ACT nurse-led clinics still a battleground one day from polls

Canberrans head to the polls in under 24 hours, but the RACGP is still hoping to change some minds.

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The RACGP has launched one final attack on nurse-led clinics as the nation’s capital prepares to go into an election tomorrow, urging the next government to invest the money in existing GP clinics.  

If ACT Labor wins – which it has done for the last five elections in a row – it has pledged to expand its five existing nurse-led walk-in centres to include mental health care and to add medical imaging services at the Belconnen centre.  

Earlier this year, an investigation by The Canberra Times revealed that each consult at the nurse-led clinic cost taxpayers roughly $190, almost double the territory’s initial claim of $110 per consult.  

It is not so much the sum of money that is frustrating, RACGP NSW and ACT chair Dr Rebekah Hoffman said, but how it is being spent.  

“Urgent care is often single issue presentations … they’re not talking about preventative care, they’re not talking about smoking cessation, they’re not talking about socio-economic status, they’re not talking about things that will make a significant, long term impact for patients,” she told The Medical Republic.  

“But to fund [urgent care consults] to the value of almost $200 is phenomenal.  

“It’s at the point that you do just imagine what a GP could do with that funding.” 

There was also an incident earlier this year where a patient with severe liver disease was prescribed flucloxacillin at a walk-in centre, which his GP considered to be dangerous.   

“When patients are unwell, they aren’t very good historians,” Dr Hoffman said.  

“They aren’t very good at telling people what medications they’re on, what their past medical history is or other important things that will change outcomes.  

“When they’re seen at the nurse urgent care centre, unless you’re able to communicate those really important bits of information, then the nurse is already starting on the back foot.” 

If the funding for that nurse-led clinic had instead gone toward existing GP clinics to pay for additional nursing staff or urgent care appointments, she said, poor outcomes like inappropriate prescribing would be mitigated.  

ACT Labor has also pledged to expand pharmacist-led prescribing powers and to spend $11 million on four new bulk billing clinics staffed by nurses, GPs and allied health professionals. 

Canberra Liberals, on the other hand, have promised to put GPs into the established nurse-led clinics and pay up to $100,000 of HECS debt for GPs who commit to spending five years in the territory.  

Both major parties and some independent candidates have also come up with proposals on payroll tax.  

From Canberra Liberals, the promise is to legislate to make contractor GPs exempt from the tax – the same solution currently being proposed in Queensland.  

ACT Labor’s proposal is to exempt any bulk-billing GP income from payroll tax, which is more in line with payroll tax solutions set up by Victoria and South Australia.  

Dr Hoffman said either solution was an improvement on the status quo.  

“All of those promises are a significant step in the right direction,” she said.  

“We would still absolutely advocate for a nationally consistent framework, looking to Queensland as the place we’d love that framework to go.”