New after-hours medical help in high demand in Lismore

A NEW after hours doctor service is already in hot demand amid reports that 54 percent of Northern NSW patients were presenting to emergency departments with non urgent issues.

Doctor On Duty launched in Ballina and Byron Bay last week after serving the after-hour medical needs of almost 750,000 people throughout Central Coast, Lower Hunter and the Coffs Coast.

Surprisingly, most inquiries came from Lismore despite not advertising the service for the area.

According to Doctor on Duty general manager Mal Leith said, "We opened about two weeks ago and have had a good initial response with very limited marketing of the service. Most local practices are very receptive and half have signed up to use Doctor On Duty to provide after hours care to their patients so far," he said.

"Costs to Medicare for visits by a doctor from such after hours medical services such as Doctor On Duty range from about $84 to 153 dollars depending on the consult type," he said.

"Costs to Medicare to see a GP after hours out of surgery range from about 54 dollars to about 131 dollars depending on the consult type. These visits are not usually bulk billed so the patients will usually also have to contribute a gap payment. This is set by the doctor or general practice but we have seen out of pocket costs of up to 400 dollars per visit."

However, the costs to Medicare for presentations of non-urgent category 4 and 5 patients to public hospital ED cost the tax payers $470 for each presentation. Ambulance presentations are about $1700 dollars including the cost of the ambulance call-out.

However the jury is out among GPs as to whether these after hours services are saving the tax payer much money.

Lead Clinical Adviser North Coast Primary Health Network, Dr Dan Ewald said, "They (Doctor on Duty) would say they are a cheap service because they are saving people from going to hospital. But many of us would say that it is over-servicing to see patients that don't need to be seen after hours and asking a very expensive payment, and it's not adding that much to the health system. But that is a debate. And there isn't really evidence yet," he said.

Mr Leith added, "Each patient should be able to get the right treatment at the right time in the right place - whether this is from their GP, their local AMDS such as Doctor On Duty or the emergency department of their local hospital. As a Doctor that works in both the NSW public hospital system and in an AMDS, my problem is when patients are accessing the wrong treatment or the right treatment at the wrong time and place. The recently published AIHW statistics show that 3.8 million patients were seen with GP type complaints in public hospitals in NSW last year. There was a roughly equal split of presentations seen during the time GPs were open and after hours. Many of these patients present to emergency departments by ambulances and delay the provision of care to patients in triage categories 1 to 3 who need urgent attention," he said.



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