The Federal Government’s decision to scrap Medicare Locals, has raised concern that the number of at-home doctor services, which help keep less serious cases out of emergency wards, will fall.
An increase in the number of home visits by WA doctors from nearly 37,000 in the 2009-10 financial year to 70,000 between July last year and the end of April this year has in part been attributed to the increased marketing by Medicare Locals.
Medicare Locals were established under Labor, to fill gaps in services, including mental health, GP and nurse primary care, after-hours clinics and allied health like physiotherapists.
The decision to scrap 61 Medicare Locals nationally and replace them with a smaller number of bodies under the name of Primary Health Networks was welcomed by the Australian Medical Association (AMA).
However, president of the WA branch of the AMA, Michael Gannon, said it was important that services such as GP home visits were retained.
“We’re supportive of the Government’s decision to scrap Medicare Locals because we believe they were heavily bureaucratised, very inefficient and very expensive,” he said.
“Having said that… they were doing some very good work, and it’s very important that when the new Primary Health Networks take over from Medicare Locals that the services that were working, like after-hours GP services, are maintained.”
Dr Gannon said the services were vital for people with limited transport or who were too sick to get to a doctor’s surgery, such as those in palliative care.
“It’s really important that we have robust after-hours GP services,” he said.
“It’s much more important that a lot of these lower acuity problems are managed by GPs rather than in hospital emergency departments and that we need to maintain those bits of Medicare Locals that were functioning well.”
Outer regions most at-risk if funding lost
The Founder and CEO of Dial-A-Doctor, Ilya Mayo, said the industry was in a “wait-and-see” situation at the moment.
“So far it seems the Government is going ahead, next financial year it’s business as usual for the Medicare Locals, and then there is a lot of uncertainty on how the after-hours funding scene will develop,” he said.
Mr Mayo said Medicare Locals funded specific programs that would otherwise be unprofitable and therefore not serviced, such as the expansion of services to outlying areas.
“The problem we will face if Medicare Locals is withdrawn is a lot of these outer regions which currently we’re being funded to service, they won’t be sustainable anymore, because if you’re bulk billing you have to see a certain number of patients per hour for it to be feasible,” he said.
“You can’t drive out into the country to see one patient per hour.”
Dr Gannon said home visits were not particularly appealing to GPs.
“Perth’s very spread out, and there are some areas in the outer suburbs where it’s hard for GPs to get to,” he said.
“I think [the] reason it’s appealing for doctors to come to your home is the reason why it’s harder for them to get there.
“It might be inefficient for a GP to spend 20-30 minutes in a car when they could be spending time seeing patients in their own rooms.”
At-home doctor visits ‘more comfortable’
Perth mother Sue Willard recently used an at-home GP service after suffering severe, ongoing vomiting over a number of days.
She had already attended her local hospital emergency department after driving herself there in the middle of the night.
Ms Willard said while hospital staff were helpful, she was still unwell two days later when she called an at-home service.
She said the GP and an assistant arrived within 20 minutes and bulk-billed.
“The fact someone can come to your door and come into your bedroom, making you as comfortable as possible, whereas if you go to an emergency waiting room, you have to get yourself there to start with, and you’re sitting on the plastic chairs and you’re waiting in a queue and there’s all these other sick people around you, it’s not very comfortable,” she said.
“They had injections there to make me stop vomiting, they had painkillers and everything, so it was exactly the same as going to a doctor or going to a hospital but it was in your own home, so much more comfortable.”