WA Premier shifts blame for hospital woes onto GPs once again

Jolyon Attwooll

6/09/2022 3:05:42 PM

Mark McGowan has drawn the ire of RACGP leadership for ‘unacceptable’ comments that accuse GPs of contributing to the state’s health crisis.

Mark McGowan
West Australian Premier Mark McGowan has again blamed GPs for his state’s overcrowded emergency departments. (Image: AAP)

West Australian Premier Mark McGowan has come under fire from GPs after taking aim at general practice while defending the state’s health system.
Facing pressure from a public inquest into the death of seven-year-old Aishwarya Aswath, who died of sepsis at Perth Children’s Hospital in April last year, Premier McGowan directed blame for the state’s stretched hospital system towards primary care.
‘I think what is a large part of the problem, is the relationship between the Commonwealth health system and the state health system,’ he said.
‘In that, if you want to go to a GP these days, very few bulk bill and a lot won’t see respiratory cases, therefore people are going into the emergency departments.
‘And that is putting pressure on our hospital system, when they actually should be dealt with by a general practitioner.’
It follows a similar pattern to remarks made in May this year when the Premier accused GPs of not dealing with patients presenting with respiratory illnesses.
‘Isn’t the Hippocratic Oath that you’re supposed to allow anyone to come in and receive medical attention?’ he said in a widely reported interview that was strongly criticised by the RACGP at the time.
RACGP President Adjunct Professor Karen Price described hearing the latest remarks as ‘like Groundhog Day’.
‘At a time when GPs and general practice teams are doing their absolute best in very trying circumstances, the last thing they need are comments laying blame at their feet,’ she said.
‘Let me be clear, this is a political misdirect to avoid accountability for pressure within the state’s hospital system.
‘I have said it before, and I will say it again – it’s unacceptable to blame an overburdened state hospital system on general practice. Premier McGowan clearly hasn’t learnt anything following his comments earlier this year.’
RACGP WA Chair Dr Ramya Raman also said the Premier showed a lack of understanding of the pressures facing general practice.
She said GPs do everything they can to help patients in a pandemic, with practices requiring strong measures in place to minimise the spread of COVID-19 among patients and staff.
‘Some practices in my home state will be able to see patients with respiratory symptoms; however, others sometimes will not depending on their circumstances, including the space of the clinic,’ Dr Raman said.
‘We have the responsibility of triaging symptomatic patients and implementing rigorous infection control precautions, and keep in mind that all of this takes time and resources.
‘So, if a practice doesn’t have the space to manage people with respiratory symptoms they will not simply turn them away, they will have processes in place to refer patients appropriately, be that to a nearby practice or a local GP-led respiratory clinic.’
Dr Raman said when GPs and other general practice staff need to take time off due to COVID-19, it can have ‘a huge impact’ on communities.
‘Once again, I say to Premier McGowan to please get behind GPs and general practice teams,’ she said.
‘We have been on the frontline of this pandemic for two-and-a-half-years, and we don’t deserve any more veiled criticism.’
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COVID-19 emergency departments hospitals Mark McGowan primary care Western Australia

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Dr Salah Amedi   6/09/2022 11:09:53 PM

Mr Premier needs to know that general practice is never a substitute for emergency medicine and hospital system . He needs to look for alternative options to manage the chronic state emergency and public sector crises.

Dr Sing Lok   7/09/2022 6:17:58 AM

What the WA premier said has some substances. I am working in a regional hospital emergency department in the Riverland region of South Australia, none of the GP practices see any patient with even the mildest symptoms such as isolated runny nose, sore throat or fever. This include practices with a huge building with pathology, pharmacy and allied health onsite. They certainly hardly bulk billed. Therefore, ED are seeing a lot of GP type of presentations and all URTI and LRTI patients.
I understand why they don't bulk bill because of the very low Medicare rebates, frozen for years. I also understand why the GP are not seeing respiratory patients, because if they get Covid-19 infection, they have to stay home for isolation up to 2 weeks, this result in lost of income.
I don't mean to offend our GP colleagues or want to get into politic, I am just stating facts. I completely understand our GP's situation, has been abandoned by successive federal government for decades.

Dr David Zhi Qiang Yu   7/09/2022 9:18:35 AM

Every GPs are showing the leadership and doing the best during this two and half COVID pandemic. Mr McGowan please accept your failure management of your state hospitals in your own state and stop the shift the blame to the hardworking GPs.

Dr Spencer Nicholson   7/09/2022 10:22:48 AM

He has no idea about primary Care and no idea what the Hippocratic oath says and is no longer used
Want less emergency attendances have more Gp’s

Dr Joanna Cooney   7/09/2022 10:28:41 AM

We have a system in place that works well. If a patient has respiratory symptoms, they are asked to wait in their car when they arrive. We first do a phone consult to elicit a brief history and if the patient is considered high risk for being contagious, they are seen outside in the car park. Not ideal but still allows patients to be assessed and in the majority of cases, reassured and treated appropriately.

Dr Suzette Julie Finch   7/09/2022 11:47:08 AM

I've seen multiple respiratory cases BUT don't have PPE, but for privately purchased P2 masks & reused 'disposable face shields. Often patients lie to receptionists so they are seen in a laundry-sized room instead of the outside area. Last week patient insisted they had a negative PCR & 3 negative RATS over the week so I wasn't warned by reception they were a respiratory case so only in a P2 mask. Reportedly had an 'asthma cough' for 2-3 weeks. Tested Covid positive later that day. When I have to take time off to test due to nasal congestion, an annual issue now with the pollen & thermal inversion smoke, then I AGAIN lose income for those day/ days. There is no reasonable financial compensation for the risk to my person health from covid infection (which I seem to have missed despite testing more than anyone I know - rhinitis!) nor the multiple thousands that I would estimate in lost income due to covid testing. But if I say no the Premier gets cranky!! Boo Hoo

Dr Bradley Arthur Olsen   7/09/2022 12:31:44 PM

Well maybe he doesn't want GPs in WA , I see all patients resp tract infection or not, I am Australian trained bulk bill and have 30 yrs of emergency, and remote GP experience ,but the local Bundaberg ED gets upset when I send in a patient-( about once a month ) and the Bundaberg surgeons refuse to see patients who have been fully investigated ,diagnosed and follow their referral rules. Perhaps the WA GPs should take my example and leave if your not wanted

Dr Sheng Horng Chao   7/09/2022 3:39:54 PM

We as GP have been criticised so much now any negative comment just feel like water at duck back

Dr Helen   7/09/2022 4:46:41 PM

Once upon a time- not so long ago- in a mysterious land called Oz- you had to get a deep clean if your clinic had a covid patient (av. cost $3000) and clinic had to close until everyone got tested (and woe betide you if you tested positive- 14 days closed wasn't it)??
1) where did all the deep cleaners go? Have they all retired because they made their millions doing something totally pointless that hapless GPs had to pay for.
2) you reap what you sow- sow chaos then that is what you reap!
3) if you - government/health dpt- destroy a system that worked then you can't then turn around and blame those you mistreated for not returning for more mistreatment!
Cheers - don't worry Mark- at the rate you and the other head honchos are going there won't be GPs in the future and then you will have to find someone else to blame!!
Here's another idea- how about we run the country for a month and you can see all the patients with respiratory symptoms- let us know how it works out.

Dr J Chapman   7/09/2022 6:36:32 PM

I agree with the premier - there is a problem between the Commonwealth Health system and the State one. State provided services are denying access to GPs as referral agents- you cannot get a patient into public hospital outpatients clinic or an acute mental health team. Our only option is to send them to emergency - the gateway to State based services. They have only themselves to blame. I have worked face to face with patients, sick or otherwise, throughout Covid. Tell me how many specialists in the hospital setting have done that. Emergency Departments have been amazing - but they have more in common with GPs than their ivory tower colleagues, who could easily have donned PPE and gone to their assistance instead of sitting in front of a computer and diagnosing a skin rash or hyperthyroidism from afar. By cocooning state services and forcing GPs in desperation to use the ED, instead of encouraging cooperation, all state governments and their health departments are to blame.

Dr Michael Sosnin   7/09/2022 10:23:15 PM

"GPs won't see respiratory cases": has the premier forgotten that respiratory/fever clinics were set up specifically to prevent potential covid cases from infecting GP clinics? The alternative being mass closure of GP clinics around the country due to mandatory 14 days isolation of all staff and contacts. So no, Mr Premier, we are not blindly "supposed to allow anyone to come in and receive medical attention", just as your state's border did not allow everyone to come in. The fundamental principle, since antiquity, has always been to FIRST DO NO HARM, to the patient, to one's staff, one's family, one's community, oneself. It was only after RAT tests became widely available that GPs were able to see more respiratory cases face to face, with appropriate precautions (PPE, car park consults, a dedicated isolation room etc.) as required, but even so, it is every doctor's right to choose whether they see such patients- many health workers have died from covid.

Dr Peter James Strickland   8/09/2022 12:25:05 PM

Lets be very clear here. The present Labor Govt here in WA is in disarray with all aspects of health care. They blame GPs, St John Ambulance, lack of bulk billing etc for problems of an ABSOLUTELY inadequate management of health services of WA. They failed to build a children's hospital in the northern suburbs, they fail to provide enough finances to expand and build other ED hospitals in both the North and South of an expanding metropolitan area of Perth, they have left the obstetric services in disarray through the whole metro area, and they have no idea how to efficiently run and finance primary care, but "bite" the hand that "feeds" it now. It is called stubborn incompetence by transferring responsibility to the real and innocent workers!

Dr Sean Roland Thomas   8/09/2022 2:43:31 PM

THE BOTTOM LINE---ED DEPARTMENTS SEND THE MAJORITY OF PATENTS HOME---how many times have we seen patients who need admission and urgent investigation only to be told to go home to your gp to organise?
Gone were the days were one could safely go to the ED and be properly
assessed,investigated and admitted
So we need more hospital beds,more supervision,more nurses and more doctors so we can admit and observe/investigate patients appropriately and not just send them home