Practice group updates
General Practice
Chair: Dr Mary-Therese Wyatt | Meeting 9 July 2025
Chair’s report
Recent GP survey had 63 responses, with insights into contractor arrangements, mixed billing and Medicare reforms pressures. Updates shared on immunisation efforts; flu program extended due to low uptake. From Federal Council of GPs meeting, progress continues on longer consults and tiered MBS items. WA-led ADHD proposal being considered for national rollout.
Chronic disease management
Concerns about limited rebate for new care plans and need to reduce paperwork, while improving financial viability through more frequent patient reviews. Opportunity costs to be balanced with better use of practice nurses and workflow redesign; obesity management qualifies under clinician judgement.
My Medicare & aged care
Registration challenges for practices working across multiple sites and rotating GPs in aged care. System inflexibility creates admin burdens, and changes have reduced incentives for practices employing nurses under CDM. Issues raised about GPACI registration and complications when enrolling patients and practices asynchronously.
Federal policy briefings – aged care & nurse incentives
Draft policy settings critiqued as discouraging GP involvement in aged care, citing flat incentive limits, punitive targets, and misguided links to facility activities. Concerns raised about growing prevalence of nurse practitioners in residential aged care, fee double-dipping, and commercial exploitation.
Practice nurse & allied health models
Nurse item paper needs strengthening. Call for clearer advocacy for GP-led practice nurses, and to reference Practice Incentives Program review to support removal of per-practice funding caps, and exploration of blended payment models. Greater allied health flexibility recommended, particularly for rural/demographic customisation, with expanded roles for social workers and pharmacists.
Transgender patient resources
Updated guidance available for confirming gender change in WA.
IMG representation
Underrepresentation of IMGs in AMA forums was raised, particularly GPs without hospital backing. Members supported a proposal to strengthen IMG and ethnic minority representation within the AMA (WA) and federally, as both an equity issue and a chance to grow membership.
Rural Doctors
Chair: Dr Paddy Glackin | Meeting 16 July 2025
Rural Health West annual workforce update
Clinical hours (rather than total working hours) being reported, not accounting for the significant time rural doctors spend on non-clinical duties. Doctor numbers appear to have grown, but offset by a decrease in clinical hours per doctor, with only 0.7% increase in actual doctor clinical hours overall. Concern about ongoing procedural skill shortages, particularly in rural surgery.
Enterprise bargaining agreement
Concerns about WACHS’ inconsistent and last-minute communication with doctors on rural generalist status and permanency. Clearer timelines needed for decisions on permanency, reclassification and back-payments. WACHS should adhere to the binding explanatory statement clarifying intent on rural generalist classification.
SAT reporting burden
Increased workload on SAT reports. More than 2,800 applications required reports in 2023–24s. Doctors legally required to provide reports, without remuneration. The AMA (WA) continues with planned advocacy to the Attorney General and Health Minister.
Rural recruitment and retention
Challenges running a viable rural private practice in smaller communities. Up to 30% of LGA budgets being used in some regions to secure GP services. Work underway with Rural Health West and WALGA to explore shared responsibility frameworks, regulatory reform, and pathways for procedural skills. Concerns about the Single Employer Model trial to commence in 2026, with decisions already made before consultations taking place.
FTE freeze at WACHS
Clarification being sought from WACHS on reports of managers advising senior doctors that recruitment into vacant positions and leave cover are not possible due to “an FTE freeze”. Many unfilled management positions across WACHS, with multiple positions being covered on an ‘acting’ basis, often by the same person. Ongoing leadership gaps affect strategic planning and service development, compounding existing workforce challenges.
Winter pressures
Small hospitals are allocating surge beds without adequate consultation with local doctors, creating unsafe expectations of coverage. Ongoing registrar credentialing and supervision inconsistencies flagged for discussion with WACHS.
Doctors in Training
Chairs: Dr Owen Taylor-Williams & Dr Natalie Ferrington | Meeting 4 August 2025
Rostering compliance
Major focus on this, with rollout of new Alternative Rosters Agreement (ARA) procedure now in place across HSPs. Only one request received so far; survey results show most non-compliance issues are isolated rather than systemic. Must report non-compliant rosters so breaches can be addressed.
Recall shifts
Strong discussion, particularly around last-minute involuntary shift allocations with a lack of appropriate recall payments. Highlighted that recall is distinct from shift overruns or voluntary shift changes; doctors have the right to refuse recall on reasonable grounds. Cultural barriers and fear of repercussions still discourage many DiTs from asserting their rights, so the group has committed to raising awareness and supporting enforcement through a cultural change campaign.
Term allocations and rotation changes
Employers are required to notify clinical rotations at least four weeks prior to the start of the calendar year and must consult doctors before making any changes once allocations are confirmed.
Inconsistent payment for telehealth & phone advice
Remains under independent review; reforms expected to align with the next bargaining round.
Unpaid pre-shift preparation & mandatory teaching
Reminder that mandatory teaching must be paid, while optional teaching should not incur penalties for non-attendance. Overtime should be claimed for additional hours worked.
Updates across the State
Mix of improvements and challenges highlighted – from stronger JMO support at Peel to workload and supervision concerns at Hollywood. In WACHS, inconsistent relocation support and last-minute site moves continue to create stress; the AMA (WA) is pushing for fairer and consistent benefits.
IMG exemption applications
Worrying reports of inadequate handling of IMG exemption applications for Rural Generalists pathway and 19AB exemptions, affecting consultants and trainees. The AMA (WA) is actively raising this with senior leaders and at federal level, pushing for fairer policies and better protection for IMG doctors.
Public Hospital Doctors
Chair: Dr Tony Ryan | Meeting 18 August 2025
Pathology permanency & workforce structure
Concerns about move to split physician-pathologist contracts, which creates inflexible roles, undermines dual training, and risks duplication of rosters. Changes threaten recruitment, retention and service delivery; Pathwest and SWIR at an impasse. The AMA (WA) will continue pressing for a solution. Escalation to the Industrial Relations Commission an option if negotiations stall.
Hospital reports on sustained strain
Joondalup reported a Code Yellow for the first time since pre-COVID; Fiona Stanley in Code Yellow most of the week; and prolonged Bed Status Black at Armadale. Fiona Stanley short of 140 RMOs, worsened by IMG credentialing delays. Equipment funding limited; delays to PET scanner delivery; insufficient new medical equipment funding allocations for new financial year.
Permanency & Reform Working Group update
North Metro remains a concern – around 80 doctors excluded from permanency. Delays across departments; some doctors awaiting offers for months. Nearly all Armadale staff received and responded to contracts, but automation failures forcing a return to manual processing has slowed down progress elsewhere.
Overtime
Junior doctors being directed to undertake unpaid pre-shift work in a regional hospital – issue escalated and resolved internally with Hospital Executive. WACHS agreed to move to an app-based, post-submission review system.
Next steps
Escalate permanency, contractual and pathology workforce issues with SWIR, Pathwest and hospital departments.
Private Specialists
Chair: Dr Brigid Corrigan | Meeting 27 August 2025
Independent perspective on the evolving private health landscape from guest speaker Dr Shane Kelly. He outlined the pressures facing private hospitals and specialists; touching on private hospital sustainability, health fund dynamics, workforce costs and associated risks. Reinforced the need for coordinated advocacy to preserve sustainability of WA’s private health sector.
Ongoing challenges discussed, including providing services for veterans, hospital bed shortages and private hospital closures, and issues affecting private obstetrics and paediatric surgery. Health fund contracting was examined, identifying opportunities for future advocacy.