GP services close over unsustainable funding

A major community health organisation has announced it will close GP services at three of its Victorian clinics, leaving thousands of patients without access to their doctor and 20 GPs being made redundant.
 
Cohealth will shut down GP services at its Collingwood, Fitzroy, and Kensington practices in December with Chief Executive Nicole Bartholomeusz pointing to funding failures of Medicare as the cause.
 
The not-for-profit company operates GP clinics across Victoria and Tasmania supporting disadvantaged communities with a range of integrated health and social support services.
 
Ms Bartholomeusz says ‘the current Medicare funding model does not support the way our GPs work’.
 
‘Despite our best efforts to make Medicare work, it simply does not cover the cost of the care, nor do existing item numbers match neatly to the way our clients access care,’ she told newsGP.
 
‘Medicare is structured around short consultations and does not account for the extended time and coordinated, multidisciplinary care that Victoria’s most complex and vulnerable clients need. Clients that we have worked with for many years to build up trust.
 
‘To put it simply – we are funded for standard care, but we are servicing extraordinary need.’
 
The move will impact a vulnerable population of patients with ‘complex health and social needs’ and comes just weeks before incoming measures begin to incentivise the bulk billing of all patients from 1 November under the Bulk Billing Practice Incentive Program (BBPIP).
 
Cohealth has called for Federal Government support to avert the crisis, saying new bulk-billing incentives won’t go far enough.
 
‘Cohealth serves people who cannot afford to pay out-of-pocket fees, and the introduction of bulk-billing incentives still doesn’t result in Medicare matching the cost of care,’ Ms Bartholomeusz said. 
 
‘This will have significant impact on the clients and the community. It will also place additional strain on our emergency departments and public hospitals.’
 
A Federal Government spokesperson described the closure of cohealth’s GP clinics as ‘deeply disappointing’, and encouraged the group ‘to explore the financial and community benefits of participating in the new BBPIP’.
 
‘We have requested the board reconsider its position,’ the spokesperson told newsGP.
 
‘The Department of Health and North Western Melbourne Primary Health Network has met with cohealth to identify possible solutions to improve financial sustainability, including through maximising MBS billing.
 
‘Clinics like cohealth will be much better off from our Government’s historic investment in bulk billing.
 
‘The Government remains committed to ensuring that all Australians, particularly those who are most vulnerable, can continue to access high-quality, affordable primary care close to home.’
 
RACGP Victoria Chair Dr Anita Muñoz urged the Victorian Government to ‘step up and save these clinics’.
 
‘This is lifesaving healthcare, including for people from disadvantaged backgrounds, those facing overwhelming barriers of living such as rising costs of rent and essential goods through to those living in a state of crisis,’ she said.
 
‘The closure of these clinics highlights what we’ve been warning about for many years – more must be done to secure the financial viability of general practice care statewide.’
 
A Victorian Government spokesperson said the state is focused on strengthening care across the system so every Victorian can get the care they need, close to home.
 
‘Community health organisations play an important role and we continue to provide them with significant funding, investing $188 million last year alone to support the delivery of care across the state,’ the spokesperson said.
 
‘We’ll continue to advocate to the Commonwealth to address Medicare rebates for patients with complex care needs.’
 
The announcement by cohealth comes after several practices buckled under financial strain in recent years.
 
In April, one of Canberra’s last bulk-billed clinics entered into voluntary administration after facing challenges around income and retaining enough doctors under its fully bulk-billed business model.
 
RACGP President Dr Michael Wright said the recently released Health of the Nation report shows ‘the majority of GPs remain concerned about financial viability of practices, and we can’t afford to lose anymore practices, no more so than in those vulnerable communities’.
 
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bulk billing bulk-billing clinic Medicare practice closure vulnerable patients