After-hours doctor changes could cut both ways

Cuts in payments to doctors for after-hours services announced today stand to reduce unnecessarily high-cost services but also run the risk of reducing access to care for those patients and families in urgent need, the Consumers Health Forum says.

“The Government is seeking to reduce the use of doctors charging premium rates for after-hours services classified as “urgent” and those savings will be reinvested in Medicare which is to be welcomed,” the CEO of Consumers Health Forum, Leanne Wells said.

“It is good to see after hours incentives will be retained for regional and rural areas and that specialist qualified GPs undertaking after-hours services will qualify for higher Medicare payments.  However the reduced payments available to non-specialist doctors may result in fewer services and/or higher out of pocket costs for patients.

“The focus on payment for quality is also to be welcomed along with emphasis on the importance of continuity of service by a patient’s usual GP.  CHF is a long-standing proponent of the patient-centred health care home model of care – access to after hours needs to be integral to that.

“However there is variable access to affordable after hours services across the country. Current after hours services have attracted strong demand particularly in areas where the demand is not being met by most standard general practices.  As CHF stated in its submission to the review into after-hours services, given the realities of modern life and the demand for after-hours care, will the existing GP workforce, which we agree is well qualified, be available in the hours they are needed?  Or are we now at risk of seeing ever more increasing variability in access to after-hours services?

“While there was a marked jump in claiming of urgent after hours payments in recent years resulting from more focused night time medical practices, the fact is that there is an underlying need from individuals and families who are unable to reach GPs during standard working hours.

“We support the principle that all treatment under Medicare should be based on clinical need and no other factor and should be billed under the appropriate Medicare items.

“Affordable and accessible after hours services are an important part of any world-class health care system. We would caution against any unintended consequences as we balance access and appropriate after hours care with unnecessary costs to the system.

“It is important that we monitor how these changes play out in the community and their impact on patients and families and to remedy any service shortfalls should they become evident.   We look to the Government to continue to work with all stakeholders and relevant service providers, including general practices, Aboriginal Community Controlled Health Services, community pharmacies, consumers and Primary Health Networks on a longer term strategy for after hours services.

“The situation also highlights the need for better community awareness about the full range of after hours options available to patients and families such as Healthdirect and locally funded PHN services and for thought to be given about how these might be extended within a quality framework using digital health solutions, for example.

“For now, it is up to the general practitioners who have voiced concerns about the practices of after-hours services to ensure that their patients are not disadvantaged by these changes,” Ms Wells said.


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Mark Metherell
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