15 March 2017

Crackdown looms for after-hours services

Medicare TheHill


Federal Health Minister Greg Hunt has turned up the heat on after-hours home-doctor services, blaming “junior doctors and corporate firms” for a blow-out in urgent items costing taxpayers nearly $250 million in the past year.  

The minister has pushed investigations into the sector since taking over the health portfolio from Sussan Ley in January, showing his alarm at the rapid rise in claims for urgent items that carry a lucrative premium.

Medicare figures show claims for urgent MBS item 597 – carrying a rebate of $129.80 – zoomed from just over one million claims in 2014 to more than 1.5 million in the year to December 2016.   

“What these figures are showing is that some people are claiming to be giving urgent services when simply it’s provision of scripts or other things,” Minister Hunt told a national TV news network on Monday. 

He said “junior doctors and corporate firms” were claiming urgent items for visits that were not genuinely urgent, costing the health system $246 million in the latest year.  

The Medical Republic has been told that the minister has already received a report from the investigation initiated by Ms Ley.  

TMR also understands government officials have been making life less comfortable for after-hours providers by tightening controls on provider numbers under the medical deputising program and reminding doctors of the criteria for claiming urgent attendances. 

RACGP President Bastian Seidel told the same Nine Network  news segment that the epidemic of after-hours call-outs was unsustainable and put genuinely ill patients at risk. 

“There are junior doctors who are inexperienced and they are the ones seeing the most urgent cases.  That doesn’t make any sense, and it puts patients at risk,” Dr Seidel said. 

The College has been urging a crackdown on aggressive advertising by some medical deputising services that promote bulk-billed home visits as free.   

It also says the services should be staffed only by qualified GPs and GP registrars under supervision, with proper triaging.

 The National Association for Medical Deputising Services (NAMDS) broke apart in December, with longstanding members distancing themselves from the private equity-backed National Home Doctor Service, which has come to dominate the sector through a series of acquisitions. 

Nic Richardson, the general manager of DoctorDoctor, one of the breakaway services, told TMR he considered the government’s move to review the value of urgent items was “completely appropriate”.

“In my view, the deputising service industry has been negatively impacted by … private equity and other interests getting involved to maximise returns on their investment  rather than concentrating on what we are here for – that is, to act for and on behalf of GPs, not competing with them,” he said.

Mass-media advertising by profit-driven outfits was changing patient behaviour, even though the code of conduct for deputisers banned advertising of after-hours medical services for convenience purposes.

“I would have thought it would be easy for the department to change those guidelines to align with the (RACGP) position paper – that mass-media advertising should be prohibited,” he said.

Dr Spiro Doukakis, NAMDS president and general manager of clinical governance at NHDS SA, said on Wednesday that the after-hours home-visits sector was thriving because of increased awareness and a recent expansion into regional areas.

“The service didn’t used to be available in regional Australia, but today around 80 per cent of Australians now have access to after-hours doctor home visits which is a national success story which should be celebrated,” he said.

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Dr Ryan Smith
Dr Ryan Smith
3 years 10 months ago
Wonder who is going to do all the after hours visits if these services are shut down? No one in this practice will, and after working a full week its the last thing Id want to do regardless of how lucrative it is. It will just turn up in the Health budget from the states as people will have no choice but to turn up to the ED. Btw I just looked up who owns Doctor Doctor and its owned by Sonic so I don’t think this guy Nic Richardson is in any position to start throwing stones about corporates… Read more »
Dr David Chan
Dr David Chan
3 years 10 months ago
Sir – surprise surprise, doctors and patients rorting the “free” bulk billing gravy train for after hours visits especially for trivial or non urgent or emergency problems? Surely, you must be joking!! It is not happening – just like the millions of “unnecessary” routine and “long and complex” consultations being “free” bulk billed to Medicare for years, incidentally by young junior doctors and also qualified RACGP VR doctors and registrars. Every “free” bulk billed program from the Dental, Chronic Disease Management and Mental Health Programs are being rorted every day for many years not just by Corporates but by doctors,… Read more »