Section 19AA of the Act was introduced in 1996 to recognise and support general practice as a vocational specialty, as well as to provide a framework for achieving long term improvements in the quality of doctors working in Australia.
Section 19AA of the Act applies to all medical practitioners who:
- held medical registration by an Australian Medical Board on or after 1 November 1996;
- are Australian permanent residents or Australian citizens; and
- do not hold continued recognition by the Royal Australian College of General Practitioners or the Australian College of Rural and Remote Medicine and/or recognition from a specialist medical college.
The Medicare provider number restrictions introduced in 1996 in section 19AA of the Act apply to doctors who were first recognised as Australian medical practitioners on or after 1 November 1996 and who are neither vocationally recognised nor hold fellowship of a recognised medical college. Section 19AA of the Act restricts the accessing of Medicare benefits to doctors who are:
- Australian citizens or permanent residents; or
- temporary residents who have completed their commitment to section 19AB of the Act.
Section 19AA of the Act ensures that all doctors receiving medical education and training in Australia possess the appropriate qualifications to practise medicine. These qualifications require Australian-trained doctors, as well as permanent residents and Australian citizens who trained overseas, to complete a program of postgraduate vocational medical training before being eligible to receive a Medicare provider number with access to the Medicare benefits arrangements.
There are exemptions from section 19AA restrictions for certain training and workforce programs. Section 3GA of the Act allows medical practitioners undertaking postgraduate education or training placements on approved workforce training programs to provide professional medical services that are eligible to attract Medicare benefits. Exemptions to section 19AA of the Act apply to most medical college training and workforce programs, including the Australian General Practice Training Program (AGPTP) and the Rural Locum Relief Program (RLRP).
2010 Review of the Legislation
Under the Health Insurance Act 1973 a review of the operations of the Medicare Provider Number Legislation, Section 19AA, 3GA and 3GC is to be undertaken every five years.
A review was conducted in 2010 and the report tabled in Parliament on 21 February 2011. This found that, although section 19AA is well accepted by the medical profession, general practice stakeholders held different views as to whether the Medicare Provider Number Legislation is achieving the right balance between workforce supply and quality care provision in rural areas. A related issue is the adequacy of resources and support for non-vocationally recognised general practitioners to achieve vocational recognition, many of whom are overseas trained doctors on workforce programs.
One of the functions of the MTRP is to monitor the impact of the Medicare Provider Number legislation. On 20 April 2011 MTRP met to discuss the 2010 review findings. A record of proceedings of this special meeting was tabled in parliament in July 2011. The main points from the meeting’s discussion related to the need for an interpretation of the recommendations, preparation of an implementation plan, inclusive of timelines, which is monitored by the Department of Health and Ageing, and a desire to see action undertaken in-line with the recommendations put forward in the 2010 Review. This work is continuing in 2012.