These issues are also a concern here in the ACT:
The largest GP group in the area have a system where patients are charged an annual membership fee and in return the patient is is Bulk billed.
The Private Health Insurer HCF has sent out a letter to all their members in the ACT that they, HCF, will pay the annual membership fee if the members would jump ship to the particular group of GPs.
Likewise there are schemes with the Health Departments that will fund a membership in return for access to bulk billing services.
Likewise BUPA has an arrangement with a large bulkbilling after hours medical service. This bulk billed home visit system is staffed by doctors that are very often not fully qualified GPs. These doctors see patients in the comfort of their own home and if you are BUPA member you can not only get your bloodpressure checked for free (as in taxpayer funded) at 7PM on Saturday, you will also get free medication there and then as paid for by BUPA.
All of this does nothing to assist continuity of care – sadly the punters will follow the money and very soon they would have forgotten what type of medicine they used to have – the new free services will be all they will remember.
Smaller independent GP clinics simply cannot compete against the commercial reality of these arrangements and slowly we will all close our doors and disappear
The practice I work for recently took over another practice. As is not uncommon in acquisitions, this caused a temporary increase in staff turnover, including GPs.
The response from patients was interesting: just about every other patient asked if I was going to stay. And most patients – not just those with chronic or complex health conditions – expressed their dissatisfaction with the lack of continuity of care.
I’m sure that many colleagues can recall similar anecdotes. This seems to indicate that our patients value personal and longitudinal primary care. Yet, we are seeing many proposals, trials and projects at the moment that threaten this model, and will create fragmented care.
For example, Queensland Health is running several trials at the moment that bypass the usual GP, including a hospital-avoidance project where the ambulance service brings patients to selected GP clinics that receive state funding.
However, usual practices do not…
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