Queensland Labor promises 50 new bulk-billing clinics

A re-elected Queensland Labor Government will build 50 new bulk-billing general practice clinics under a $365-million plan to ‘fix primary care’.
 
Making the announcement over the weekend, Premier Steven Miles said, if he is successful at the upcoming state election, Labor will continue ‘pulling every lever to drive down cost-of-living pressure and deliver better healthcare’.
 
His plan would see the funded clinics rolled out over the next four years across areas battling the worst workforce shortages in Queensland.
 
The pledge comes following commitment from both parties to scrap payroll tax in the state, directly off the back of RACGP advocacy on the national issue.
 
While the RACGP welcomes the latest announcement of investment in the state’s general practice, Queensland Deputy Chair Dr Aileen Traves said there are glaring concerns, and the implementation needs to be done carefully.
 
‘We welcome any improvements and recognition that general practice needs additional support, but overall, 50 bulk-billing clinics is not a well thought through plan,’ she told newsGP.
 
‘There are some concerns, and we certainly would be hoping to speak to whoever is in government about how they would actually do that, because the threat of introducing additional bulk-billing clinics is that we will lose additional services around Queensland that exist currently.
 
‘It does threaten the viability of existing practices, and that certainly is not a financially sustainable model of providing general practice services to communities.’
 
Mr Miles said the locations of the 50 bulk-billing clinics and the support required for their rollout will be determined based on consultation with general practice bodies, including the RACGP, AMA Queensland (AMAQ) and Rural Doctors Association of Queensland, to ensure placement in areas of most need across the state.
 
Alongside AMAQ, the RACGP welcomes the opportunity to consult on the clinics’ locations, but backs AMAQ calls that funding needs to be injected into existing clinics to ensure viability and for patients to access their regular GP, rather than setting up new clinics.
 
Earlier this month, Queensland Labor also revealed election plans to expand its rollout of satellite hospitals by building a new facility in Cairns.
 
Seven of the hospitals already exist in the state, with the initiative aimed at reducing pressure on busy emergency departments.
 
But RACGP President and Mackay practice owner Dr Nicole Higgins has raised fresh concerns for what the proposal would mean for her community.
 
‘This is what policy on the run looks like, and the impact it will have,’ she told newsGP.
 
‘It’s a moving feast without co-design with local medical communities and would break community general practice in Mackay … in an outer-regional town, the impact this has on existing services is huge.
 
‘The setup of satellite hospitals and Government-run bulk-billing clinics means existing community general practice can’t compete because it can’t match the wages paid by Queensland Health, and it creates a vacuum.’
 
With an existing shortage of doctors, nurses and administrative staff across the state’s regional towns, Dr Higgins says satellite hospitals and government-run bulk-billing clinics will further exacerbate workforce shortages, and to the detriment of general practice.
 
AMAQ also recently highlighted the need for clear messaging on satellite hospitals, urgent care clinics and GP clinics because it is creating patient confusion over where to go for care, as well as adding additional workforce pressures on each of these services.
 
‘What this might mean to the community in the long run, is community general practice is not able to thrive or survive, because we can’t compete,’ Dr Higgins warned.

‘Where does the Government think these staff are going to come from? Are we going to continue to fly workers in and out at huge cost to the taxpayers’ purse, to fulfill a thought bubble of policy? Instead, we want the Government to be investing in general practice.’
 
The Miles’ Government’s announcement also included that rent for the new bulk-billing clinics would be covered under the funding package, but Dr Traves says the actual costs of running a clinic have not been considered.
 
‘It doesn’t pay for the nurses, the receptionist, the overheads of insurance, all the other normal costs of living that we all know are going up, it doesn’t cover those gaps,’ she said.
 
‘So there is no financially sustainable way of keeping a fully bulk-billing clinic open without additional and ongoing funding from government. And what you don’t want is 50 clinics that stay open for a short period of time, then close and further deteriorate care to the community.’
 
As part of the consultation process with the Queensland Government on its election promises, the RACGP will continue to advocate that investing in general practice is the most cost-effective way of investing the health dollar, to ensure all practices benefit and remain viable.
 
‘If re-elected, we’d be strongly advocating [to the Queensland Labor Government] for investment to strengthen existing practices, rather than opening up new bulk-billing practices,’ Dr Traves said.
 
‘With the incentive payments the [Federal] Government previously did introduce for those who were eligible, it certainly did see an increase in bulk billing, so there is evidence that investing in existing general practices will actually increase bulk-billing rates.
 
‘But the reality is, general practices are small businesses, and they’re not financially sustainable with rising costs of living and increasing costs of running a small business without actually having government investment.
 
‘We’ve already seen general practice closures across the state, and certainly what we don’t want are more of those … So the implementation [of bulk-billing clinics] has to be carefully considered and not risking existing general practice, because we can’t afford to be losing small practices.’
 
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