CATHERINE TURNER, HUNTER NEW ENGLAND AND CENTRAL COAST PRIMARY HEALTH NETWORK: Good morning and welcome to the opening of the Charlestown Medicare Urgent Care Centre. My name is Catherine Turner, I’m the Executive Manager of Commissioning at the Primary Health Network, and I’ll be your MC for this morning. I’ll begin by acknowledging that we are meeting on the unceded lands of the Awabakal people, and we pay our respects to the Elders past and present and thank them for their ongoing custodianship of this beautiful country, and remind ourselves of the important work for the improvement of the health of First Nations people.
I would like to welcome our very important guests this morning. I feel odd because you’re behind me Pat, but the Honourable Pat Conroy who’s the Federal Member for Shortland and Minister for International Development and the Pacific and Minister for Defence Industry and Capability Delivery. Sharon Claydon is the Federal Member for Newcastle and a Deputy Speaker of the House of Representatives. Richard Nankervis from the Primary Health Network who’s our Chief Executive Officer. Simon Taylor-Cross, Director of Operations at ForHealth. Simon tells me this is their 38th Urgent Care Clinic so congratulations to them, and I’d also like to welcome Louise Lazic who’s the General Manager of Integrated Care, Networks and Partnerships for Hunter New England Health, and we really acknowledge the importance of Hunter New England Local Health District in working in this sector.
I’m just going to take a moment to also acknowledge our team in this because this is the fifth one of these clinics that we’ve commissioned and opened in the last 18 months I think – about 15 months since the first one opened – and it’s an enormous amount of work and there’s such a lot of interest in such a high profile program, and they’ve really done a very professional job working in the community, working with service providers, and making sure these things happen. So I’d like to thank Mitch Cootes, Billi McGrath, Amy Clyde-Smith who looks after our New England clinics, and Blythe Scully for the all of the work they’ve done here on that.
So, without further ado I’m going to handover to Pat Conroy to say a few words. Over to you, Pat.
PAT CONROY, MEMBER FOR SHORTLAND: Sorry, just getting some last-minute facts, but it’s great to be here with Sharon Claydon, my friend and a neighbour, obviously Catherine, Richard, and Simon and the whole team here. Access to affordable healthcare is the number one issue for the people of Shortland. It’s obviously related to cost of living, but I am finding that when I’m door knocking and phone banking, while cost of living is still there, being able to see a doctor is the number one issue for the people of Shortland. And the Albanese Labor Government is listening to their concerns and we are acting on them. We acted on them in the lead up to the ’22 election when we made commitments around restoring funding for the GP Access After Hours service. We responded to those concerns by committing to returning the Distribution Priority Area to this area so that we could get overseas and scholarship doctors. We listened to it in the last couple of Budgets where we tripled the bulk billing incentive to make it easier to see a doctor, particularly a bulk billing doctor.
But we know it’s a challenge to see a doctor, we know it’s a challenge to see a bulk billing doctor, and it’s a challenge particularly after hours – if it’s on Saturday afternoon and your kid’s come off a skateboard or has a sporting injury, or it’s late on a weeknight, your doctor might not be open, and that’s why these Medicare Urgent Care Clinics have been so phenomenally successful and so well received in the community, and that’s why it’s critical that we deliver one for the Lake Macquarie/Newcastle area.
Thirty five per cent of presentations to the John Hunter Hospital – the busiest hospital between the Hawkesbury River and the border, the biggest hospital as well – are for non-urgent or semi-urgent cases. So by putting in a Medicare Urgent Care Clinic in the catchment area for the John, not only do we make it easier for people to see a bulk billing doctor when they need it, we’re taking pressure off the emergency department because like many people in our community, I’ve spent hours waiting there, and I’ve seen a whole lot of people who if they’d had access to a doctor, a GP, they would have gone there instead.
So I’m so delighted that this clinic is now open and servicing the community. Simon tells me it’s already seen 173 people since its opening on Wednesday which is phenomenal, and I am sure that it will only ramp up as the hours extend from the current 8am-8pm to 8am-10pm every day of the week. So it fills my heart with joy. It’s critical for our community, and it’s another example of the Albanese Labor Government listening to what the community prioritises most. I now invite Sharon to make some contributions.
SHARON CLAYDON, MEMBER FOR NEWCASTLE: Thank you Pat, and enormous thanks for having us here today. This is the best Christmas present ever for Novocastrians. I was reflecting as I was coming over here that three years ago on the eve of Christmas, I was standing outside the Mater Hospital holding a press conference advising my community that the former Liberal Government had closed the GP Access After Hours service at Mater Hospital. It was there and then that myself and the Labor team in the Hunter region committed ourselves to ensuring that we would not just reopen the clinic at the Mater Hospital, but restore all of the remaining four clinics to their full operational hours, and with the entire Labor team, we rededicated ourselves to strengthening Medicare.
Why is that important? Well a) everybody needs to be able to access affordable, high quality primary healthcare. That’s what keeps people out of hospitals. And b) when they are presenting at hospitals with conditions that really, they shouldn’t be here, those categories that Pat was just referring to, we need those people to be able to come to centres like this Urgent Care Clinic to get the kind of quality primary healthcare that they need. That is the ambition of a Labor Government, and I can tell you that, you know, the contrast between three years ago where we were announcing, well protesting against the closure of primary health services in our region, this is why the opening today of a Medicare Urgent Care Clinic is the best Christmas present to Novocastrians.
There is not a day that goes by in my office where people are seeking to find bulk billing doctors. The lack of affordability now is really quite critical for many of our families, and so having services like this available that have got access to, you know, a whole range – it’s a multidisciplinary team in this centre, but having a service that is, you know, when you unwrap those Christmas presents and the kids are starting to get on their new skateboard and push bike, we know how often that involves a stack at the end of the day – I suspect you might see a few of those here Chrissy Day – but let’s hope that your staff aren’t too run off their feet.
But this is really, I think you’re really seeing the results of some long-term commitment from a Labor Government to strengthening Medicare in our region. We know that this is the underpinning of universal health, and we are dedicated to ensuring that people can walk in to get the kind of healthcare they need, where the only card they need to do so is their Medicare card. Thanks very much.
RICHARD NANKERVIS, CHIEF EXECUTIVE OFFICER, HUNTER NEW ENGLAND AND CENTRAL COAST PRIMARY HEALTH NETWORK: Thanks very much to Pat and to Sharon, and on behalf of the PHN I’d just like to say how grateful we are as a PHN and on behalf of the community for the investment that the Commonwealth Government is making into Urgent Care Clinics. These centres are really important for us across the region. This is the fifth across the PHN region that we are opening, and I think that this is about the most fast-tracked of any Urgent Care Centre in the country so far, and I really just want to pay tribute to the Commonwealth Government and the service provider ForHealth – Simon and Matt and the team – for how rapidly they’ve been able to stand this centre up. It’s not a straightforward endeavour to do so, and there’s a lot of work behind the scenes that happens to enable this sort of opening, and so we are really thankful and proud of that.
As Pat and Sharon have said, these centres are really for non-life-threatening injuries and illnesses. They’re for some of those things that you might often go to an emergency department for, but with the opportunity of attending an Urgent Care Centre, you can absolutely seek the right care, in many cases in a better place than you would have if you’d have gone to an emergency department. So that’s really what we are looking for here.
We are incredibly heartened by how busy the centre is so far. We had high hopes in this centre but also high confidence in the centre and the ForHealth team to be able to deliver. The other thing just to note is that in such an urban centre, it’s important for these centres to connect well with GPs in the surrounding suburbs, and that is a key hallmark and feature of this centre as well, and we look forward to seeing that connectivity continue to grow as the centre develops. So I just want to again thank our team but thank the Government – Pat and Sharon – whose commitment to our communities is unquestionable and the health of our communities. And thanks to Simon and the team for standing (inaudible).
SIMON TAYLOR-CROSS, DIRECTOR OF OPERATIONS, FORHEALTH: Thank you everybody for coming today, and thank you to Pat and to Sharon and to Richard. For us at ForHealth, we’re the largest operator of the Medicare Urgent Care Clinics across the country, and we absolutely every day see the benefit that these clinics founded by the Albanese Government are delivering to communities. Here, we will be operating 8am-8pm seven days a week, and you can walk in, no appointment, covered by your Medicare card, and if you don’t have a Medicare card, you can still walk in and get that access that you may need.
Operating a number of these clinics, we see that just over a third of people who walk through the doors are under the age of 15, so we know that these clinics are really popular with young families and gives that important access for children in a different environment to a hospital department. Being a father of an eight year old and a four year old with experience having a trampoline accident and coming to an Urgent Care Clinic, the ability to come in, see a doctor or a nurse, have an x-ray on site or any bloods that may be required, and to be back out and back at home in an average of about 90 minutes is a really good experience for children.
So, we know up here in Newcastle and Lake Macquarie, this will be extremely popular I am pretty sure - as Sharon said – over Christmas. We are preparing for that, but in addition to that, we’ve also brought new doctors to the area. We know there’s a shortage of GPs in the area, and for this clinic we have two full-time equivalent doctors new to the Charlestown area who are working within this clinic, so we’ve been able to increase our workforce in here as well. So thank you to everyone for their hard work in getting this off the ground, and we look forward to it being very successful.
REPORTER: I was just going to ask Simon, you run ForHealth, and I was just wondering how do you decide who gets access to the Urgent Care Clinic, because you have- could you have some patients who may perhaps use the normal clinic?
TAYLOR-CROSS: Yeah, so patients will get to the reception desk of the Urgent Care Clinic. There’s a frontline triage process within there. We’ve got clear inclusions and exclusions criteria. If they meet the inclusions criteria after being triaged by the nurse, then they’ll go through to the Urgent Care Clinic. If they don’t meet those inclusions criteria, then they- a path will be open to either find access to their regular GP, and quite often a call to their regular GP will slot them in for an appointment. It may be a different access point within the healthcare system, it may be a pharmacy that they need to go to, or if they don’t have a regular GP then they can be redirected to the main desk of the practice here and we will have walk-in available appointments for a normal GP.
REPORTER: Is it just based on, you know is there a list of priority things that an Urgent Care Clinic treats or is it in on more, I guess, socioeconomic-
TAYLOR-CROSS: No, it’s really clearly on the inclusions and exclusions criteria, so they’re normally categorised and Category 4 or 5 presentations in the Department, so like a laceration, a cut, or a fracture, they’ll make that clinical assessment within those criteria.
CONROY: Are there any other questions about today’s announcement?
REPORTER: Oh yeah I wouldn’t mind, the annual funding that you guys have, I don’t think that’s really (inaudible). I mean, it’s public money, are you guys able to share that?
CONROY: Well we’ve got the global figure, do you have the specific figure or? (inaudible) Because obviously each one is commercial in confidence for a number of reasons, but the key thing here is that there is a requirement to put on a number of staff and to be open a certain number of hours, and as I said, based on Simon’s information, 173 in half a week already. To give an example down at Lake Haven, 350 patients a week are being seen on average, so it’s massive for the community. But we will get you those figures offline.
REPORTER: Can you take some questions on say the, I mean we have talked about it but seeing as we’re here, the amount of people not seeing a GP due to cost. I mean this is obviously something that’s going to help with that, but can you touch on that Pat?
CONROY: Well this is a – and Sharon might want to make a contribution as well because both of us addressed this in our opening remarks – this Urgent Care Clinic will make a massive difference for the Lake Macquarie and Newcastle community. It just will, and it’s one part of our approach. We recognise that access to affordable healthcare is a critical concern for people in the community. That’s why we’ve taken so many, so much action. Whether it’s allowing overseas-trained doctors and Australian bonded doctors to practice here again – why Peter Dutton and the last government banned overseas trained doctors practicing in our area is beyond me, but that led to a doctor shortage. We’ve reversed that, that’s obviously critical. Restoring the hours of the GP Access After Hours clinics including Sharon’s fight to get the Mater reopened is making a difference. Tripling the bulk billing incentive was seminal, and the regular Medicare rebate increases are all turning around bulk billing rates nationwide and in our region.
Bulk billing rates in our region are on the rise again. We’ve been very clear that they’d flatlined at the end of the last government because they defunded Medicare, and I am sorry for being political with non-political people in the background, but we are repairing damage that’s been done through 10 years of neglect. Well, it’s not even neglect, it’s 10 years of attack under the last government.
REPORTER: Fair enough, but –
CONROY: Sharon did you want to add anything?
CLAYDON: Sure, I think that it’s really abundantly clear to both Pat and I as local members the need for increasing the access to Medicare funded doctors’ services in the region. I know Pat would say the same – on the doors, on the phones, this is what people are talking to us about. So when we reopened the clinic at the Mater Hospital for example, 8,000 presentations in the first three months of operation. So there’s no doubt the need, and from the figures for the first week of this clinic, 173, I think you are getting a very clear demonstration of the need that exists there.
We’re trying to address the issue, Damon that you referred to where people are forgoing, you know, treatment at an early stage are going to primary healthcare practitioners for treatment. We want people to do that because, you know, to take advantage of primary healthcare because we don’t want people to unnecessarily end up in a tertiary health setting like a hospital. So it makes great sense for households and government to be actually encouraging people to get, you know, good healthcare at the early intervention stage as possible.
REPORTER: While we’re here too, could I just touch on that GP shortage? Pat, that was an interesting comment you said about the overseas doctors and Dutton. From what I can see looking into it, we’ve got the Royal Australian College of GPs, and they have a kind of monopoly over the training, and talking to a health economist about that, he says there are these barriers to entry, and that is affecting the price that people pay, the gap fees that people pay. I don’t know if that’s a bit of a mouthful, but what I’m getting at is, are you guys looking at anything like that to try and-
CONROY: Well not only are we looking at it, we’ve made critical policy changes to fix this. The first one is – and Richard might have something to add from the PHN given they’re actually the experts in this area – but two things. One, restoring the Distribution Priority Access designation for this area. So in 2018, Mr Dutton as part of the Morrison Cabinet banned overseas trained doctors and any Australian doctor who went to uni on a scholarship from practicing in our area. That led to a massive doctor shortfall. I’ll give you an example in my electorate, half of the doctors in Lake Munmorah disappeared, just disappeared. So that was one of our election commitments and Mark Butler stood outside the Windale Medical Clinic in the poorest postcode in all of New South Wales after our first Budget and announced the restoration of the DPA. That was a critical first step.
The second thing is we’ve streamlined recognition of qualifications and experience from countries most similar to us, and that was a recent announcement. So that’s countries like the United Kingdom, Canada, and New Zealand, and that is speeding up – and I’ve had that feedback already. I was down at Gwandalan Medical Clinic having a street stall last week or the week before and they were so positive that that will speed up their opportunities to get doctors from overseas in areas where we should recognise their qualifications. If you’ve qualified and practiced in the UK, you’re clearly fit for here as long as your records are good. So that will help too.
Three, we’re ramping up training. So there’s a record number of trainees going through the GP training scheme now. I want to say a 25 per cent increase but I could be wrong, it’s about 1,500, and so getting that training pipeline as well. So letting foreign-trained doctors practice here, speeding up the recognition so they don’t have those barriers, and increasing training of Aussie doctors is all helping solve the problem. Richard, I’m not sure whether you wanted to add anything.
NANKERVIS: Oh, I think you’ve nailed it, Pat. What we’ve seen from the Commonwealth Government recently is a review into the distribution levers for the medical workforce in Australia, and we have seen that fast-tracking of the ability for GPs from New Zealand, the UK, and Canada to become registered in Australia for the first time. But also, what we’ve seen in recent years is a reduced local pipeline of Australian trained GPs, and the recent announcement of the significant increase in GP training numbers in Australia will make a significant difference for our GP workforce within this region.
REPORTER: (inaudible) have you got an opinion on that?
NANKERVIS: I think the further numbers we will need to keep an eye on, but the increases that have been recently announced will make a significant difference to our GP workforce in this region. And what we see for the GP workforce in this region is that for better or for worse, the metropolitan centres, the large metropolitan centres continue to be the major drawcard for the GP workforce, but what the increase in Australian trained GP numbers will mean for us is that we start to see more of that impact in Newcastle, in our outer urban areas, in our regional and rural areas. So, I think we’ve got a nice trajectory for the next 5-10 years.
REPORTER: Last one from me I promise. I just want to, I just thought I should ask you guys, you may have a thought or opinion on this, I haven’t asked you before, but with the- the health economist was saying with the gaps that are growing, you know, the costs of seeing a GP, it would be fairer to bring private health insurance to cover that area at some point. Do you guys have an opinion on that?
CONROY: Well, what I can say is the fairest thing to do is to increase bulk billing rates, and that’s what we are doing. That’s why we’ve tripled the bulk billing incentive, that’s why we’ve increased GP pay through the Medicare rebate. If we don’t have the Medicare rebate going up and cost of living is going up, doctors are going to charge patients more, and that’s why the six-year freeze of the Medicare rebate under Peter Dutton when he was the Health Minister, when he was voted the worst Health Minister in the history of the country, has done enormous damage to doctors’ pay. So we’re restoring that through increasing the GP rebate and tripling the bulk billing incentive, and that’s how you increase bulk billing rates so that people can afford to see a doctor, and that’s the most critical element.