‘Waterline rallies to save nursing program’ (Sentinel-Times 8/07/14, p3), confirms to me that amongst some in the community there is a lack of knowledge and understanding regarding both the nurse practitioner program and the future of GP services in the Waterline community areas.
Firstly, the funded nurse practitioner program was always going to be a short term project; therefore in order to continue beyond the funded period the nurse practitioner program has to survive as a private health service in exactly the same way as any other general medical service.
Secondly, by providing medical rooms at $40 a day, the Bass Coast Shire Council is substantially subsidising any medical/nursing service to a considerable degree.
The going rate for renting medical rooms is anything between $120 and $250 a day depending on the facilities and type of service provided and whether it complements an existing medical service.
The amount of $40 a day is bargain basement rent.
Some time ago I looked extensively at the viability of independent nurse practitioner services and came to the conclusion that a single practitioner service is not viable if it is to meet both the income aspirations of the nurse practitioners and the real costs of providing the service.
It may be just viable if the practitioner charges fees on a scale comparable with a private GP service, however the lower Medicare rebate means a significant out of pocket expense for the patients.
With a single practitioner it is also extremely difficult to provide cover for vacation and other types of leave.
In my view nurse practitioner services are only viable if allied to an existing service that is either prepared to subsidise them and/or is able to derive some benefit from the alliance.
These difficulties aside, it was reported in the article that “the campaigners meeting outside Grantville Transaction Centre last week also agreed that they would support a user-pays system”.
If that is truly the case then I do not understand the issue.
As previously mentioned, $40 a day is already way below the commercial rate for rooms and the prospective patients have stated they are prepared to pay on a user-pays basis, by which I assume they mean they are prepared to pay the gap between what the practitioner charges and the Medicare rebate.
Could it be that the nurse practitioner themselves have looked at the numbers and realised that a non-bulk billing sole practitioner arrangement is simply not viable?
The Bass Coast Shire is already under pressure for the recent rate rises; in this environment would residents be prepared to provide further funding to what is a private service?
As rightly pointed out, it would set a precedent for other services to claim reduced rents or even reduced rates.
With regard to GP services in the area, the Wonthaggi Medical Group has invested heavily to provide an excellent medical facility which will shortly be extended to include the adjoining shop.
At present there is a single doctor at Grantville on a daily basis backed up with a dedicated nurse and receptionist or sometimes by a nurse-receptionist.
To date it has been very successful with very positive feedback from the patients using the service.
Kernot resident Barrie Stewart was reported as saying “I haven’t been to a regular doctor in two years” ; however Grantville Medical Centre has been operating since last October and appointments are always available if not on the day then certainly within a couple of days.
The main doctor at Grantville is Dr Mariajoseph and presently, while he has been on an extended holiday, Wonthaggi Medical Group has rostered doctors at Grantville to ensure that the service continues unabated.
The readers may also be interested to know that the Grantville Medical Centre has been actively recruiting a second doctor and are awaiting finalisation of the paperwork.
Once the doctor is available there will be some initial orientation at Wonthaggi lasting a few weeks but after this has been completed it will result in both a male and female doctor being available at Grantville on a daily basis.
Since establishing the Grantville Medical Centre, the Wonthaggi Medical Group has always said that it will respond to the needs of the area in a manner which can be sustained in the long term.
The Grantville Medical Centre doctors do not intend to be ‘fly by nights’.
Aside from the medical practitioners, the practice has an excellent visiting physiotherapy service operating from the premises and when the adjoining rooms are completed it will also have regular pathology collection by Gippsland Pathology.
The practice is also investigating the provision of a regular obstetrics clinic for expectant and post natal women and the provision of mental health services and podiatry.
As a matter of policy, Wonthaggi Medical Group bulk bills all pensioners, children and health care card holders are at all its locations and on occasions the practice doctors will bulk bill other patients in financial stress and requiring extended treatment.
John Turner, Wonthaggi Medical Group