Ochre Health's Grafton GP Super Clinic raises questions about equity and access

Here is a thumbnail sketch of general practioner medical services in Australia:

Australian Government expenditure on general practitioners in Australia was $6.4 billion, or $287 per person, in 2010-11. Australian Government expenditure on the PBS was around $7.3 billion, or $326 per person, in 2010-11. Total expenditure by all governments on community and public health was around $7.9 billion in 2009-10. [http://www.pc.gov.au/__data/assets/pdf_file/0007/114847/11-government-services-2012-factsheet-chapter11.pdf]

Nationally, there were around 2.1 million GP-type presentations to public hospital emergency departments in 2010-11…..

GP-type presentations to emergency departments are presentations for conditions that could be appropriately managed in the primary and community health sector

(Van Konkelenberg, Esterman and Van Konkelenberg 2003). One of several factors contributing to GP-type presentations at emergency departments is perceived or actual lack of access to GP services……

GP visits that are bulk billed do not require patients to pay part of the cost of the visit, while GP visits that are not bulk billed do…..

Reduced competition for patients can also reduce bulk billing rates……

Deferring or not visiting a GP can result in poorer health. Nationally, in 2010, 8.7 per cent of respondents reported that they delayed or did not visit a GP in the previous 12 months because of cost. [Australian Productivity Commission, Report on Government Services 2012]

Here is one example of how it is working on the NSW North Coast:

The Grafton GP Super Clinic will offer the community a compliment of general practitioners, practice nurses, physiotherapy, audiology, podiatry, chronic disease care managers and dietitians. The GP Super Clinic will also bring together visiting specialists and other allied health professionals to meet the needs of the local community.

With a specific focus on chronic and complex disease management, our team uses a single shared electronic medical record system and takes a team-based approach to healthcare. The GP Super Clinic aims to develop a health partnership with each and every patient, ensuring that we work in a preventative mode to reduce the chance of patients developing complex or chronic preventable illness. [Ochre Health website]

Grafton Super Clinic stated over the telephone on 2 February 2012 that bulk billing is not the norm for the clinic.

Ochre Health needs to respond to the questions raised in the letter below and, explain why it should continue to charge low-income individuals/families for basic consultations on everything from earache to influenza - given that the federal government paid in excess of $5 million to build this particular super clinic and set up the private medical practice in order to offer bulk billed services for concession card holders, children under 16 and patients with chronic conditions and complex care needs under Enhanced Primary Care Medicare item numbers, with a view to taking the burden of non-urgent free health care delivery off the sholders of public hospital Accident and Emergency departments.

GP Super Clinic

I WOULD like to see the Examiner do a story on the GP Super Clinic in Grafton.
The super clinic was built and paid for by the government to reduce the strain on the public hospital system by giving patients somewhere else to go.
However, due to the greedy nature of doctors in Grafton, of course, this is the only GP Super Clinic that does not bulk bill its patients.
Thus, the people still go and sit in the waiting room at the hospital for up to three and four hours at a time just to see a doctor.
You can go and see a doctor and be bulk-billed by Medicare in any other city in Australia, except Grafton.
This is what is known as price fixing and it is illegal in Australia. Yet, no-one seems to want to do anything about it.
The money promised to the City of Grafton by the Australian Government was to build a GP Super Clinic for all the people of the area to use and alleviate the pressure on the over-strained hospital system.
However, the greed of doctors in this area has ruined what should have been a great thing for Grafton. We should shame these doctors into running our super clinic properly and to bulk bill patients, like every other super clinic in Australia.

KEN HINTON

Grafton

[Letter to the editor in The Daily Examiner Feb 2012]