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]

Federal Labor accuses NSW O'Farrell Government of attacking foster and grandparent carers

In October 2011 I posted that In NSW 24,000 children may be in care by 2013 and, pointed to reports that the O’Farrell Coalition Government was attempting to squeeze foster parents with children sixteen years of age and over and, cost-shift more of the financial responsibility for these children onto natural parents and the Commonwealth.

Now JENNY MACKLIN, Minister for Families, Community Services and Indigenous Affairs, Minister for Disability Reform, and

JULIE COLLINS, Minister for Community Services Minister for Indigenous Employment and Economic Development, Minister for the Status of Women, are taking the NSW government to task in this 2 February 2012 media release.

Liberals attacking foster and grandparent carers in NSW

The O’Farrell Government has shown the Liberals’ true colours when it comes to dealing with families and vulnerable people.

The New South Wales Liberals have slashed $213 a fortnight from the already stretched budgets of foster carers of teenagers aged 16 and over.

The Minister for Families, Jenny Macklin, and the Minister for Community Services, Julie Collins, today called on the NSW Government to reinstate these payments to foster carers of older teenagers.

This is an attack on carers, who not only open up their homes to young people in need, but give their time, energy and financial assistance to help them have a better life.

The Liberals cuts come at the same time as the Gillard Labor Government has boosted family payments by up to $4,200 a year for teenagers aged 16 to 19 in school or training.

Only a Labor Government understands the pressures on families and carers who feel the pinch on their household budget every week.

We recognise that it doesn’t get cheaper to raise children as they get older.

That’s why we’ve ensured that eligible foster carers can receive the boost to the Family Tax Benefit, to make sure they’ve got room in their budget to give the teenagers they are caring for the best chance at a great future.

But the Liberals are putting this at risk. Foster care families will go backwards under the O’Farrell Government’s slash and burn policy making.

This attack on foster carers follows the threat from NSW Minister for Community Services, Pru Goward, to grandparent and other kinship carers that they must apply for child support from the child’s parents.

The Child Support Scheme is an Australian Government initiative to ensure children from separated families are supported by both their parents.

The NSW Liberals’ policy to ‘require’ grandparent carers to apply for child support is misleading and is not consistent with the Australian Government’s policy.

It is unnecessarily putting pressure on the sometimes strained relationships between grandparent carers and the child’s parents.

Although the option is available for relative carers in NSW to apply for child support, the Australian Government does not require or compel carers to do so.

The Australian Government also does not support changes to the Child Support Scheme proposed by the NSW Liberals to open up child support arrangements to foster carers.

These are just more cost-cutting exercises from Pru Goward, who is feeling the heavy hand of Barry O’Farrell on her department’s budget bottom line.

We do not support these ‘policies’. We understand that it is not always in the child’s best interests for grandparent carers or foster carers to apply for child support. 

A Labor Government will always act in the best interests of children.

Date: 2 February 2012

Tweet of the Week

 

R_Chirgwin R_Chirgwin

Love it - a story about a planet 22 light years away with the obligatory Google map in the sidebar, showing Washington.

The Group of Sixteen is not a ringing endorsement of the anti-climate change position

On 27 January 2012 The Wall Street Journal ran an opinion piece titled No Need to Panic About Global Warming. WSJ editor stated that this was signed by the 16 scientists listed at the end of the article.

To assess this opinion one needs to look closer at these signatories than just the name and job descriptions they supplied:

Claude Allegre, former director of the Institute for the Study of the Earth, University of Paris and former politician – so beloved by his fellow scientists that 400 in climate-related fields signed a letter objecting to his statements.

J. Scott Armstrong, cofounder of the Journal of Forecasting and the International Journal of Forecasting – apparently has a BA in Applies Science, a BS in industrial engineering and is a Professor of Marketing mostly teaching in university business schools.

Jan Breslow, head of the Laboratory of Biochemical Genetics and Metabolism, Rockefeller University – an MD with degrees in chemistry famous for creating the heart attack mouse which makes him an obvious candidate to comment on climate-related disciplines in which he is not qualified.

Roger Cohen, fellow, American Physical Society – and retired from ExxonMobil Research and Engineering Company.

Edward David, member, National Academy of Engineering and National Academy of Sciences – as well as former President of Exxon Research and Engineering from 1977 to 1986 and amateur gem hunter.

William Happer, professor of physics, Princeton  - Chairman of conservative think tank the George C. Marshall Institute and former U.S. Federal Government on matters of defence and other technical issues.

Michael Kelly, professor of technology, University of Cambridge, U.K. – an engineer teaching in the electrical engineering division with eight publications to his name.

William Kininmonth, former head of climate research at the Australian Bureau of Meteorology – apparently unpublished in peer reviewed science journals on the subject of climate change and a member of the Lavoisier Group which is something of an astroturfing organization.

Richard Lindzen, professor of atmospheric sciences, MI – according to DeSmogBlog  Lindzen has published work with the conservative think-tank, the Cato Institute. The Cato Institute has received $125,000 from ExxonMobil since 1998. In his 1995 article, "The Heat Is On," Ross Gelbspan notes that Lindzen charged oil and coal organizations $2,500 per day for his consulting service.

James McGrath, professor of chemistry, Virginia Technical University – on the Board of Directors of ChemFab Inc which had commercial ties to the U.S. Military.

Rodney Nichols, former president and CEO of the New York Academy of Sciences - his industrial consulting included the research laboratory of GTE and Shell Technology Ventures, and is presently a partner in GothamOrient LLC which states that We leverage our deep industry connections, decades of collective in-country experience in Asia, and relationships in the government and financing sectors to most quickly and effectively open markets on behalf of our clients.

Burt Rutan, aerospace engineer, designer of Voyager and SpaceShipOne – into conspiracy theories.

Harrison H. Schmitt, Apollo 17 astronaut and former U.S. senator –  a Cold War II warrior whom I always found to be an arrogant and opinionated Ugly American Abroad on the few times I ran into him, so it probably is no surprise to find him on this list.

Nir Shaviv, professor of astrophysics, Hebrew University, Jerusalem – see his blog and decide yourself.

Henk Tennekes, former director, Royal Dutch Meteorological Service – quite a dummy spit when he left the service after an erratic time as director.

Antonio Zichichi, president of the World Federation of Scientists, Geneva – a member of the Pontifiical  Academy of Sciences at the Vatican.

Antarctic Pine Island Glacier Crack precusor to 900 sq. km iceberg

Pine Island Glacier

In mid-October 2011, NASA scientists working in Antarctica discovered a massive crack across the Pine Island Glacier, a major ice stream that drains the West Antarctic Ice Sheet. Extending for 19 miles (30 kilometers), the crack was 260 feet (80 meters) wide and 195 feet (60 meters) deep. Eventually, the crack will extend all the way across the glacier, and calve a giant iceberg that will cover about 350 square miles (900 square kilometers). This image from the Advanced Spaceborne Thermal Emission and Reflection Radiometer (ASTER) instrument on NAS's Terra spacecraft was acquired Nov. 13, 2011, and covers an area of 27 by 32 miles (44 by 52 kilometers), and is located near 74.9 degrees south latitude, 101.1 degrees west longitude.

Image Credit: NASA/GSFC/METI/ERSDAC/JAROS, and U.S./Japan ASTER Science Team