FNQ skin cancer clinic charges patients after govt funding pulled

After losing government funding of $100,000 a year, a Far North Queensland skin cancer clinic has stopped bulk-billing patients, regrettably having to charge them instead.

As the state struggles through a statewide GP and specialist shortage, Cairns doctor Vin Rajeswaran, whose practice treats more than 67,000 patients in Far North Queensland, is having to charge his most vulnerable patients after the federal government pulled funding.

Last year his practice, FNQH Skin Cancer Centre, lost its government incentives, amounting to $100,000, after not qualifying as a general practice, because it performs primarily dermatology and skin cancer procedures.

“So we ticked all boxes, except one box where it says we should do more than 50 per cent of general-practice procedures, and not just not just one specialty,” Dr Rajeswaran said.

“So we lost $100,000 a year in funding, so instead of bulk-billing a patient, we’re now having to charge to make up for the deficit.

Cairns doctor Vin Rajeswaran. Picture: Lyndon Mechielsen

“I now have to charge patients for melanoma incisions and melanoma checks, and I’ve been pushed to charging pensioners, who we used to bulk-bill.

“It is a heartbreaking decision, but at the end of the day, it was either that or shut up and walk away.”

The government says a practice must be a general practice as defined by the Royal Australian College of General Practitioners.

The industry accreditation body, Australian General Practice Accreditation Limited, indicated in its 2021 assessment that FNQH Skin Cancer Centre does not conform to RACGP’s definition of a general practice, because “more than 50 per cent of patient health records were related to skin consults”.

Dr Rajeswaran said the reason he took on predominantly skin cancer patients was due to the high volume of patients needing treatment and the scarcity of specialists in the region.

“We don’t have enough specialists, and we only have one full-time dermatologist in the Cairns base hospital, and that covers the whole of Far North Queensland,” he said.

FNQH Skin Cancer Centre lost its federal government incentives, amounting to $100,000, after not qualifying as a general practice, because it performs primarily dermatology and skin cancer procedure.

“We perform 120 skin cancer incisions a week, so that’s almost 5400 incisions in a year.

“But then if I refer all my patients to the public hospital, that’s 5400 incisions they have to cover – this is why my practice does this much skin cancer work.

“So you can’t do ‘one-size-fits-all’ accreditation standards because I’m regional, and we don’t have been plastic surgeons and dermatologists in every street corner.”

Aside from dermatology and skin cancer treatments, according to its website, FNQH Cairns also offers a variety of GP services including chronic disease management, women’s health, and ante-natal care.

Dr Rajeswaran said medical practitioners across regional Queensland were calling for more funding, with many feeling the pressure because of the lack of state and federal government support.

“We are losing family businesses, people are losing their livelihoods; I’ve seen first-hand how much it’s affecting Australians in our region,” he said.

Cairns doctor Vin Rajeswaran. Picture: Lyndon Mechielsen

“Essentially, regional Australia is depending on individuals like me to subsidise medical care for the citizens,

“Rural and regional Australian practices needs a higher rebates then you have to incentivise doctors to come to rural areas.”

Despite calls for the RACGP to change the definition of a general practice, RACGP Rural chair Dr Michael Clements said it was unlikely likely the government would provide GP incentives to practices that specialised in one service.

“The government is deliberately trying to support holistic general practices, practices that do everything,” he said.

The industry accreditation body, Australian General Practice Accreditation Limited, indicated in its 2021 assessment that FNQH Skin Cancer Centre does not conform to RACGP’s definition of a general practice.

“The government has signalled that it doesn’t support practices like that to primarily skin cancer in these rural and return areas.

“So even if we were to change our definition, you know, as a college, the federal government’s intent is clear.”

The RACGP, however, supports the government providing additional funding and incentives for specialists.

“So what (Dr Rajeswaran) is asking for really is for the federal government to provide more financial support to skincare, medicine, and of course, that’s a good call,” Dr Clements said.

“We certainly support that – GPs who provide primarily skincare services do great work.

“We certainly need them in the rural areas and regional areas where we don’t have enough dermatologist and non-GP specialists.

“So we certainly do support investment, more investment in regional and rural practices.”