GPs threaten to walk over Medicare Locals contracts

GPs at a division awarded one of the first Medicare Locals contracts have warned the Federal Government that they will “walk away” from the deal if they are forced to give up control on their boards.

Medical Observer understands the contracts, sent to many of the first 19 winning bidders in recent weeks, explicitly state the Medicare Local (ML) must have a board of 7–10 directors with no single profession dominating.

NSW division GP Access is involved in one of the first tranche of MLs, and currently has six GPs among its eight board members. Board member Dr Arn Sprogis said the clause was “obviously aimed at GPs”.

“No other organisation would put up with such a prescriptive clause,” he told MO.

Dr Sprogis said for the first five years of transition from GP divisions to MLs “all the heavy lifting... has to be done by GPs”. 

This includes most after-hours care and hospital liaison, he added. 

“If you’re expecting GPs to do all the work, you wouldn’t put a clause in that says their numbers are to be reduced.”

Fellow GP Access board member Dr Allan Kirkpatrick said a board meeting to discuss and potentially sign off on the ML contract last week was postponed due to concerns about the governance clause. 

“We may have to go back to the drawing board and say [to the Health Department] ‘sorry’. The membership may not go for it either,” he said.

GP Access was discussing the contract with the Health Department and remained hopeful it could be renegotiated to create greater flexibility on board membership as MO went to press. 

“If we think our community isn’t going to be better off with the contract that’s on offer, then obviously we’ll walk away from it,” Dr Sprogis said.

Sydney GP Dr Harry Nespolon, chair of the Northern Sydney General Practice Network, which missed the first tranche of MLs, was concerned that if GPs involved in the first round of contracts did not ensure adequate representation on their boards, future MLs would suffer as a result. 

Dr Nespolon warned that the Health Department would assume it had resolved contract problems, meaning all subsequent MLs would be forced to sign uniform “vanilla” contracts.

“One of the great promises was that they were supposed to be local, and we would be able to tailor the business for its constituency,” he said.

The Health Department had not responded to MO queries at time of press.