Dr Glasson said the policy supports existing medical services, which already provide round the clock care to our communities.

"New services must be GP designed and driven if they are to meet the needs of the community," Dr Glasson said.

"Until the release of the Coalition's policy yesterday, policy from both parties had the potential to devalue and discourage existing individual doctor or group after hour arrangements.

"The Coalition's decision to increase the Medicare patient rebate for all services provided after 8pm on weekdays, after 1pm on Saturday and all day Sunday, will help make this care more affordable and accessible for patients.

"But the policy needs to go even further and include all services provided after 6pm on weekdays and any time on the weekend as this is when general practice costs rise.  To help GPs keep their doors open longer the Medicare Schedule must be amended to include a more realistic definition of after hours service.

"The financial support for after hours GP services will help GPs establish new services and keep successful services running.

"This policy will encourage GPs to establish services that will address the needs of their own community. There is no one size fits all solution to after hours services and the Coalition has accepted that local solutions, devised and run by local GPs, are the answer.

"In addition, the recurrent funding and supplementary grants will help keep after hours services that are providing quality patient care open.

"I am particularly pleased the Coalition has listened to the profession and promised this funding will only go to services with demonstrated local GP support and that do not compete unfairly with existing services.

"The AMA has been telling the Government and Australian Competition and Consumer Commission (ACCC) that the Trade Practices Act inhibits after hours care by deeming certain rostering practices unlawful. As recently as August, the AMA put in a submission to the ACCC on this issue. I am pleased the Coalition has committed to address this anomaly," Dr Glasson said.

The AMA's position on after hours GP services is set out in AMA Key Health Issues for the 2004 Federal Election (see attached).

27 September 2004

CONTACT:     Judith Tokley  (02) 6270 5471 / (0408) 824 306

General Practice

 

1.1       After Hours GP Services

 

 

Background

The AMA supports the right of all Australians to timely and appropriate primary medical care. GPs and their practices have an ethical and professional obligation to ensure access to appropriate care and continuity of care for patients who choose to engage them in their care.  It is unreasonable, however, to expect any doctor to be available 24 hours a day.

Key Issues For Patients

Patients should be able to access trained GP care whenever they reasonably need to.  GP workforce shortages are making provision of after hours care more difficult but GPs are developing innovative solutions to this problem based on local situations and needs.

Key Issues for Governments

Both the Government and the Opposition believe co-located after hours GP services can take pressure off the public hospital system, but a study by the Australasian College for Emergency Medicine shows these clinics will not significantly reduce emergency department overcrowding, and will undermine both community after hours services and continuity of patients' care.

Despite the advice of the AMA and other medical groups, the Federal Government has reached an agreement with the Western Australian Government that will allow GPs in hospital clinics at four hospitals to access the MBS (although regulatory amendment of the Act is still required).  NSW is looking for support similar to the model trialed in the Hunter Valley, and Victoria has independently established co-located clinics that bulk bill.

The Australia Health Ministers' Advisory Council (AHMAC) is examining the potential for a national call centre network.  The Opposition is considering GP "hot spot" teams, where salaried GPs will be set up in hospital-based clinics in areas where bulk billing and GP numbers are low.

AMA Position

The AMA will not support any proposal that includes "in-hours" services and compulsory bulk billing.  These unfairly subsidised clinics would compete with local general practices, potentially undermining their viability, and threatening access for patients.

Any funding for these clinics must be "new" funding and cannot rely on cashing out existing MBS after hours funding.  This would unfairly discriminate against patients of existing after hours services and force them out of business, limiting choice for patients.

Clinics can only be established with full support from local GPs.

The function of call centre triage and call centre advice services should only be to advise people on how to access the most appropriate form of service and what choices are available.  Call centres must only be used as a tool to access doctor initiated triage and not as a substitute for general practice care, to restrict access to services, or to introduce managed care.  Experience is some States indicates these are not cost effective.