State and general practice join forces for rollout

Jolyon Attwooll

30/08/2021 4:06:06 PM

A pilot program involving state health officials and GPs is aiming to boost out-of-hours COVID-19 vaccination rates in Victoria.

Dr Mukesh Haikerwal prepares COVID-19 vaccinations with members of the Altona North Medical Group team. (Image: Supplied)

A trial collaboration between general practice and the Victorian State Government to boost out-of-hours COVID-19 vaccine coverage could be adopted elsewhere if deemed a success.
Dr Mukesh Haikerwal has said around 1000 extra COVID-19 vaccine doses have been delivered at his Altona North clinic in Melbourne’s Western suburbs over the past two weekends after a pilot scheme gained State Government support.
The Victorian Health Minister Martin Foley referenced the trial at the weekend, confirming his government is assisting with infrastructure costs and vaccine supply at Dr Haikerwal’s clinic. 
Dr Haikerwal told newsGP the collaboration is unique in his time as a GP and a welcome boost for a vulnerable part of the city.
‘There is a need to step up supply of both testing and vaccination, because we’re deemed to be the area where there’s the highest levels of COVID infection and potential [for infection],’ Dr Haikerwal said.
‘I’ve been working with State Government and Federal Government for around 30 years and this is the first time the State Government has materially supported a general practice-based entity [like this].
‘It’s never been done because [of] the argy-bargy between state and federal [governments].’
Dr Haikerwal says he wants to challenge what he calls the ‘erroneous notion’ that general practices can only work with Commonwealth authorities.
‘We’re at pains to point out that we’re Victorian businesses, working in Victoria, with Victorian providers, looking after Victorian patients,’ he said.
The arrangement should suit all concerned, he believes.

‘It’s a win-win-win for the patients and providers in the area because they can do vaccinations and get more people cared for, [and] it’s a win for the State Government because there are more Victorians getting jabs in their arm,’ he said.
‘And this is a win for the Federal Government, because obviously, Australians have been covered, but also the CVC [Commonwealth Vaccination Clinic] program is delivering so the numbers go up.’
Minister Foley told media on Saturday the State Government is not subsidising the Medical Benefits Schedule (MBS) but ‘meeting extra establishment costs’ for the out-of-hours vaccine clinics.
‘Supporting GPs to demonstrate they can do more is the right thing to do,’ he said.
‘If we can demonstrate to the Commonwealth through a couple of model examples that they can do more, then we think that’s a wise investment, particularly in those areas of those north and western suburbs where there [are] disproportionate cases of COVID.’
RACGP Victoria Chair Dr Anita Muñoz said she backed the extra support for GPs, and praised Minister Foley for being ‘very receptive’ to ideas to bolster the state’s vaccine coverage.
‘This is a marvellous collaboration between general practice and Minister Foley’s office and is very welcome,’ Dr Muñoz told newsGP.
‘Although there are out-of-hours item numbers for vaccinating, the magnitude of the cost of running a business out-of-hours far exceeds the remuneration of MBS item numbers alone.
‘I’m really pleased the State Government wants to remove whatever barriers it can to make sure vaccinations are as accessible as possible and they were open to hearing our description of this logistical challenge in general practice.’

The vaccination waiting area at the Altona North Medical Group. (Image: Supplied) 

Dr Muñoz said she hopes the pilot will prove successful and be adopted more widely, while adding that the partnership highlights the financial pressures on practices.
‘There will be an ongoing need about how we fund health given the costs of health and running a business have only increased and MBS have not met the same indexation,’ she said.
‘That’s a longer-term conversation but in terms of urgently getting as many Victorians vaccinated as quickly as we can, I think it’s a wonderful collaborative effort – and I think it indicates the State Government really understands how integral general practice is to the whole of the state.’
Dr Haikerwal, in the meantime, is also advocating for what he describes as ‘community vaccination surge capacity’ in the local government area of Hobson’s Bay.
He hopes general practice, local and state authorities can work together to allow existing infrastructure to be used to boost out-of-hours vaccination in an area he described as ‘the Ground Zero’ of the current COVID-19 outbreak in Melbourne.
In theory this could use a roster system for staff from multiple practices, again backed by State Government support.
He hopes such schemes will help address disparities in vaccination take-up highlighted in the geographical vaccine data now being published by the Department of Health.
Another doctor working outside of the usual confines is Dr Joe Garra from MyClinic Werribee. On Friday, he assisted at a vaccination clinic on a City of Wyndham council site, where 400 vaccinations took place – and where council staff were on hand to help.

He says the assistance from the local council has allowed the clinic to carry on with its day-to-day duties more easily.
‘Offsite is so much more efficient for the GP because nothing else is happening, just jabbing,’ Dr Garra told newsGP.
‘There are no scripts, there are no referrals. No one can ask for anything. It works really well.’
Dr Muñoz said hearing stories of collaboration between different levels of government is heartening.
‘If we try to see some good that comes out of a crisis like this, the spirit of working together and cooperating is wonderful,’ she said.
‘We are proving to ourselves that some of the lines that are drawn between funding streams are not as definitive as we thought they were.
‘With collaborative effort and will, we can innovate over and around those traditional funding stream barriers.’
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