EMERGENCY department staff fear the closure of an after hours GP clinic will have a profound impact on waiting times in Hunter hospitals, as pressure mounts on the state and federal governments to stop "buck-passing" and support the pioneering service.
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One of the inaugural clinical directors of GP Access After Hours, Dr Annette Carruthers AM, said the service was facing its "most serious threat" in more than 18 years due to the state's "short-sighted" withdrawal of funding and the Commonwealth's unwillingness to recognise its true value.
Dr Carruthers said the Hunter's hospital emergency department staff were "really, genuinely concerned" about the impact of reduced GP Access services on wait times - even if the decision makers were not.
"A doctor has told us that while working in the emergency department this month - when a GP Access shift was not operating at short notice - the usual wait of two-to-three hours extended to seven," Dr Carruthers said.
She wants Hunter New England Health to reinstate its financial support for GP Access, and to "recognise the value" of the large number of patients the service sees from its emergency departments.
"The whole point of this is that we take less seriously ill people away from the emergency department so that they can concentrate on the seriously ill ones," Dr Carruthers said. "It is really very logical."
But the federal government also needed to fund the service adequately.
"We have to make the community realise it is both federal and state - not one or the other - that benefits from this, and to stop this buck-passing," she said.
A Hunter emergency department doctor told the Newcastle Herald they were already "run off their feet" and the reduction of GP Access services would make the situation "much worse".
"I really don't know how we'll manage," the doctor said. "The end result is that it will be the public that suffers and our staff will be under even more pressure than they already are and it's unsustainable."
It comes as state health minister Brad Hazzard conceded the funding issues for GP Access - raised during Question Time on Monday - were a "concern for all of us," before pointing the finger back at the Commonwealth.
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Hunter Primary Care, which runs GP Access After Hours, intends to close the service's Calvary Mater clinic on Christmas Eve and reduce operating hours at the remaining four in the new year, citing a rise in operating costs not being matched by funding.
The service is primarily funded by the Commonwealth via the region's Primary Health Network, but it has also received financial support from Hunter New England Health - on behalf of the state - until now. The health service intends to provide "in kind" support only from next year.
Dr Carruthers said when GP Access was first established, it was "very strongly supported" by Professor Katherine McGrath, the chief of the Hunter Area Health Service at the time.
"She really understood the benefit for the hospital system in that, by being co-located with emergency departments, we could also see people who arrived in the ED with minor conditions," she said.
Dr Carruthers said the news the federal government was sitting on a report that recommended funding for the service be brought back in line with similar - but different - after hours services nationally was "really worrying".
"It is bringing us back to mediocrity," she said. "That's how I feel about it; that we have to dumb it down to the rest of the country, not recognise and celebrate something that actually does a really good job. It is actually the best after-hours service in the country. There are similar versions, but they don't have all the bells and whistles ours has, and it is those bells and whistles that make it so successful."
The Hunter's state MPs have approached the health minister about their concerns for GP Access, and the projected impact on Hunter emergency departments should its services be slashed.
Responding to Lake Macquarie MP, Greg Piper, during Question Time on Monday, Minister Hazzard said it was concerning the funding arrangements that were supposed to be there for GPs were not there from the Federal Government.
The NSW government "valued GPs".
"Which is why the local health district has been, if you like, filling the gap and putting some money in," Minister Hazzard said.
"Because, since 2013, the then Labor government but also followed by our colleagues in the Liberal-Nationals have not been increasing the Medicare rebates as GPs need to reflect their provision of medical services. The coalition government has now changed that and is increasing it, but nowhere near enough to be able to provide the services."
Minister Hazzard said he had written to federal health minister Greg Hunt "demanding" he look at these issues and increase funding.
"The NSW government, of course, will continue to do what it can to provide services. I know in some hospitals GPs are given free accommodation, a free place to practise. But, at the end of the day, they also need to get the appropriate Medicare rebates. That is the big issue."
The Commonwealth has contributed over $4.3 million a year to the service, plus a "one off top up amount" in the last financial year taking it to $5.9 million. A Department of Health spokesperson said this additional funding was added in recognition the state had reduced its funding by $450,000. The state has previously provided $559,798 a year to the service, which receives between 10,000 and 12,000 referrals from Hunter EDs each year. GP Access takes about 70,000 calls through its patient screening service and has 50,000 clinic presentations a year.
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