Well, my last post on the contract negotiations between SA Rural Doctors and the Country Health Dept was in mid-November.
By way of background, the current contract was agreed in 2010 and was due to expire on 1/12/11, in part because the Rural Doctors Association SA were unhappy with the oncall fees negotiated last round.
There was expectation that the current round of negotiations would yield a better oncall payment, recognising the significant impost that responding to the requirements of the public hospital has on the GP’s own private practice.
Sadly negotiations have dragged on; indeed, it was only on 30/11/11 (the date of expiry of the current contract) that Country Health SA wrote to GPs stating that the contract would be extended a further three months. No reason was given for this delay, which is disappointing.
In early December, the RDASA received a revised offer from CHSA – and in a news release to members on 15/12/11, the RDASA have advised that the offer falls short of what was asked for and remains unacceptable.
However there will be a further attempt at negotiation with CHSA, with RDASA pushing for the following:
– increased payments for oncall rosters
– recognition by CHSA that many patients presenting to public hospital EDs are NOT routine general practice and should not be billed by the GP (a blatant cost-shift by CHSA onto Medicare and the patient). In some circumstances, CHSA has refused to pay the attending doctor for providing emergency services, with patients being asked to pay for a service that they would receive for free in a metro ED (eg: reduction of fracture/dislocations, forensic medical exam etc)
– RDASA rejection of the proposal by CHSA to tie admission privileges and fee-for-service payments to being on the oncall roster (a move that would discriminate against doctors on sick/maternity/paternity leave, or those who wish to continue to admit patients under their care but not to participate in an onerous oncall roster)
The new contract, if it is accepted, will be for three years. I have an opinion on this, but it is vital that rural doctors consider their position should the Health Dept fail to meet the proposals of the RDASA, and the RDASA are unable to recommend the contract to members. In such circumstances it will be for individual entities to determine whether they wish to accept the contract, or negotiate separately…or withdraw entirely.
Having worked in rural NSW for the past 12 months, it has been interesting for me to compare terms and services between this State and South Australia. Certainly there appears to be less bickering over cost-shifting, with the NSW Health Department paying the doctor if he/she is called to attend as part of his/her duties oncall for the hospital – rather than the obfuscation in SA. Of course, such differences play a factor in recruitment and retention of rural doctors. As a GP-proceduralist, I am certainly tempted by better money interstate, the chance to live in a coastal town and most importantly by a hospital that continues to provide obstetric and anaesthetic services.
To be offering a newly-announced ‘rural proceduralist’ pathway in SA, yet failing to nurture the relationship between rural doctors and CHSA seems tautologous. Let us hope that CHSA will recognise the value of the rural medical workforce before it is too late.
You can feedback to the President of RDASA, the Negotiation Committee, or regional reps via the RDASA website
Interesting times, indeed.