In an Australian-first, Victoria is opening GP clinics in 100 secondary schools
The Victorian government is opening GP clinics in 100 secondary schools in a bid to head off health problems in disadvantaged young people before they become entrenched.
The $43.8 million pilot scheme is being rolled out at 20 government schools in the current school term, with Primary Health Networks recruiting local GPs to partner with schools. Another 40 will follow in term three of this year and 40 more in the first term of 2018.
Half of the schools taking part were in regional areas where there were barriers to healthcare access, and 25% were in growth areas where services were under stress, the state government said.
About 70,000 students will have access to GPs when the scheme is in full flight.
Dr Ewa Piejko, a GP and medical adviser for the Murray PHN, which has three schools in the first tranche of 20, said a doctor would attend a school clinic for about four hours a week, seeing patients but also working with the school to raise health literacy.
“Doctors who are putting their hands up for the program are really keen on early intervention and illness prevention, and those who are interested in mental health,” she said.
Medical services would be bulk-billed, with separate payment to cover times when the doctor was not seeing patients or performing an education role for the school. GPs would receive a grant to take care of set-up costs and undergo training before they took up the role.
“There will also be a practice nurse who can provide additional information and education – on asthma, for example, because it’s a big problem in our rural areas, or sexual health,” Dr Piejko said.
“It’s also about educating adolescents that they can go and see their own doctor. It’s teaching them about confidentiality and access, to provide that broader service to improve health and well-being among adolescents and get early intervention at an earlier age.”
The Victorian program is unprecedented in Australia, although there are isolated cases of clinics on school campuses, including one at Melbourne’s Wellington Secondary College, which caught the eye of Victorian Premier Daniel Andrews and inspired his election promise to deliver the program.
Melbourne GP and academic Dr Lena Sanci, who advised the government on the concept, said problems in young people arose largely from risky behaviours or stemmed from abuse or violence.
But the largest unmet need was in mental health.
“Probably the most important health issue that is often not picked up in this age group is mental-health concerns. We know that about half of all adult mental-health disorders start to occur by about the age of 14. By about the age of 24, it is around 75%,” she said.
Dr Piejko noted extra challenges for teenagers in rural and lower socio-economic areas, such as longer travel distances, time-poor parents or embarrassment about seeing a doctor they had known all their lives.
It’s also about educating adolescents that they can go and see their own doctor.
“Coming from a smaller area, they might feel uncomfortable about seeing their family doctor for whatever reason. This provides an opportunity to see someone else,” she said.
Dr Sanci said the program could break new ground in understanding of school-based healthcare intervention because of its size and preparation informed by overseas examples. “The US has a four-decade history of school-based healthcare and dominates the published literature. But it is patchy, depending on the state,” Dr Sanci said.