AMA Advises COAG Caution on National Call Centre
AMA President, Dr Mukesh Haikerwal, today urged the Federal and State and Territory Governments to put off any COAG agreement on a proposed national triage call centre until there has been proper consultation with providers of care and due regard given to the effects on hospital emergency departments and the impact a national service would have on successful local services currently operating.
Dr Haikerwal said there is still no compelling evidence that a national call centre would reduce the number of people presenting at emergency departments.
"In fact, it could have the opposite effect and increase pressure on public hospitals depending on the nature and time of the calls to the centre and the pattern of referrals," Dr Haikerwal said.
"Without detailed analysis of the impact and without defined expectations of patient benefit, the national call centre concept is little more than expensive window dressing.
"For such a system to work properly, it must be linked to existing local call centres and existing local after hours GP services.
"We cannot afford duplication of services that would waste rare health funding dollars.
"The only way a national health call centre could work is if it linked local services already operating and if it complemented, not replaced, currently available after hours GP resources and services," Dr Haikerwal said.
Dr Haikerwal said the AMA's concerns about a national health call centre are mirrored in a report by ACIL Tasman of November 2004, which was prepared for the Australian Health Ministers Advisory Council (AHMAC), and which ultimately fed into the current COAG process.
This is what ACIL had to say about some of the key arguments for a national health call centre:
1. Reducing pressure on hospital emergency departments
'Direct evidence that call centres have reduced unnecessary demands on emergency departments - along with costs and possibly the effectiveness of treatment of those cases where emergency treatment is appropriate - is weak and patchy.' (page vi)
According to the Federal Government's own data, Category 5 attendances at emergency departments fell by 11 per cent between 1998-99 and 2003-04.
At the same time, however, Category 2 attendances increased significantly, by 45 per cent, over the same period.
It is clear that GP patients are not the issue in terms of pressure on Emergency Departments.
2. Cost and financial resource investment
'Where a sound after hours GP service has been developed and incorporates telephone triage, we can understand concerns with a wider policy development that may threaten that service.'
'…the key issue faced by Health Ministers remains that of a national approach - whether it is justified and, if so, the form it should take and, presumably, how it should be funded. In principle, this is different from the question of whether health call centres constitute good policy' (page 1)
Dr Haikerwal said the national health call centre proposal is underdone, does not constitute well-founded health policy, and should be put off by COAG until the proposal has been more thoroughly examined by all stakeholders.