A group of physicians is attempting to block proposed governance changes to the Royal Australasian College of Physicians (RACP), due to be voted on tomorrow. These changes have been proposed by the current RACP Board of Directors and include changing its size from 19 to nine Directors and its structure from a Board of ex-officio representative Directors to a largely skills-based Board. Seven of the nine Directors will be RACP members, with two community representatives.
The RACP is the peak body representing consultant physicians in Australia. Its members occupy senior roles at all levels of the health system in Australia and have an important influence on health policy. The College has more than 20,000 members and controls a budget of more than $50 million.
According to RACP President-Elect, Professor Nicholas Talley, it is the change members have been asking for.
“Our members have told us that the College is complicated and slow to act,” Professor Talley said. “Simplifying an overly bureaucratic College structure is required, and the Board is leading on this.”
“The College is a complex organisation, with over 21,000 members across 36 medical specialties. The current structures we have in place served the College well in the past, but we are building a College for the future and need to reform and perform,” Professor Talley said.
However, the plans to change the governance of the organisation have attracted serious concerns among senior members of the College, who have called for a planned general meeting to be postponed to allow full discussion about their implications.
These members believe that the changes are being forced through undemocratically and, if successful, will threaten the representative nature of the organisation. The ‘no vote’ campaigners have also stated that the College may ‘disintegrate’ if the changes progress.
“The College Board has deluged members with materials to influence people to vote for the change. This is no substitute for reasoned debate and both sides should be given equal weight. We call on the College to delay the vote so that the debate can take place,” said Professor Paul Komesaroff, a physician from Melbourne, one of the members of the group.
One of the main points of contention is the proposal to introduce a nominating committee of unelected, non-members of the College who will control who can stand for election,” said Associate Professor Henry Kilham, a senior paediatrician. “This would set the basis for a small group of people to gain control over a large organisation and maintain themselves in power indefinitely.”
“This is about democracy and due process,” said As-sociate Professor Ian Kerridge, a haematology specialist from Sydney. “Change has to occur, but it is crucial that the members are consulted and that all options are carefully considered.”
“We are concerned that what is happening here may be a grab for power rather than a democratic process,” said Professor Peter Brooks, a former Executive Dean of Health Sciences at the University of Queensland and a former Honorary Secretary of the College. “Change has to occur, but it has to occur properly. Let’s take our time and hear both sides of the argument.”
However, Board Member Associate Professor Sue Maloney said that members have been given sufficient time to assess both sides of the argument and that the organisation has actively facilitated the provision of ‘no case’ materials to members. She argued that it is the responsibility of the Board to advise members of the Board’s position but that opportunities have been provided for alternative views to be heard, for example via the organisation’s ebulletin sent out to all members.
Assoc Prof Maloney also stated that regardless of the outcome of the meeting it was important for the Board to hear the messages of the ‘no case’ group and take their concerns on board. “It’s important to consider the views of all members, even those whose opinions are not shared by the Board,” she said.
At last count the vote was 25.3% against the changes and 74% for the reforms. The ‘yes case’ needs a minimum of 75% of the votes to be successful.