“After-Hours”

An open letter to the Hon. Nicola Roxon, Federal Health Minister.

In response to the local publicity on the GP shortage in the Stones Corner/Greenslopes area you were reported as pointing out that OTDs can in fact work in designated ‘Inner Metropolitan’ areas – provided that they work after-hours (i.e 6 pm to 8 am).

This response, Ms. Roxon, is unsatisfactory. It is clearly the response provided to you by your advisors. It is patronising and unhelpful. It serves only to highlight the abyss that gapes between GPs working at the coal-face and bureaucrats working from their ivory towers.

I one wants to find out about knitting, one does not ask a carpenter. May I respectfully suggest that if you want to find out what is really happening in general practice on a day-to-day basis, that you do not ask a bureaucrat.

I offer the following comments, which I would be grateful if you would pass on to your Departmental advisors during your next discussion.

1. If you are suggesting that each individual practice could solve their workforce problem by employing an OTD after-hours, could you please explain how this would assist a practice which cannot find a doctor to fill the morning shift from Monday to Friday to meet their accreditation requirement (based on the RACGP Standards) to have a doctor available during office hours (8 am to 6 pm)? As you are aware, practice accreditation is linked with remuneration, and hence financial survival.

2. In any case, to suggest that every small individual practice could afford to employ an after-hours doctor is ludicrous. It would necessitate the employment of after-hours administration and security staff, which would be financially impossible for every practice I know. Some of the large corporate practices tried this in Brisbane some years ago, but even with their economies of scale, they were not able to make it a viable business proposition. There may be two remaining 24 hour practices left in Brisbane.

3. Inner metropolitan practices do in fact employ OTDs ‘after-hours’ – but most do it via a subscription to the commercial After-hours service.

4. This ‘solution’ is equally unnacceptable to the community if it is offered as a substitute for availability during office hours. A mother of an infant is not going to want to take her child for routine vaccination at 9 at night because the practice does not have a doctor available at another time, nor is a frail elderly lady going to venture out on her own late at night to get her blood pressure checked.

I look forward to your response.

Yours sincerely,

Dr Janet Clarkson

Logan Road General Practice.