‘Insulting’ proposal to hide GPs in a UCC back room

3 minute read

ACT Health planned to quietly introduce GPs into its nurse-led clinic … but patients would not be able to request to see them.

Last year, the ACT government proposed integrating GPs into its existing nurse-led walk in urgent care clinics.

And by “integrate”, it meant “fill out forms”.

Canberra’s five walk-in priority care clinics predate the federal government’s Medicare urgent care clinic initiative.

Instead of rolling out separate GP-led clinics under the UCC model last year, the ACT struck a deal that allowed it to use the Commonwealth money to expand the existing nurse-led clinics instead.

A consultation document from early 2023, released this week under freedom of information laws, reveals that the territory did intend to integrate GPs into the clinics, but not in a traditional model.

According to the proposal, which the federal government agreed to in principle, one GP would be employed to provide after-hours and weekend consults as well as virtual advice and telehealth services for all five walk-in clinics.

The benefits of this, the proposal said, would be to support nurse practitioner training and supervision, as well as the “ability to complete worker’s compensation and third-party paperwork”.

Canberra Health Services wouldn’t advertise that there was a GP in the clinic, nor would it allow patients to request to see the GP.

“Rather GPs will work as part of the team, extending the scope of skills available on shift and treating patients accordingly,” it said.

“To do otherwise, would create significant additional demand to the centres and disrupt the provision of local GP services.”

This would “preserve and optimise” the existing nurse-led model.

Shadow Health Minister Leanne Castley told The Medical Republic that the idea of hiding GPs in a back room was “insulting”.

“We know the Health Minister and Labor-Greens government do not respect or prioritise GPs and are more interested in taxing them instead of working closely with our hardworking GPs to ensure Canberrans have access to important primary healthcare,” she said.

The hidden GP proposal was ditched following consultation with key stakeholders.

In a ministerial brief compiled in August 2023, also released under FOI laws this week, ACT Health wrote that the consultation had revealed “strong sensitivities between medical and nursing representatives” over the proposed UCC model.

According to AMA ACT president Dr Kerrie Aust, the “strong sensitivities” referred to in the letter was not doctors rejecting the idea of being hidden.

“We raised concerns about some of the model options that were on the table, but we were hoping to find solutions to those that ensured that there was appropriate clinical oversight and evidence-based approaches to urgent care management,” she told TMR.

What’s more, she said, some doctors had such a positive experience working in multidisciplinary covid clinics that they were keen on the idea.

“We were quite surprised when we were told that having GPs in [the urgent care] clinics was no longer going to be considered, and we weren’t given any further feedback about why,” Dr Aust said.

Following recent revelations that the nurse-led clinics are far more expensive than previously touted by the ACT government, there is a growing call for an independent review of the five centres.

Trouble is also brewing for state-based UCCs further down the Hume highway, with rumours that Victoria will slash funding for the priority primary care centres opened in 2022 and 2023.

Anonymous sources told Nine Newspapers that clinics were told they could lose up to a quarter of their funding in June, following which most signed on to two-month contracts.

These will expire in August.

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