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Cost blowouts at nurse-led walk-in centres exposed
Internal emails show ACT public health officials recently buried around $10 million in additional annual expenses.
New estimates suggest nurse-led walk-in centres have a cost-per-service of around $194.
ACT health bureaucrats grossly underestimated the cost of its nurse-led walk-in centres, according to new emails released under freedom of information (FOI) laws.
The alleged cover-up, exposed by The Canberra Times, suggests the controversial initiative’s cost-per-service is approximately $194, almost double the ‘less than $110’ figure Canberra Health Services (CHS) initially spruiked last month.
The investigation also revealed that officials have not measured the number of walk-in patients redirected to emergency departments since October 2022.
RACGP President Dr Nicole Higgins told newsGP the actual costs reinforce that the money could have been better spent on general practice.
‘This is just more evidence that investment has to be put into the right places if you want to get outcomes,’ she said.
‘Funding drives results. If the Government had put this sort of money into general practice, it’d get much more bang for buck.
‘This model, it’s not free. It’s costing taxpayers five times more than what it would if they saw their GP.’
The now-public internal emails indicate overhead costs associated with running the centres account for much of the discrepancy between the initially provided figures and those unearthed by the FOI inquiry.
CHS officials had originally calculated an average cost-per-service of $109 by dividing the five centres’ allotted $12.6 million budget for 2022–23 by the 115,000 presentations that took place in the 2023 calendar year.
But internal spreadsheets released as part of the FOI request reveal that the centres actually cost $14.7 million to run in 2023, while officials decided not to include $7.6 million in additional operating costs when making their calculation.
In response to the newly published documents showing total annual expenditure had reached $22.3 million – $9.7 million higher than they had acknowledged – a CHS spokesperson reportedly noted that there had been a ‘back and forth’ between bureaucrats when responding to the initial media enquiry.
‘During this process, one area developed an estimate of the cost per service at walk-in centres that included a range of overhead costs,’ the spokesperson said.
They also reportedly said the $109 figure was a ‘rough estimate’ and that they had relied on the $12.6 million budget figure because it was considered the most relevant and the one in which they had the ‘most confidence’.
Meanwhile, measurements for emergency department redirections have reportedly not taken place in the past 20 months as officials have not had an ‘agreed methodology’ to calculate the figure after the Digital Health Record was rolled out in November 2022.
Walk-in centres were in-part designed to ease pressure on public hospitals, but wait times in Canberra’s emergency departments have deteriorated according to ACT Health’s 2022–23 annual report. The city also has the lowest bulk billing rate in Australia.
The last independent review of the walk-in centres took place more than 13 years ago and Dr Higgins said further evaluation is long overdue.
‘What it does is create a two-tier system where we’ve got fragmentation of care, duplication of services, and increased costs due to increased test ordering and referrals back into the emergency department and general practice,’ she said.
‘It’s a false economy. Investing in general practice in the first place would have saved taxpayers more money, but there aren’t many shiny ribbon cutting ceremonies in general practice.
‘Australia’s got one of the best health systems in the world. Let’s use what we have, but make sure it’s funded appropriately – and that means supporting general practice to keep people out of hospitals.’
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