The federal health minister isn’t willing to sit on his hands while awaiting an independent evaluation, which will be used to “tweak", not terminate, the program.
Medicare urgent care clinics will “continue well into the future”, says federal health minister Mark Butler, arguing that cost-effectiveness should be modelled against emergency departments not general practice.
“This program is working, there is no doubt about that,” the minister told the press yesterday.
“This program is going to be a permanent feature of Australia’s healthcare system.
“Whether the evaluation comes to us with some suggestions about changes to the way in which the program operates, remains to be seen.”
On Sunday, the federal government announced that it would invest $644 million in opening 50 new bulk-billing UCCs during the 2025-26 financial year, despite the lack of evaluation of the 87 currently in operation.
According to the government, 80% of Australians will live within 20 minutes of a UCC once the new clinics are opened.
As reported by The Medical Republic, the RACGP has maintained its stance against continued investment in UCCs.
The college raised concerns around the cost of UCCs compared to general practice.
Speaking at a press conference on Tuesday, Mr Butler said the college was using “the wrong comparator” and referenced a HealthEd survey published last year.
“With respect, I have a disagreement with the college of GPs on this,” he told the press.
“I want to point out that in a big survey last year, 70% of GPs said this program was a good program, and 80% of GPs said it was having a good impact on local emergency departments.
“I think the college of GPs is wrong about this.
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“The proper comparator is not the price of a standard consult a GP might have on a weekday.
“The proper comparator is what it is costing for people to end up at emergency departments … because we know the vast majority of people who go through these UCCs tell us they would otherwise end up at a hospital ED, particularly on the weekend or after hours.”
When asked why the government was spending millions more on a policy that had not yet been evaluated, Mr Butler said “because there’s a clear demand for this”.
“I have no doubt this program will continue well into the future in Australia.
“We [were] one of the very few countries without an urgent care clinic program.”
The minister noted the 15,000 UCCs in the United States – arguably not the health system to use as a benchmark.
“The UK, New Zealand and Europe operate them as an integral part of the healthcare system, that sit between a standard general practice and a fully equipped hospital emergency department,” he said.
“The evaluation will help us tweak the program or provide some changes to its design, as would be appropriate given this is a new model of care for Australia, but I’m not going to sit on my hands and see this enormous demand for urgent care out in communities … while we await that independent evaluation.”
So far, evidence of the benefits of UCCs has been largely anecdotal.
However, Mr Butler said earlier this week that some semi-urgent and low-acuity ED presentations had decreased by as much as 10-20% in areas with UCCs.
When asked by TMR where the data came from DoHAC said, “ED hospital data is publicly available on the AIHW website”.
“Publicly available AIHW hospital ED data shows there has been a decrease in semi-urgent and non-urgent ED presentations across a number of hospitals that are supported by Medicare UCCs.”
The office was unable to provide a list of said hospitals, or examples, prior to the publication deadline.
AIHW was unable to meet the publication deadline. Its response will be added to the article once received.
Mr Butler said he was confident in the attractiveness of the UCC model to staff but was working to address shortages.
“We just had a terrific discussion with the operators of this UCC [in Wyong] about some of the challenges they have – not because of the attractiveness of this model; it’s a really attractive place to work as a doctor or a nurse; I get that feedback all over the country – but some of the system barriers and hurdles that communities like this have in attracting GPs,” he said.
“We don’t have enough people coming into general practice, and certainly that provides downstream challenges in staffing areas like the emerging UCC network.
“But we’re working very hard to make sure that in addition to more UCC and more bulk billing, we are delivering more doctors.”
