A SERVICE that helps up to 80,000 sick people each year in the Hunter access after-hours healthcare advice and treatment is at risk.The GP Access After Hours Service takes pressure off the region’s hospital emergency departments by diverting less urgent patients to its clinics.
But Hunter Medicare Local clinical director Dr Lee Fong said it could be lost after funding runs out in June next year.
Newcastle GP Dr Annette Carruthers described the service as the ‘‘jewel in the crown’’ of primary healthcare in the Hunter.
‘‘It’s the best after-hours service in the whole country – 250 GPs work in it and rely on it for their after-hours services for their patients, and the community relies on it,’’ she said. ‘‘I’d be devastated if that fell over.’’
Blacksmiths mother of three Kaz Amos, who used the service recently, agreed.
‘‘That service is a godsend, especially in the middle of the night when you don’t know whether you’re doing the right thing,’’ Ms Amos said.
Medicare Locals across the nation are preparing tenders to transition to a new model of ‘‘primary health networks’’, making it a critical time for the non organisation.
The resignation of Hunter Medicare Local chief executive Carol Bennett last week shocked the medical community and raised doubts about the future of the organisation and also the GP access service.
Dr Fong said the Hunter Medicare Local board needed to ‘‘do everything it can to give the organisation the best possible chance to transition’’ into this new model.
‘‘The risk of the service closing is there,’’ Dr Fong said. ‘‘I am assured that the organisation, led by the Hunter Medicare Local Board, is working hard to prevent this.’’
Along with a telephone line (1300130 147) manned by registered nurses, the after-hours service includes five GP clinics based at hospitals in the region.
It’s the best after-hours service in the whole country – 250 GPs work in it and rely on it for their after-hours services for their patients, and the community relies on it
They are located at Belmont, John Hunter, Calvary Mater and Maitland hospital emergency departments as well as the Toronto polyclinic.
On average, the telephone line takes 80,000 calls each year, while the clinics see around 50,000 people – 40per cent of whom are under 16 (of which 24per cent are younger than five).
In the 2013-14 financial year, the service received more than 8500 patients diverted from emergency departments.
About 93per cent of patients attending clinics are seen within 30 minutes of their booking time and 92per cent of calls to the telephone line are answered, by a person not a recording, within five minutes.
The clinics consistently run at 86per cent capacity.
The service began in Maitland in 1999 with a pilot program.
The service now boasts a network of 260 doctors covering 72 shifts every week across the region.
Dr Fong said a great deal of effort had gone into establishing it.
‘‘If it were to fall away you’d be hard pressed to get it up and going again,’’ he said.
‘‘It’s hard to put together, not too bad to sustain, but if you let it go you’re in trouble.
‘‘It achieves that concept of relieving the emergency department of cases that could be seen more efficiently by a GP.’’
Dr Carruthers, one of the founding members of Hunter Medicare Local when it was the Hunter Division of General Practice more than 20 years ago, agreed there was a real risk to the organisation, and GP Access After Hours particularly.
‘‘I think it’s really important that the local organisation gets the tender and not a Medibank Private or the state government or something like that, and that risk is absolutely real,’’ Dr Carruthers said.
‘‘Local is just so important and with this jewel in the crown, GP Access, it’s such an important organisation.’’
Chair of the Australian Medicare Local Alliance Dr Arn Sprogis said he would be shocked if the government didn’t continue to fund the after-hours service in the Hunter.
‘‘It both nationally and internationally sets the benchmark for an after-hours GP service,’’ he said.
‘‘Equally important, it is also the most cost effective and productive after-hours service in the country
‘‘It would be a huge error by any government not to support its ongoing function.’’
Practice manager of Hamilton Medical Centre Lesli Dunnicliff used to work in the Maitland area, where the service is most relied upon.
‘‘From my time working in Maitland, it was very valuable,’’ she said.
‘‘It would be very sorely missed, especially in the valley.’’
A spokesman for federal Health Minister Peter Dutton confirmed the existing after-hours arrangement in the Hunter was guaranteed only until June next year.
‘‘Medicare Locals will continue existing after-hours arrangements to June 2015,’’ he said.
The spokesman added that the government would consider the recommendations of the Horvath Review of Medicare Locals.
The Horvath Review was critical of newly established after-hours services, recommending the government should ‘‘assess the appropriateness and effectiveness of the current delivery strategy’’.
A MENTAL health service that helps more than 3000 people a year is one of the many important Medicare Local programs that hang in the balance in the Hunter.
In the 2012-13 financial year, Hunter Medicare Local’s mental health service provided 15,377 psychology sessions to 3163 patients.
It also helped 250 people flagged as being at risk of suicide through 1000 sessions.
Hunter Medicare Local clinical manager Philip Carr said there had been a ‘‘notable’’ increase in demand for the primary mental health program after recent cuts to state-run counselling services.
‘‘Not having these services would mean that a large proportion of the community would have significant barriers to access free mental health services,’’ he said.
‘‘This would place further pressure on GPs that are currently experiencing difficulties in accessing services for their patients with mental health issues.’’
Another major focus of Hunter Medicare Local has been to help people manage chronic diseases such as diabetes, respiratory illnesses and heart problems.
Demand for its ‘‘Closing The Gap’’ program – encouraging indigenous residents to have their health assessed – has risen 300per cent in three years.
This financial year, it has carried out 5000 health checks on Aboriginal clients.
Hunter Medicare Local is also working on a program that has reduced the number of aged care residents being taken to emergency departments by 40per cent.
It provides added support and guidance to employees at aged care facilities when an elderly person suffers health problems after hours.
Hunter Medicare Local services, and who they helped in 2012/13:
Health Pathways – an information portal for clinicians at the point of care – 253 doctors participated, with more than 18,000 visitors to the website
Primary Mental Health Care – psychology services for children, adolescents and adults 3163 patients were referred to psychologists for 15 377 sessions.
Suicide Fast Response – for patients at ‘moderate to high risk’ of suicide, or who have attempted suicide or deliberate self-harm – last year managed over 250 people and offered nearly 1000 sessions.
Care Coordination Quality Improvement Project programs (CCSS and Connecting Care) – to reduce chronic disease risk factors, encourage earlier detection and better management of chronic disease in primary care for Aboriginal and Torres Strait Islander people – manages an average 213 active patients per month.
eHealth – a personally controlled electronic health record system – 75 per cent of the Hunter’s general practices were registered, with one of the highest consumer registration rates in the country
Closing the Gap – delivering healthcare to the Aboriginal community and finding ways to improve access to main stream services
Headspace – a youth-friendly service (for 12-25-year-olds) offering mental health support and counselling, general and sexual health services; alcohol and other drug services (Hunter Medicare Local is the lead agency among a consortium)