its Australian counterpart some insights into its education and research projects. At the same time, it presents a further 12 Rose-Hunt medals to the college. The college also finalises its response to the Doherty Report at this meeting. The President, Dr Fisher, has already rejected the report as contrary to the aims of the college. The college’s official response relates to:
- A failure to recognise the urgent need for primary health care to be promulgated through general practice
- A failure to make recommendations for appropriate training and delivery of health care through general practice
- A failure to recognise the need for mandatory vocational training for general practice while accepting the need in other disciplines
- A lack of support to develop a quality assurance program for general practice.
- A lack of support for the college’s argument that 2 years hospital training with general practice rotation is insufficient to enter unsupervised general practice.
The AMA is supportive of the new descriptors that have been developed by the college. The descriptors describe what a GP does during a consultation. The Minister for Health, Dr Neal Blewett, accepts the descriptors but ties their implementation to vocational registration. The AMA vigorously opposes vocational registration and not only withdraws its support but also campaigns strongly against the proposal. It is a stern test for the new President.
The first departments of general practice are set up in teaching hospitals.
The immediate past President is elected as the first general practice craft representative on the newly reorganised AMA Federal Council.
This year sees the introduction of vocational registration for GPs. The college holds an Emergency General Meeting on 1 April 1989 in Sydney, which is called by a group of GPs who support the AMA view and oppose vocational registration. It is a disparate group. The meeting is heated but fails to alter the college’s position, which is supportive of vocational registration. A motion requesting council to no longer negotiate with government is lost. A motion insisting that the college communicate within its own organisation and with other medical organisations is carried. The college sets about negotiating with the government relative to the principles of implementation. Certain core principles are set down. The college agrees to:
- Register those who meet the criteria
- Register all Fellows and members of the college
- Register those who have completed 5 years in general practice (grandfathering)
- See all unreferred patients
- Provide home visits
- Provide after hours services
- Undertake continuing professional development.
The college admits that there could be an appeal against vocational registration refusal. Later in the year, a Senate Committee holds an inquiry into the proposal. As a result, vocational registration is implemented. An appeal Committee (the VRAC) consists of a Chairman nominated by the Minister, two representatives nominated by the college and two nominated by the AMA. In any event they are all members of the college. The Committee will later hear appeals against nonregistration. The college, by this one decision, becomes more widely and publicly known. The Vocational Registration Eligibility Committee (VREC) is also established, with similar appointments to the VRAC.
June: The college is well represented at the WONCA Conference, which is held in Jerusalem.
Support for asthma awareness and hepatitis B awareness weeks gives the college a higher profile.
The Preventive and Community Medicine Committee produces Preventive Medicine in General Practice – A Guide to Periodic Health Examination, a handbook to assist members in their work.
Conjoint Fellowship examinations are held in Malaysia and Hong Kong.
The Accreditation Committee makes a recommendation to council concerning the conditions under which teaching allowances will be paid.
The Communications Committee approves the videotape Medicine Today to be distributed to all GPs.
Advanced training courses in women’s health and palliative care are scoped, and the Women’s Health Course is instituted. An Advanced Course in Obstetrics and Care of the Newborn attracts 180 registrants. The Joint Consultative Committee of the RACOG and the RACGP states that in isolated rural areas, GP obstetricians are expected to manage in an emergency any obstetrical problem.
The Practice Management Committee produces a report entitled ‘Management of Medication Records and Production of Medication Prescriptions’ for circulation to members. It also institutes a practice advisory service to analyse individual practices and advise on ways that they could be improved. The Services Division continues its useful activities with medical records, community information services, the income protection plan, the Inter-practice Comparison Survey, the National Directory of Members and the Computer Assisted Project.
The Quality Assurance Program begins to make greater headway with the appointment of a Project Officer. It consolidates and defines the options whereby the program can be completed so that they become more meaningful.
The Research Committee produces A Conceptual Framework for General Practice Research, a document that council adopts as a position statement on research. The Research Unit begins a study on sleep apnoea and dementia in the elderly.Two Nutrition Research Fellows funded by the Australian Dairy Corporation are appointed to the NSW Faculty.
The Archives Committee compiles the history of the college for the previous ten years. It is entitled The Royal Australian College of General Practitioners 1978–1988.
28 September: The 32 nd Annual General Meeting is held at the Sheraton Hotel, Hobart. Attendance is minimal and Convocation and the Academic Session are cancelled due to a pilots’ strike that prevents the majority of members from attending.
October: Another Extraordinary General Meeting is called to endeavour to stop the college negotiating with the government. The meeting supports continuing the negotiations.
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.
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’.
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.
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.
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.
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.
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?
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.
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.
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’.
3–5 February:More than 800 people attend the 10th Computer Conference at Darling Harbour from 3-5 February. There is something for everyone in a conference that features local and overseas opinion leaders, the latest in research and hands on tutorial workshops.
The Commonwealth Government announces plans for a radical change to the delivery of general practice training. The change will see a move towards a competitive system and the possibility of using universities, divisions of general practice and community based organisations to deliver vocational training for general practice.
The college begins surveying public views on alternatives to general practice such as acupuncture, osteopathy and Chinese medicine to see if they can be encompassed.
The Minister for Health announces that there will be recruitment of doctors from overseas to go into rural areas.
The college develops the practice based assessment (PBA) as an alternative pathway to Fellowship with no financial support from the government. The Censor-in-Chief warns of his concerns regarding non-GPs controlling GP training and the push for renewed grandfathering for vocational registration, which run the risk of undermining over 30 years of work in building up the significance of the Fellowship examination process.
The Standards Directorate produces the second edition of Standards for General Practice; it is also involved in developing PBA. It wins a tender from the commonwealth to develop standards and guidelines for Enhanced Primary Care Medicare Benefits Schedule items that it delivers in March. It is also successful in tendering to develop the implementation of a strategy for evidence based, best practice clinical guidelines for general practice in Australia. Over 4500 applications for educational programs are assessed and a booklet, Clinical Audit Options, is sent to all enrolled GPs.
The Research and Practice Support Directorate runs activities on areas such as Aboriginal health, women’s health, Enhanced Primary Care (including falls in the elderly and chronic disease self management) and health promotion/population health.
The Executive Director of Education in the Training Program resigns in February after 12 years in the position; however the college is fortunate to replace him with a successor who has years of academic experience. The program introduces new training arrangements with national terms and conditions for registrars and sees a strong increase in numbers in rural general practice. It also places a high priority on training in Aboriginal health for all registrars, improves distance education for registrars, and for the first time includes a statement of the minimum and essential knowledge and skills for general practice.
The refurbishment of College House in South Melbourne is completed; the building at Forest Lodge is sold for $2.95 million to the previous owners.
May: The CEO is dismissed.
The Corporate Services Directorate is the last part of the restructuring to be completed. It incorporates finance, human resources, information systems, investments, property, the national resource centre, and publications and services into the one directorate; consequently, the college loses the services of the finance director and the human services director who had been in those positions for some time.
Publications produces Hepatitis C Guidelines, Naltrexone Guidelines, RACGP Practice Procedure Manual, Sterilisation Guidelines, Standards for General Practice and Medical Care of Older Persons in Aged Care Facilities.
The Strategic Planning Unit sets priorities, targets and goals for the college to decide on, which will then be monitored and reviewed to track progress.
The faculties and standing committees adjust to the strategic plan and find their place within it, while at the same time managing their core functions.
The operating deficit is $1 624 602, an improvement on the previous year brought about by a profit on the disposal of buildings and the disposal of shares worth $618 007.
11 October: Dr PJH Hemming is installed as the 21 st President of the college by Dr MRJ Kilmartin at the Annual General Meeting in Townsville. Professor Dame Lesley Southgate delivers the WA Conolly Oration.
Drs JA Comerford and Dr E Jane are awarded Rose-Hunt Medals conjointly.
The meeting of council following the conference leads to the commissioning of a review, to be carried out by the Princes Hill Consulting Group. The review will look at the college’s structure and function after government changes in December 2001 that will see an end to the college’s monopoly as the sole provider of vocational training for general practice. The commonwealth provides funding for this review.
The college receives a report from KPMG in relation to the function of standing committees.
February: Ms L Furler becomes CEO.
May 28: The Princes Hill Report is presented to council. The objectives of the review are to streamline the organisation in order to achieve higher levels of effectiveness and efficiency and to position the college to respond to the strategic challenges and opportunities that lie ahead. After the report is presented, it is distributed to the faculties for discussion. There is a good deal of discussion in the faculties about their future role and the role of standing committees, who will now be centrally appointed rather than being composed principally of faculty representatives. The report makes 63 recommendations, many of which address perceived deficiencies in the college that have developed in recent years. One recommendation concerns the high relative cost of medical staff; as a result of the review, these staff are dismissed, even though they are Fellows. Another recommendation suggests altering the structure of council, reclassifying the membership to make the President Chairman of Council, and giving the CEO a seat on council. It is recommended that the positions of Treasurer and Vice President be appointed from council rather than elected by the members. This requires an alteration of the articles of association. An Emergency General Meeting is called 6 weeks before the Annual General Meeting to give effect to these changes. Over 500 proxies are gathered for the meeting – by far the greatest number of proxies at a general meeting. (It is the only meeting called in the name of The Royal Australian College of General Practitioners Limited, despite the fact that the college has held a licence from the Governor since its inception to omit the word ‘Limited’ from its name as a limited liability company.) It also recommended that the Training Program be ‘spun off’ into a separate entity owned by the college, which is to be established by 1 September 2001.
The archives are moved from Sydney to storage in North Melbourne. Papers belonging to Dr JS Collings which are processed at this time have not been located since.
July: General Practice Education Australia is launched to take over the remaining elements of the college’s involvement in GP education and training, with the understanding that its role would cease at the end of 2003.
There is no Annual Report this year. Council issues a President’s report and a financial report that are presented without notice to the Annual General Meeting in October. The financial report shows the college has recorded an operating surplus of $1 599 484. This is due in part to surpluses of $1 920 034 from the Training Program and $339 739 from the faculties. Other savings are made by charging the travelling expenses of interstate members of the Finance and Grants Advisory Board to the Family Medical Care Foundation for the first time; however, this reduces the amount that is available for research grants.
30 September: The Annual General Meeting is held in Sydney. Anger is expressed at the dismissal of medical staff; questions are raised about the financial state of college and the loss of collegiality to centralised control. Professor Bruce Conolly delivers the WA Conolly Oration, which is named in honour of his father, the first President of the College. His speech is entitled ‘The Hand that Heals around the World (In Giro Per Il Mondo A Curar Le Mani)’.
Dr Mary Mahoney is presented with the Rose-Hunt Award.
Although the decision concerning the change to the position of Council Chairman could be implemented in 2001 or 2002, at the first meeting of the 44 th council, council decides, by secret ballot, to abolish the position of Chairman forthwith and appoint the President as Chairman. The CEO is appointed to have a seat on council.
A proposal for a ‘GP House’ is received from the Commonwealth Government. Based on a significant commonwealth grant, the proposal is to house the college and other GP organisations in a new building within the parliamentary triangle. Negotiations continue for several months.
Council is bogged down by discord from its inception. This discord begins to be reflected in the membership and continues throughout the life of the 44 th council.
The discord continues into 2002. The President remarks in his report for the year that council has focused on the governance-management interface, and that this has led to significant tensions between a small number of individual councillors and the main body of council. This dissent is very destructive rather than constructive. Too often the debate within council is coloured by a lack of trust, understanding and forgiveness; as a result, communications reach an all time low. These debates are essentially about governance matters and should have been resolved. This situation leads to a motion of censure on one of the councillors that is later rescinded when the composition of council changes. These differences cause problems with the management of council business and frequently overshadow the strategic policy decision making, which is clearly a prime role of council.
The administration of the college is controlled by the duopoly of the CEO and the National Manager – Marketing and Membership Services. The staff complain that this is restrictive. At the end of May, when a blanket offer of voluntary redundancy is offered to all staff, many in the National Office and in the faculties take the option of leaving the college, leaving the college bereft of many loyal and long serving staff once again. This makes it extremely difficult to mount the second Fellowship exam.
In the Princes Hill Report, no mention is made of the Board of Censors or the Board of Examiners. In the restructure of the college, the actual placement of these two bodies within the college has still not been decided.
The College decided to submit its own training and assessment processes for accreditation by the Australian Medical Council. It was one of the first recognised medical colleges to submit to the process. It understood that the process was exhaustive and would take some time.
The President reports that from the very beginning council has had difficulties in functioning as a united body. There have also been difficulties relative to the interface between government and management within the college.
Reports from the standing committees set out what they hope to achieve. There are no reports of any meetings being held. The faculties too struggle to define their role in the new structure, but carry on their support for members, particularly during the indemnity crisis. They all express regret at the resignation of valuable staff.
Early in 2002, Dr Michael Wooldridge, the former Health Minister, is appointed as a consultant to the college. This is hailed as a great coup by the management of the college but the members view this, together with GP House and the other changes in the college, with some consternation and distress. Council appoints new auditors who gradually reveal the true financial state of the college; up until this time, council has been unaware of the college’s true financial position. As a result the council moves to stand down the CEO and the National Manager – Marketing and Membership Services. This is followed by their resignations.
August: Dr P Hegarty is appointed Acting CEO and immediately begins work to reverse the college’s fortunes by restructuring its administration.
Council reports an operating deficit of $7 337 239. The President says that although a large part of the deficit is related to the failure of the commonwealth to acknowledge its responsibilities for the redundancies in the Training Program, there are other aspects of the college’s financial management which give cause for concern. This is spelt out by the auditor at a very stormy Annual General Meeting. It includes, among the other losses, voluntary redundancies worth $796 000 and an increase in payments to consultants of $1 035 825 – an operational loss of $1.8 million.
The President reports that it is time to reflect on the wisdom of the council changes. Motions are put to the Annual General Meeting to revert to the previous arrangements of having a member of council as Chairman as well as removing the CEO from council.
The Annual General Meeting is held at the Burswood Casino in Perth. Professor M R Kidd is installed as the 22 nd President of the college by Dr PJH Hemming.
After the Annual General Meeting in Perth, and the installation of Dr Michael Kidd as President, the college decides to submit its own training and assessment processes for accreditation by the Australian Medical Council. It is one of the first recognised medical colleges to submit to the process. It is understood that the process is exhaustive and will take some time.
Professor J Belle Brown delivers the WA Conolly Oration.
Dr N Spike receives the Rose-Hunt Award.
The 45th council meets with the daunting task of making significant changes to the operations of the college. It appoints an Acting CEO and National Manager of Finance who begin to reform the college structure. They immediately begin to reduce staffing levels to reduce costs; they also institute monthly reporting on an accrual and cash basis. Due to a 2 month delay in sending out membership subscription notices because of the implementation of a new membership system, there is a decline in membership subscriptions. The new council and administration immediately set about correcting this anomaly to improve cash flows. The college’s ability to pay its debts as they fall due requires intensive and expert management.
The college begins the year in a dire financial position, with an operating loss of $2 502 850 for the first 6 months of the financial year. This rises to $2 554 085 by the end of January and thereafter begins to decline. On the 1 July 2002, the net assets of the college were $5.7 million; by 31 December 2002 they have fallen to $3.8 million. Thereafter they begin to rise again.
29 April: Mr D Wright is appointed CEO.
The college initiates a long membership drive in an attempt to restore the financial fortunes of the college. The membership at the end of the financial year in 2002 was 10 890, yet falls away to little more than 1000 financial members due to the delay in sending out the subscription notices. By the end of the drive, the college has achieved a membership of 10 029.
The big issue of the year is working towards Australian Medical Council accreditation of the college’s education and training standards and processes. The report is eventually submitted during the year. The AMC accredits the college’s program of education and training for a period of 3 years to 2006, when it will be reviewed again. It makes recommendations for improvements to support high quality education and training for Australian general practice. Council begins to successfully implement these recommendations.
The standing committees develop policies and programs to be implemented as the college recovers and adapts to the composition of the new committees. The GP Advocacy and Support Committee persuades the government to refer the issue of red tape in general practice to the Productivity Commission. The Quality Care Committee revises and expands Putting Prevention into Practice and endorses SNAP, a population health guide to behavioural risk factors. The Research Committee supports and promotes research among GP members and enhances the building of research capacity in Australian general practice.
All faculties report that the year has been one of challenges to be met by consolidation and rebuilding and by concentrating on their core functions. The college takes advantage of grants from government, philanthropic trusts, private industry and others to develop programs to enhance general practice knowledge. During the year the RACGP is engages in approximately 40 programs involving research, education and training.
The college manages to reduce its operating deficit to $457 214. There is a carryover of the RACGP voluntary redundancy program of $353 152, bringing it to a total of over $1.1 million over the 2 years between 2001–2003. The cost of consultants falls by almost $1.8 million.
The Censor-in-Chief reports that a record number of candidates – 900 – sit the exam in nine centres across Australia, with 500 examiners at the two clinical sittings. In 1995 the Censor-in-Chief reported that there were 1265 candidates. While the 1995 figure is larger, changes in the examination structure account for some of the reported reduction, as in the 1995 examination candidates were able to sit for individual segments rather than for the whole examination only. Therefore, the numbers of individuals sitting in 1995 was greater, but in a different format.
At the 46 th Annual General Meeting in Hobart Professor WE Fabb delivers the WA Conolly Oration.
Professor JE Murtagh is awarded the Rose-Hunt Medal.
A new senior management team has been established and the college begins to move forward. It ensures the strength of the faculties to support members and their efforts to maintain high quality general practice.