State Minister's plan for GPs in ED hospitals 'misguided'

19 May, 2014

Proposals by the NSW State Minister for GPs to be put into state hospitals to deal with the probable influx of GP-type patients to emergency departments are misguided and will end up increasing health costs and poorer patient outcomes, says Dr Costa, National President of the Doctors Reform Society.

"GPs save the health system money because they see patients they know well, thus minimising costs of unnecessary investigations, avoiding duplication, keeping people healthy and out of hospital - including responsibility for immunisation and preventive screening as well as managing chronic health care problems and providing continuity of care," Dr Costa said.

"A GP in casualty/ ED would be seeing strangers and most patients for the first time and without their background history- so the need for a lot more tests and duplication - blood tests CT scans, MRI scan etc.  A lot of duplication and expensive tests the family GP would not have required.

"The hospital GP would also NOT be providing continuity of care.  Who will follow up and manage the problem, including the results of the tests if the patient can't afford to see their family GP because they have stopped bulk billing?  What if the patient does not have their own family GP?  Who will be responsible for the immunisation - not done in ED - routine health screening, bowel screening, Pap test or mammogram etc?

"A GP in the hospital ED would just be a very expensive one stop shop, and probably even more expensive than the current model where minor conditions seen by the hospital intern on duty. And it would give a much degraded GP service - a one stop with no continuity of care or proper management of chronic illness.

"Even worse, placing GPs in hospital ED would only encourage more GP-type patients into ED/ public hospitals and away from their family GP - fracturing normal GP continuity of care arrangements and making it unclear who is responsible for the patients care - query the hospital GP they saw last or query the family GP they cannot always afford to visit? A medico-legal nightmare at the very least.

"Scrapping Medicare and bulk billing is the worst public health decision by any government in the last 40 years. It won't be fixed by allowing those patients who cannot afford to see their GP, to instead use the hospital ED as an alternative," Dr Costa said.

"Such a move won't save money.  It will be just transferring more health care responsibility and more costs onto cash starved public hospitals and resulting in poorer patient care."