Doctors encouraged to provide their own after hours hotline for patients under after hours reforms. Picture Thinkstock Source: ThinkStock
EXCLUSIVE: After hours health care is set to become chaotic in the next six weeks with the popular GP helpline to be axed and at least one after hours service treating 50,000 patients threatening to close.
The changes, driven by a major government reform of the area, could see hospital emergency departments under increased pressure until a new system is established.
The $42 million GP helpline used by over 200,000 people a year seeking advice on medication and minor health issues will be axed from June 30, Health Minister Sussan Ley has confirmed.
Instead, doctors will be paid an “incentive” to take direct after hours calls from their own patients to manage their after hours concerns.
GP ‘incentive’ to be on 24-hour call
Medicare Locals that currently run the $122 million after hours service will lose their jobs and the minister says she will instead pay family GPs directly to provide after hours services through a Practice Incentive Payment.
Primary Health Care Networks that will replace Medicare Locals will be paid to plan, coordinate and support population-based after hours health services.
However, six weeks from the start date of the new scheme the government is still negotiating the contracts with these new PHNs.
“These new funding models will improve access to after-hours primary health care, which will help keep more people out of emergency departments and healthy, happy and in their communities,” Ms Ley said.
The government insists it is not cutting the $160 million currently spent on after hours care. Instead it is “redistributing” how those dollars are spent.
Six-week deadline
Doctors have just six weeks to sign contracts to get new incentive payments for after hours care before the new scheme begins, the government could not say yesterday what those payments were.
Australian Medical Association GP spokesman Dr Brian Morton has welcomed the changed and says it is good after hours care is being removed from bureaucrats and returned to doctors.
However, he says its “a good question” whether doctors can be signed up to the new system in the six week time frame.
“Yes there will be confusion and it is possible there will be more pressure on emergency departments in the short term,” he said.
Royal Australian College of General Practitioners President Dr Frank R Jones said having GPs coordinate after-hours care is a win for patients who will be able to access the care they need from a general practice when they need it — even if it isn’t during normal operating hours.
“The RACGP will be seeking a guarantee from the Government that this funding will adequately support provision of after-hours care,” he said..
A spokesman for Sussan Ley denied that hospital emergency departments would be under extra pressure and said the department would be working overtime to get the new system up and running.
Service to close
The Hunter Medicare Locals GP Access After Hours Service which has provided after hours care for 50,000 patients a year for 10 years says it will wind up next month because its funding runs out.
“With no funding guaranteed past June, the Board of Hunter Medicare Local has no option but to begin to wind up plans for the closure of the GP Access After Hours Service.”
A spokesman for the minister said the funding for the service would beprovided to the new PHN in the area.
The changes implement the key recommendations of an as yet unreleased government review into after hours care.
‘Unnecessary presentations to emergency’
A copy of that review obtained by News Corp shows it wanted the GP hotline to be axed because of “a perception that the service results in unnecessary presentations to emergency departments, that the advice does not always fit the local context and that it has a high load of low-acuity conditions”.
This is even though the review found just six per cent of people who used the hotline were referred to emergency departments.
One in four patients were told to see a GP immediately, just over half the patients were given advice on self- care or told to see a GP during normal operating hours.
Medicare funded 9.7 million after hours services at a cost of $604.6 million last financial year.
But the report raises concerns about the proliferation of medical deputising providers who provide doctors for after-hours care GP practices.
The number of these has more than quadrupled from 16 in 2006, to 83 in 2014 and many of these services are now advertising bulk billed care in a persons own home during business hours as well.
Medicare funded 9.7 million after hours services at a cost of $604.6 million last financial year.