Setting the benchmark for Urban Primary Healthcare in P.N.G
CONCEPT PAPER – Part 1: Introduction
By Dr. Poyap James Rooney, MBBS (UPNG), PG Cert AVM (ECU- WA)
Current situation – General Practice in PNG
In terms of post-graduate medical training in PNG, the University of PNG still provides the majority of the training. For doctors the UPNG Masters in Medicine Program (MMed) is the only established and recognised training pathway towards attaining a specialist’s post-graduate qualification.
Specialist programs include: Internal Medicine, General Surgery, Anaesthesiology, Paediatrics, Obstetrics and Gynaecology, Emergency Medicine, Ophthalmology, Otorhinolaryngology, Pathology and the most recently introduced? Rural and Remote Medicine.
The UPNG Master’s program in Medicine (Rural) was partly spearheaded by The PNG Society of Rural and Remote Health and focuses on the training needs of doctors who wish to practice in rural PNG. Candidate do rotations in all the major disciplines gaining experience to allow them to confidently perform lifesaving procedures and surgery in the very remote areas of PNG. Candidate also cover administration and public health subjects.
While the majority of PNG voters are based in rural and remote areas, and by all means these areas should remain a priority area for the government there is a fast growing urban population especially in Port Moresby and other major city centres whom are in formal employment and who are increasingly relying on privately practicing GPs for their primary healthcare needs.
It is important that an entity, similar to the PNG Society of Rural and Remote Health be established for GPs practicing in urban areas. The professional needs of these GPs and that of their clients are quite different to their rural practicing colleagues and therefore their training and continue professional development will also differ in many ways.
I am proposing the establishment of a PNG College of General Practitioners (PNGCGP) to be the entity that serves the interests of and links up the private practicing GPs and their urban dwelling clients and the regulators/government.
Stakeholders in this somewhat novel step in PNG towards the lifting of the standards of urban general practice and healthcare in general in PNG would be consumers (patients), healthcare providers, medical insurance providers, IT industry, the PNG Government and other similar entities overseas interested in investing in PNG’s healthcare future.
In the more developed countries, like Australia the Universities are responsible for undergraduate medical training while the individual colleges take on the responsibility of postgraduate training in their respected field. The Royal Australian College of General Practitioners for example provided postgraduate training for candidates whom after completion attain a fellowship of the college. Fellows are also required to undertake ongoing continued profession/medical development/education in order to retain their fellowship.
Fiji now has an established Fiji College of General Practitioners and it would be very appropriate for PNG to establish our own PNG College of General Practitioners. While FCGP no doubt have issues they are working through, in general it has been a step in the right direction. It has allowed a professional group to remain in their profession and still contribute to the broader national issues by influencing their politicians without becoming national politicians themselves.
The Fijian Government has passed a decree that ensures by law, that anyone wishing to provide a private GP service in Fiji must be a member of the FCGP and must take out, at their own expense, Medical Indemnity Insurance. The FCGP in turn is responsible for providing continued medical education (CME) for its members, updating their registry, represent its members in dialogue with the government and other national and international bodies.
One example of a positive outcome resulting from the establishment of the FCGP is their associate membership into WONCA – The World Organisation of Family Doctors. WONCA in turn have been very supportive of the FCGP and Fiji as a member of WONCA has a local WONCA office in Fiji which acts as an important link between the FCGP and WONCA.
In October 2013 I attended a workshop on “Research in Primary Care” in Fiji co-hosted by FCGP and WONCA – (Asia Pacific Region) and had the pleasure and privilege of meeting representative from FCGP and WONCA who expressed their support and interest in assisting in the establishment of a PNGCGP in the near future. I am very grateful for their support and look forward to working closely with these two organisations to pave the way for a higher standard of healthcare in PNG and the region. This sort of collaboration will open doors to a more effective and frequent dialogue with our regional colleagues about health issues.
Why is the establishment of such an entity important?
For the General Practitioners:
For any professional group it helps to be a part of a body that can represent them. In the healthcare profession it is also important to be a part of a program for continued medical education (CME) that will keep GPs abreast with the latest in the medical field especially in primary health care and a PNGCGP can provide these.
For the consumers:
As end users of the healthcare services, the paying public deserve to have some sort assurance that the service that they will be receiving from their healthcare providers is of a high quality, provided by suitably qualified healthcare practitioners who participate in some form of CME program that ensures their practice is based on up to date, evidence based medicine. If it was made compulsory for all private urban GPs to be members of a PNGCGP, this entity will act as this 3rd party to set the benchmark for all member GPs for the quality of healthcare service provided to the paying public.
For the Regulators
For the regulators/government who are off-course interested in the health and well-being of their constituencies a PNGCGP can act to provide a benchmark in medical services for the voting public to ensure that the care that their voters receive is of the highest possible quality standards.
For the Medical Insurance industry
For insurance companies who provide medical insurance as part of their policy to their members, it will make very good financial sense that their preferred healthcare providers are practicing good, high quality medicine which ensures that their clients are treated in a manner that results in their quickest recover. This means practicing quality standardised and evidence based medicine. This will mean savings and therefore a more attractive bottom-line for the insurance companies.
Overall the setting up of a PNGCGP is a win-win concept for all stakeholders whom should come on-board and support such an initiative.
In 2014, I shall be working closely with some Port Moresby based GPs and other stake holders including the PNG Medical Board, The Ministry of Health, Office of Higher Education, UPNG, the Fiji College of General Practitioners WONCA and others, to get this project off the ground. It is my hope that the Papua New Guinea College of General Practitioners be established mid to late 2014.