Ensuring quality and safety for after-hours care
The Australian Government is taking steps to ensure that patients needing an after-hours doctor receive the best quality care under Medicare.
The Hon Greg Hunt MP
Minister for Health
PDF printable version of Factsheet – Improving quality in after-hours GP services (PDF 282 }
PDF printable version of Factsheet – Urgent After-Hours Review Recommendations and Government Response (PDF 300 }
18 December 2017
The Turnbull Government is taking steps to ensure that patients needing an after-hours doctor receive the best quality care under Medicare.
We know that Australians want access to a doctor at home when they need urgent care.
Under the Coalition, Australians will always have access to after-hours doctors under Medicare.
From 1 March, GPs will receive a greater level of financial support for after-hours visits, compared with non GPs in metropolitan areas. There will be no change to arrangements for regional areas in recognition of their special needs.
This change follows a comprehensive review of the after-hours sector, conducted by the Medicare Benefits Schedule (MBS) Review Taskforce, and has been welcomed by the Australian Medical Association, the Royal Australian College of General Practitioners and the GP Deputising Association.
The independent MBS Review Taskforce is made up of clinicians and consumers, and raised concerns about the current arrangements.
The use of urgent after-hours items has increased by 157 per cent between 2010–11 and 2016–17.
There is no clinical explanation for the large increase, but rather the growth has been driven by a corporate model of largely advertising on the basis of convenience, rather than medical need.
The Taskforce found that access to urgent after-hours care should be used only when necessary and that funding should be appropriate to the level of care being provided.
The changes to after-hours arrangements will mean doctors are able to provide the best care to their patients, and that after-hours services are provided by an appropriate doctor to people who require genuinely urgent treatment.
The Medicare rebate will be adjusted to better reflect the qualifications of the doctor providing the urgent after-hours care to patients.
All savings will be reinvested into Medicare.
GPs and doctors in regional and rural areas will receive a higher rebate. Non GPs will have their rebate adjusted in stages over coming years.
All GP services that operate after-hours will continue to be able to treat patients under Medicare using any of the 24 standard after-hours items.
The Government will also maintain current rebates for all doctors providing services between 11pm and 7am.
As well, services provided in rural and remote areas will not change, in recognition of the difficulty Australians in these areas can face in accessing after-hours care.
The changes will include limitations placed on inappropriate advertising, and the practice of pre-booking urgent consultations before the after-hours period will no longer be permitted.
The changes are in response to concerns raised by GPs that some doctors who are not GPs are providing urgent after-hours care, and that some treatments being claimed as urgent are not genuinely urgent.
These practices were examined by a specialist Working Group established by the Taskforce. The Working Group, led by Dr Steve Hambleton, included members from the Australian Medical Association, Royal Australian College of General Practitioners, Rural Doctors Association of Australia and Australian College of Rural and Remote Medicine.
President of the Royal Australian College of General Practitioners, Dr Bastian Seidel said “The changes are pragmatic, evidence-based and they do incorporate the substantive feedback from the medical profession and patients.
“The changes to the Medicare rebates provide certainty to the after-hours sector in metropolitan as well as rural communities,” Dr Seidel said.
“We commend Minister Hunt for listening to the concerns of the RACGP and for implementing evidence based adjustments to after-hours Medicare rebates.”
“The gold standard for after-hours care is a consultation with a specialist GP. The proposed changes to the Medicare rebates make that very clear. This can only be in the best interest of patients.”
President of the General Practice Deputising Association (GPDA), Dr Nathan Pinskier welcomed the Government's response to the after-hours MBS review.
“The Government has clearly listened to and acknowledged the concerns of our members. The reforms will ensure that the after-hours sector remains viable and that the Australian public will continue to have access to high quality after-hours GP services,” Dr Pinskier said.
“The GPDA strongly supports the requirement for accredited medical deputising services to have a formal and ongoing relationship with the patient's regular General Practice. This will support better continuity of care.”
The Australian Government invests $1 billion a year in services and support for people seeking care in the after-hours period, in addition to hospital funding. This includes funding for standard after-hours MBS items, Healthdirect, the after-hours GP helpline, and Primary Health Networks.
At the Budget we committed an additional $145.5 million for Primary Healthcare Networks to continue their work giving local communities access to vital after hours services.
The Government will continue to work with stakeholders including the AMA and RACGP on longer-term reform of the after-hours program, building on the Taskforce report and reinvesting funding into improving services.