Patient advocates say changes to after-hours regulations ignore the needs of vulnerable patients warn the moves could rebound on taxpayer
The near blanket ban on advertising by home-doctor services might not be a done deal, with patient advocates saying it ignores the needs of vulnerable patients who don’t have a regular GP and also warn the move could rebound on taxpayers.
The policy, announced last week, has been welcomed by the RACGP and the AMA, and was “broadly supported” by the GP Deputisers Association at an initial meeting called to review the changes.
But the ban is under challenge, not only from the larger deputising industry body led by National Home Doctor Service, but from health consumer groups who say the policy is heavy handed and could leave vulnerable patients at risk.
Under the new regime, after-hours services taking part in the government’s Approved Medical Deputising Service (AMDS) Program will be banned from advertising directly to patients as of March.
AMDS businesses will be allowed only to reach out to GPs and to see the patients of GPs with whom they have a written contract, the new AMDS guidelines say.
Of course, providers who don’t sign up to the AMDS program do not have to follow these rules – but then they will lose the right to use non-VR doctors, which account for an estimated 60% of the after-hours workforce.
The Consumers Health Forum said there had been a lack of attention to the likely impact on vulnerable patients.
These included the chronically ill, young families and others who might not know how to contact an after-hours doctor and were unable to get to a hospital, CEO Leanne Wells said.
“Given the ban on advertising to consumers of after-hours services, we hope there will be effective public communication of the continuing availability of deputising services.”
Alison Verhoeven, CEO of the Australian Healthcare and Hospitals Association, called for “caution” around restrictions on promotion of health services, adding it was “superficial” to say most people had a GP and would know where to go.
“People need to be able to access information, but I agree there shouldn’t be rampant promotion of services to lure people in,” she said.
She added that hospitals remained concerned about the effect on emergency departments in the after-hours period, indicating administrators did not think the issue had been properly explored.
“We don’t think (the impact) has been particularly well explained by the data that has been provided in the review process,” she said.
The association’s concern was focused on patients rather than the business model, she said.
The Consumer Health Forum said it had urged the government to ensure that any changes to services would not be at the expense of after-hours access for patients in serious need of immediate care.
“We acknowledge that the use and costs to Medicare of after-hours services did rise significantly under the arrangements now being abandoned,” Ms Wells said.
“Nonetheless ,the response showed a widespread demand for after-hours medical services at home, reflecting the real difficulties many people had in getting to care in working hours.
“The responsibility now rests with the GP community to ensure these new arrangements will deliver timely care to patients,” Ms Wells said.
Dr Spiro Doukakis, president of the National Association of Medical Deputising Services, which represents most providers, said his organisation was seeking clarification of the advertising ban.
“This goes beyond the recommendation of the MBS Review which spoke to alignment with AHPRA regulations,” Dr Doukakis, who works for NHDS in South Australia, said in a statement.
“The proposal would appear to be inconsistent with the principle of universal access as there remains a significant part of the population that is without a regular GP and would be unaware how to access the after-hours program.”
