COMMENT, by Dr Ruth Tinker

We are now several weeks into the new GP training regime – so how are we doing?

Firstly in the spirit of full disclosure, I am one who wanted to withdraw services in protest at the centralisation of training providers in NSW. All other existing providers had been told they could only lodge a proposal to manage one of the new regions in NSW. So it came as a shock that one provider had not only been allowed to lodge several proposals, but that that single provider was then granted the entire state.

This means there is no longer any competition between providers, previously touted as an important way of improving quality.

Secondly, it seems not even they believed they would be granted the whole state. They had no idea how they would do it, no plans in place, not even a skeleton structure on which to build. They were to take over from 1 January 2016, but six weeks before that date it seems they did not have a proposed structure. Hence, no idea of what staff they would need, so could only ask for “expressions of interest” rather than have people apply for real positions.

This lack of preparedness is showing. Thirdly, Sydney-centred management is very difficult, and often has no understanding of the reality of rural life and work.

At the final NCGPT training weekend in Coffs Harbour, the Synergy CEO bravely fronted the meeting, but failed to effectively answer most questions. Some because he couldn’t as there wasn’t a plan in place; some because (it seemed) he didn’t hear what was being asked.

So how is it panning out?

Firstly the issue of contracts. We were promised in Coffs Harbour, and again in December by Synergy officers in the Sydney office, and also by the North Coast GP Training staff (based on what they had been told), that all practices with a pre-existing contract with NCGPT would continue on that contract for the first six months of 2016.

The reality is only those that currently had a registrar continuing beyond February can continue on the old contract. Those taking on a new registrar, or a new Term, even though the agreement was made last year with NCGPT, are required to accept a Synergy contract starting February 2016. This was not made clear until trying to get onto their cumbersome website, where, as supervisor, you can’t do anything until the contract is accepted. There are 18 pages of addenda and notes, in addition to the general Terms and Conditions for registrars. Synergy has labelled this as a “misunderstanding”. It isn’t.

While not unexpected it is disappointing that my fears here have been confirmed.

Secondly, the lack of preparedness means that two weeks after the new regime began, they still do not have phone numbers for the new local office in Ballina. I dialled the 1300 number provided in an email. This was answered by a telephonist (in Sydney) who didn’t know where or who I was, nor did she know that the person I was trying to contact was in fact in the same region. She offered to email and have the local person contact me. As my contact with the training organisation is usually sandwiched between patients, when I have a few minutes, this is not an efficient way to get in touch.

When I did make the contact, the person was not familiar with the Synergy programme either. She is new in the job, and didn’t know her way around the new programmes. We worked it out together. But my expectation is that the support staff should be trained and supported enough, and that they can answer basic questions with confidence. It must be very difficult for them dealing with us, without sufficient time or training to understand the system.

This is again a consequence of the lack of time and preparation by Synergy.

Thirdly the “orientation” for supervisors was inadequate. There was a meeting in Coffs Harbour on a Thursday evening, or brief videos online. The videos were simplistic and unhelpful. I pointed out that this was a three-hour drive for me, and it was impossible to attend without giving up at least half a day’s consulting, and for safety’s sake, should include an overnight stay.

The meeting was the only meeting between Newcastle and the Queensland border. I asked that it also be offered as a webinar. This suggestion has met the same response as my last three emailed suggestions – no response.

To ensure our continued participation, and gain our confidence, Synergy needs to keep their word. They also need to be more responsive. Two weeks in, I would grade the experience as 3 out of 10. There is plenty of room for improvement. We dearly hope it happens. If they don’t (or can’t) lift their game, it will not only be GPs and registrars, who suffer the consequences, but ultimately our patients, even if they never get to know the word ‘Synergy'.