FAQ for Practices
Which Registrars in Tasmania are eligible to participate?
Any Registrar that is on a GP training program with an endpoint of Fellowship of the Australian College of Rural and Remote Medicine (FACRRM) or Fellowship of the Royal Australian College of General Practitioners (FRACGP) or Fellowship of the Royal Australian College of General Practitioners - Rural Generalists (FRACGP-RG).
Which practices in Tasmania are eligible to participate?
Any practice (MMM2-7) that has accreditation for GP training, a willing supervisor participant and a willing Registrar participant, preference will be given to remote/rural areas and those serving vulnerable populations.
How does the funding work for practices under SEM (Single Employer Model)?
All Registrar billings are collected by the medical centre hosting the Registrar. On a quarterly basis, there will be a financial reconciliation process between the THS and the medical centre where 50% of the Registrar billings will be kept by the Practice and 50% provided to the THS.
Can a current Registrar participate?
Yes, we will be seeking expressions of interest from current registrars and will be seeking advice on any potential grandfathering arrangements for registrars that have already left the THS; we are currentiy working in private practice to see what may be possible.
Can a Registrar leave the SEM?
Yes, participation in the SEM is optional and they can leave at any time (on agreement with the practice if part way through a rotation); once they leave, they will not be eligible to re-enter the SEM at any time.
What are fulltime hours and leave entitlements?
All leave and entitlements are as per the Salaried Medical Practitioners Agreement (SMPA). Fulltime employment under SMPA is a 40-hour week (or 80-hour fortnight); this can be worked between two (or more) workplaces, for example, the Registrar could work 20 hours in general practice and 20 hours in the emergency department per week.
How do Registrars apply for leave?
Wherever possible the SEM pilot aims to place operational decisions with the Practice and Registrar in their work setting. Registrars will be required to provide evidence of approval of any leave requests and supply this when applying for leave through the THS.
How will this affect Registrar training and education?
GP training and accreditation is run by the Colleges; there will be no changes in the training and education of general practice selection, and trainee progression remains with the GP supervisors and Colleges; there will be no additional requirements. Registrars that don’t progress will be managed the same way as they are currently.
What is the 19(2) exemption and how will it affect the practice?
Section 19(2) of the Health Insurance Act, 1973 precludes state-employed medical practitioners from utilising Medicare Benefits for non-admitted, non-referred professional services unless an exemption applies. The Tasmanian Department of Health has a Memorandum of Understanding with the Commonwealth Government that will enable participants on the Single Employer Model pilot to utilise a 19(2) exemption, this means GP registrars participating in the Single Employer Model pilot will be employed by the State Service and Medicare Benefits will still be applicable to the services they provide.
What industrial tool will the registrar be employed under?
GP Registrars will stay employed under the Salaried Medical Practitioners Agreement (SMPA) like any other registrar in the State Service.
Does the 19(2) Exemption for SEM link with the COAG 19(2) Exemption?
No, the Commonwealth has confirmed the 19(2) exemptions are separate, and the 19(2) exemption for the Single Employer Model is not subservient to the COAG 19(2) exemption.
My Practice is an ACCHO and already has a 19(2) exemption, do we need another one?
No, the Commonwealth has confirmed the 19(2) exemptions that ACCHOs already have can be used for the Single Employer Model and those locations do not need to be separately listed on the SEM 19(2) exemption.
What are the financial implications for Practice and Registrars?
The intention is that all participants will be as financially supported as they are now or will see an improvement in their financial support for GP training, of that equal of other trainee doctors.
The scheme will be designed so that practices are not financially disadvantaged; additional funds have been allocated to this scheme to support supervision.
The intention is that General Practice Registrars participating in the program will have terms and conditions of employment at least consistent with their peers in the State Service; individuals will need to determine if they will be better off on the scheme or as a private contractor.
Can Registrars take LWOP for an extended period from the THS?
The program will support periods of LWOP to further their training where it cannot be undertaken in Tasmania (or public system) or if exposure to another worksite is beneficial for career development; enabling LWOP or a secondment for a fixed term employee ensures accrued benefits are retained, which is also an incentive to return to the role.
The registrar could access up to 12 months LWOP to do Private GP work as this could be considered development.
The THS would not support LWOP for a holiday; the employee would need to access accrued for this purpose; if LWOP was needed for health reasons, then this would be treated as Sick Leave Without Pay once accrued sick leave exhausted.
LWOP could also be utilised if the Registrar is on the SEM, has a GP Practice lined up to complete their placement, but the Practice is not listed on the 19(2) exemption, this would allow the registrar to retain their leave entitlements and return as a THS employee when the practise list is updated.
Can Registrars enter the SEM at anytime?
Currently lateral entry is permitted, this is subject to change and may not be a future feature.
Who will cover the Registrars indemnity?
Registrars are covered by the State Service indemnity, it is also recommended that they have their own personal medical indemnity in addition to the State Service indemnity.
Who will the Registrar be employed by under SEM?
The Registrar will remain employed by the State Service.
Is the Trainee required to have an Australian Business Number (ABN) and register for GST?
Trainees are not considered to be undertaking a business activity as a result of participation in the SEM initiative and accordingly, do not require an ABN or register for GST. If undertaking work outside the SEM, then they will need to seek their own legal and financial advice.
What are the tax considerations for the registrars on the SEM trial?
All amounts billed under the Registrars Medicare Provider Number are to be collected in full by the host Practice.
Host Practices are required to provide written reports to Trainees at the end of each quarter which indicate the gross Trainee billings for the quarter and the amount of billings paid over to the host Practice.
Trainees are advised to seek their own professional advice in respect of their taxation compliance obligations resulting from their participation in the SEM initiative.
What funding has been made available to the Single Employer Model Pilot?
There are three main activities that the $7.96 million provided to the Single Employer Model pilot by the Commonwealth will be used for:
- Establishing the Single Employer Model (approx. $2.56 million) - this allows us to test the Single Employer Model with assurance that no Registrar, Supervisor or Practice will be financially disadvantaged through the pilot period while we evaluate the pilot for ongoing sustainability.
- Supporting supervision (approx. $2.4 million) - this allows us to test innovative supervision models to make the most effective use of our supervisor capacity in a way that supports supervisors to participate in GP training programs without financial disadvantage.
- Capital infrastructure (approx. $3 million) - this allows us to support practices that are willing and able to host GP trainees but are constrained by capital infrastructure needs.
While there is opportunity to use project funds for administrative costs, the Department intends to utilise existing capacity and resources to undertake this project where possible. This includes the project being managed through the existing Tasmanian Rural Generalist Pathway Coordination Unit, with input from areas such as the THS Medical Staffing Units, DoH Industrial Relations, Human Resources and Government Relations and Strategic Planning teams.
The $5 million State contribution includes the commitment to the Rural Medical Workforce Centre that has $1 million for capital infrastructure to refurbish existing teaching space at the Mersey Community Hospital, and $1 million per annum over the four years of the pilot. The operational funds of the Rural Medical Workforce Centre support the mandatory hospital rotations for GP trainees in paediatrics and anaesthetics at the THS North West, as well as some Additional Skills Training posts in the North West.
In addition to this funding, the John Flynn Prevocational Doctor Program funds the intern and RMO rotations in rural primary care. This program has just over $5 million to deliver 80 thirteen-week rotations to interns and RMOs over the next two and a half years. This funding covers the doctor in training salaries, accommodation, and travel, as well as supervision support.