My letter in the Sentinel-Times (July 15) about the Nurse Practitioner Program was followed this week (July 22) by two responses from Lyn Whitlam of Glen Forbes and Christopher Nagle of Grantville. I would comment as follows:
I wrote the letter so that the community would be properly informed as there seems to be a lot of misunderstanding in the community about the program.
The heading given to the letter by the editor ‘Health care is already here’ presumably to stimulate debate, did not convey the intent of the letter or its contents.
It was not meant to undermine the NP program or understate the benefits of the program to those in the community that use it.
The basic facts I presented were these:
1) The nurse practitioner program as approved for Bass Coast Community Health, was a pilot program funded for a limited time. It was not funded as a permanent service. Everyone involved in the program would have known that from the outset even if the community was not so informed.
2) A sole practitioner, whether GP or Nurse Practitioner is difficult to sustain financially and is generally considered impractical in the health sector. A nurse practitioner program would certainly require outside funding to be sustainable.
The Medicare rebates are lower for a nurse practitioner consultation. They are lower for a reason; when you attend a medical consultation you are accessing the professional skills and training of that medical practitioner.
Doctors generally possess Fellowship of the Royal Australian College of General Practice (FRACGP) or the Australian College of Rural and Remote Medicine (FACRRM) and our doctors usually have specialised training in emergency medicine, obstetrics, anaesthetics or some other speciality.
Nurse practitioners are not doctors, they have not undergone the same level of training as doctors and the government necessarily limits their ability to prescribe medications as a matter of safety.
Limitations are also placed on other aspects of their practice.
To suggest that the different Medicare rebates apply to the same service is therefore totally misleading.
It is the same reason why the rebates are higher for certain medical specialist skills such as dermatology, cardiology etc. compared with a GP.
Frequently a GP can provide the “same” advice or service but we recognise the unique skills of the specialist who has undergone further training in his field of medicine.
3) The commercial rates for renting medical rooms are $120 to $250 depending on the service provided to the practitioner and the service the practitioner provides to the public. So the $40/day presently requested by the shire is heavily subsidised as it represents less than one third of the cost a practitioner would normally pay for rooms.
These facts are indisputable.
One can hold opinions about these facts about whether they are fair or just, but they are the facts.
Another reason I wrote the letter was because there were members of the community who seemed to believe that the demise of the program was in some way the result of Wonthaggi Medical Group’s actions and they have actively been promoting that view. This is simply wrong.
I also wanted to reassure the community that the Medical Services that Wonthaggi Medical Group were bringing to the area, are long term and will grow in terms of the services provided and access to services.
Finally, I want to say that Wonthaggi Medical Group has been very supportive of the NP program.
When Wonthaggi Medical Group decided to establish a practice in Grantville in response to the many requests from our patients, our immediate thought was to establish that practice at the transaction centre, complementary to the Nurse Practitioner Program and offering a cooperative model (with the Nurse Practitioners) of patient care.
In fact, Wonthaggi Medical Group started this way but the fact that this did not eventuate in the long term was not the fault of Wonthaggi Medical Group doctors.
Suffice to say that we came to the conclusion that the only way we would be able to provide a service was by setting up in a new premises. Furthermore, when it became apparent that the NP service would not be receiving further funds we offered to co-locate the service at our new premises in Grantville as a way of supporting the efforts to get further funding for the NP program and as a way of supporting a cooperative care approach. This suggestion was not taken up.
John Turner, Business Manager, Wonthaggi Medical Group.