Victoria, NSW to open 25 free urgent care clinics in each state

The Perrottet and Andrews governments have heralded a “new era” of collaboration across states and political parties, announcing they will each open 25 urgent care clinics to ease demand on emergency departments.

But the $70 million announcement has drawn swift scepticism from rural doctors, who have serious concerns about how the clinics will be staffed, while the country’s top emergency medicine college warns it will not solve the worsening crisis in Australian hospitals.

Dominic Perrottet, Daniel Andrews.Credit: Edwina Pickles, pool

In a joint press conference in Melbourne on Tuesday, Victorian Premier Daniel Andrews said the 50 clinics were needed because it had become increasingly difficult to book a bulk-billing appointment with a GP, unnecessarily pushing people into hospital emergency departments.

Andrews said the clinics would be bulk-billed and patients without a Medicare card would be able to use the services free of charge. “This is just common sense,” he said.

Rural Doctors Association of Victorian president Rob Phair questioned where the required staff would be found in regional areas, which were grappling not just with a GP workforce crisis, but shortages in nurses and other healthcare workers.

“Whether it is GPs, doctors, nursing staff or admin staff, where are they going to find these staff to have them open 16 hours, seven days a week?” Phair asked.

“This does nothing for those in regional and rural Victoria, for example, the 15,000 people in Mildura recently lost the Tristar GP clinic, which closed after going to administration, and who have been left without any primary care at all.”

He added that despite rural areas being hit the hardest by the healthcare crisis he was disappointed only about four of the 25 clinics announced so far would be regional Victoria.

The announcement, however, has strong support from the Royal Australian College of General Practitioners. Victorian president Anita Munoz said only medical clinics which already had the staff to meet the requirements, including extended opening hours, would be considered to run the centres.

“It is self-evident that urgent care centres alone are not the answer to emergency department problems, but they are one component that will add to an entire panorama of solutions to make the health system work better,” she said. “It is a step in the right direction is terms of funding and system capacity and that’s to be lauded.”

Munoz said GPs would not be poached from other areas to fill vacancies in the clinics, warning such a move would be like “shifting deck chairs on the Titanic”.

Australasian College for Emergency Medicine president Dr Clare Skinner said while the clinics may result in a small reduction in low acuity ED presentations, the pressures in hospitals were being fuelled by patients who were seriously ill and requiring inpatient care. These were people too sick to receive the care they needed at an urgent care service, Skinner said.

“These patients then suffer long waits, stuck in the emergency department,” Skinner said “This creates a bottleneck in the ED that leads to overcrowding, ambulance ramping, excessively long waits for care, staff burnout and distress, and poorer patient outcomes, that can include death.”

Urgent care clinics at a glance

• Fifty urgent care clinics will open across NSW and Victoria – 25 in each state.
• The clinics will offer after hours care for non-critical conditions such as mild infections, fractures and burns. 
• Treatment will be free for everyone, including those without a Medicare card.
• The clinics will open near major hospitals to ease demand on emergency departments.

Skinner said the only way the issue could be fixed was “by an increase in significant resourcing across the entire health system”.

NSW Premier Dominic Perrottet, who joined Andrews for the announcement on Tuesday, said forging ahead with a state-based partnership shouldn’t be seen as either state trying to “pass the buck and shift the blame to the federal government”.

“We’re not here to complain,” Perrottet said. “What you can see is a new era of state governments collaborating together across party political lines, because as Dan says, this is not about politics, this is about people.”

The clinics – run in partnership with GPs – will be free for everyone, including those without a Medicare card and focus on providing people with timely care after hours for non-critical conditions such as mild infections, fractures and burns.

The premiers said they expected the services to continue once they were evaluated after 12 months.

“It’s $70 million. It’s not a cost, it’s an investment,” Andrews said. “The cost of failure is so much higher. If that person ends up admitted into a hospital, we pay 50 per cent, the feds pay 50 per cent, and it’s not 50 per cent of what it costs to see the GP a week or month earlier. It’s 50 per cent of a much higher amount of money, and that bed is then not available to someone whose condition was not preventable.”

Andrews said the clinics would be strategically placed near hospitals that were most crowded with patients who did not need emergency care.

Perrottet said presentations to emergency departments in the state increased 30 per cent in the past decade. There were 600 patients currently in NSW hospitals who could have been discharged, he said.

He said forging ahead with a state-based partnership shouldn’t be seen as either state trying to “pass the buck and shift the blame to the federal government”.

During this year’s federal election campaign, Labor pledged to trial bulk-billed urgent care clinics. At the time, health experts warned that the centres wouldn’t empty the nation’s crowded hospital emergency rooms.

A spokeswoman for Federal Health Minister Mark Butler said the 50 clinics will be up and running by mid next year.

Victorians will head to the polls in November. There is a NSW state election due next year.

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