GPs Down Under Posts

GPDU Post 4 20/8/26

The right questions

I initially entered the RACGP presidential election as an outside candidate because I was concerned that as doctors, our ethical foundations seem to be coming into direct conflict with an accelerating corruption of the shared values, laws, and institutions on which our practice is based.

We GPs are, as usual, at the pointy end of this problem and I wondered what we as a College could do about it, motivated more by getting people thinking and broadening the debate than winning a position.

Having had a crash course in College-ology over the past few weeks, I’m still convinced that our strong ethical foundation and commitment to the service of humanity gives us a reserve of moral authority not granted to those whose lives and careers focus on personal gain or power.

But we still seem to be asking the wrong questions about how to use this authority and risk squandering it on fighting hardest in the wrong battles.

Constant crisis?

As I’ve said throughout this election process, in my 40-odd years in and around medical practice in three countries there has never been a time when we GPs haven’t felt underfunded, concerned about others nibbling at our role, or anxious about regulations and taxation. We also feel we are always in a uniquely urgent existential crisis, yet here we still are.

We clearly need to keep working on these issues. But despite excellent College advocacy over many years, they haven’t disappeared. So, it would be wildly optimistic to think they will go away in the future if we just advocate at higher volume.

Hidden threats

I am concerned that the sneakiest threats to our role and independence are coming from elsewhere, including:

• corporatisation of GP practices and vertical integration

• pressure to abandon universal healthcare

• racist attacks on our IMG and indigenous colleagues and patients

• erosion of women’s rights to full spectrum health care

• poor planning for climate resilience

• health funding being drained by preparations for unnecessary wars

• erosion of our free speech and right to protest

So, what should be the College advocacy priorities and how can we ensure these reflect the views of our members?

Evidence-driven advocacy and engagement

Medicine is an evidence-driven profession. Our ability to interpret data and complexity and give advice based on facts is not only one of our key strengths but is also a core part of why we are given a highly privileged position in society.

I believe we need to apply the same evidence-driven approach to our advocacy. But we do not currently have the data to accurately identify the breadth of member experiences and concerns and there is widespread concern about low member engagement.

My fellow candidate Dr Anita Muñoz has suggested appointing a Presidential advisory group to improve representation and draw on existing expertise. And this would be a good first step. But I think we need to go further.

I’ve proposed that the College create a larger randomly selected advisory forum of members, with the ability to add to Board agendas and initiate non-binding member polls on key issues. The forum would be matched to the College’s overall demographic mix, supported by a small research and administration secretariat, tasked with reviewing briefings on issues and priorities and providing input to the Board.

Input from this group would ensure the Board is aware of the full spectrum of member views and priorities. It would also enable the Board to feel confident in advocating strongly on potentially controversial topics, amplifying our moral authority and providing a shield for the inevitable pushback. (There is more detail on this on my website - www.anotherfuture.com.au)

Another future

I’ve learnt a lot from this election process (including how to set up a website over a weekend) and met many good people working hard to keep up the awesomeness of general practice. Whatever the outcome of this election I plan to continue to think, write and advocate for general practice and the many broader issues facing our world. We can do so much more than just drift along with the tide of events – another future is always possible.

Facebook post 3 16 August 2026

GPDU Debate Followup

Thanks for allowing me to join this group during the RACGP presidential election campaign, and the invite to the debate last night. As Karen mentioned, there was a misunderstanding re the format on my part (I had assumed we were doing a moderated webinar with live questions) so I was working on my mobile with no articles or other material handy to paste and a tiny screen to squint at. As a result I think I only answered a small subset of questions. Last night I said I would try to look at the questions later and am now back with a full keyboard and screen. I will try and post all or part of the following to some of the individuals who asked questions, or link to this post.

My quick statistical analysis of the session:

·      41 questions in total

·      Worries re role definition was the largest group (n= 9),

·      Next was MBS/funding (n = 4).

·      Three questions each on training and supervision, RACGP vision and policy

·      1-2 questions each around other issues (including rural and remote support, College and other fees, diversity, candidate record to date, and whistleblowers)

·      Three questions seem not to have been answered yet by at least one of the candidates (two about the AHPRA/IHRA issue and one about support for closing the gap and ATSI trainees).

I’ve little to add to MBS/funding (yes, a sensible MBS and more money is always nice), training and supervision (it’s a core College business and needs constant vigilance/support), or other issues on which I agree wholeheartedly but for which it would be disingenuous to promise anything outside the President’s control (i.e. most things – they are largely a figurehead/spokesperson subject to Board policy). And I’ll answer the APRHA/IHRA and indigenous support questions at the end [see relevant pages in menu bar].

Threats to the GP role

Role definitions/encroachments/respect was the most popular topic, so let’s go a bit further into it. I’ve written about this elsewhere (see my website) but the summary of my take is:

a) there is a perennial turf battle in healthcare and it won’t go away

b) the College is very aware of this and works to raise the professional profile of GPs pretty well already

c) shouting and demonising fellow health professionals hasn’t worked in the past and divides us from natural allies

d) worrying too much about the government controlling us diverts us from the greater threat of vertical integration/corporatisation/Americanisation of health care

e) point d) is accentuating possible conflicts of interest for practice-owning GPs versus contractors or employees.

Something to think about: The College board has more practice-owners than non-practice-owners (around 8 of 12 practicing GP members own practices) and I am the only candidate who is not a practice owner. Health insurers, laboratory/radiology providers and private equity are rapidly buying up/setting up primary care clinics and services. Any practice owner in a desirable location is likely to have had offers to sell or merge. Practice owners in rural/remote or less revenue-friendly locations, perhaps not so much. Should the College advocate against this trend? Or for regulation of practice purchases/mergers? How long will GPs continue to have clinical freedom within a corporation primarily working to maximise profits for its shareholders or owners?

Facebook post 2, 14 August 2026

2026 RACGP Presidential Election Campaign Material

Short-ish and sweet-ish

I have only posted on GPDU once so far in this presidential campaign - I’m not a big fan of social media for dealing with contentious issues and prefer other fora. I’m also not keen to add too much to the number of election-related GPDU posts so far. So here is a brief update post:

You can find my statement, CV and link to my website (anotherfuture dot com dot au) on the RACGP election page, along with links to answers to questions raised by members via RACGP.

The website gets updated (by me) and now has more to see and read, plus copies of interviews/questions etc from other sources, including AusDoc, Medical Republic, the Climate and Environment RACGP SIG, and the GP Registrar Association.

I’m happy to receive questions via the email on my website, via the RACGP, or at one or more of the three upcoming candidate webinars:

GPDU on Sunday 16/8 (1900 AEST)

Doctors for the Environment Australia on Monday 17/8 (1930 AEST)

RACGP on Tuesday 18/8 (1930 AEST)

Sneak preview and TL;DR on my views:

In my 40-odd years in and around medical practice in three countries there has never been a time when we doctors haven’t felt underfunded, concerned about others nibbling at our role, or anxious about regulations and taxation. We also feel we are always in a uniquely urgent crisis, yet here we still are. Despite excellent College advocacy these pressures haven’t disappeared to date so it would be wildly optimistic to think they will go away in the future if we just advocate at higher volume.

And the sneakiest threats to our role and independence are coming from elsewhere – corporatisation of GP practices and vertical integration, pressure to abandon universal healthcare, racist attacks on our IMG and indigenous colleagues, erosion of women’s rights, poor climate resilience, and health funding being drained by preparations for unnecessary wars. Brought to you by erosion of free speech and a rapid slide towards some kind of non-democracy at home, or towards being a subservient colony of a distant power (again!).

If we refuse to obey in advance and are courageous in our resistance, we might just escape this possible future. We are one of the few professional groups who still have the moral authority to speak out without accusations of self-interest.

Let’s not be distracted.

Facebook post 1, 30/7/26

2026 Presidential Election Campaign Material

I’m Gavin, a GP/ED SMO type person based in Far North Queensland, and I’m a bit reluctantly standing for the RACGP presidency. I’m concerned we are missing some urgent issues outside our core work and concerns which will swamp any incremental changes the College may achieve. The College website has a link to my candidate statement, my intro video, my CV and my website so feel free to have a read.

TL;DR: I’m not trying to sell myself to College voters but trying to introduce some ideas and a sense of urgency into the election mix and wondering if we as a profession are up for using our trusted status and moral authority to have an impact beyond our consulting rooms and Colleges.

The mid-length version:

We are in extraordinary times – our largest ally is fighting or supporting endless wars, rolling back the rights of women, deporting immigrants, erasing indigenous and black history, dismantling environmental protections, and criminalising antifascism (which may be all you need to know).

Happily, none of this is on the agenda here. Our politicians and public servants are not obeying in advance, there is no chance they see their current roles as job interviews for lucrative positions in the colonial administration of the new empire, anti-immigrant rhetoric isn’t spreading like a bad rash, and we are steadily sorting out how to deal with our past and present relationship with the first nations inhabitants of this amazing continent and its islands. Or not.

Yes, there are a lot of threats to general practice as we know it but I fear these will only be amplified under any future Australian government which abandons the ideals of fairness and democracy in favour of a free for all pursuit of money and wealth concentration.

I’ve plenty to say on hot GP issues such as the role of pharmacies, the impact of LLM’s, Medicare shenanigans, growing conflicts of interest between practice owners and other GPs, etc. So ask me. But while these are important, we can’t afford to lose sight of the big stuff.

Things we could do together as a College do might include:

·      Proactively advocating for full spectrum women’s health

·      Resisting attempts to stifle criticism of any government which ignores international law

·      Standing up for our own immigrant members and calling out hate speech against those less privileged

·      Refusing to stand by while we are led towards a war in our region.

And not to forget the need to strengthen relationships within the College (ideally via a sortition-selected advocacy council of ordinary members), and joining with and encouraging other Colleges and professional associations.

So, take a look at the candidate information on the College website, maybe have a bit of a read outside the box, ask difficult questions, and above all get out and vote.