The Royal Australian College of GPs (RACGP) has today warned that a Canberra GP clinic's difficult decision to end bulk-billing for veterans is another sign of the pressures facing practices across Australia.
It comes following reports of YourGP clinic in Canberra no longer accepting the Department of Veterans' Affairs' (DVA) rebate as payment. In an email sent by the YourGP clinic to patients, the practice owners acknowledged that the change "will come as a shock".
The email also states: "We wish to assure you that this change in billing is being implemented reluctantly, and with sadness, due to the financial necessities of running a small business. Along with Medicare rebates, DVA rebates have been frozen for much of the past decade…DVA payments are based on a model that financially penalises doctors for spending more time with patients."
The clinic's decision and the potential impact on veterans has achieved considerable coverage, with one health analyst suggesting this week that the decision might be politically driven.
RACGP President Dr Nicole Higgins said she understood why the practice made the tough call.
"YourGP would not have made this decision unless it was absolutely necessary. Due to long-term, chronic underfunding of general practice, their hands are tied," she said.
"The owners of the clinic have to find ways of keeping their heads above water or they will have to shut up shop, a scenario in which no one wins, particularly regular patients who have been frequenting this practice for many years. This is a sign of things to come, government must heed our calls and urgently boost investment in general practice care so that practices aren't forced to hike fees or close. The key to relieving pressure on our entire health system is giving general practice care a shot in the arm."
Dr Melian Deery, GP and co-owner along with her GP husband Dr John Deery, told newsGP it was a difficult move.
"It was a big decision to make and made under significant financial pressure,' she said.
"It was 100% about financial viability. It was not a decision we took lightly; we considered it carefully over six months. We greatly value our veterans. One of the sad aspects to me was that veterans might not understand and may feel under-supported by the community they have served. This decision is driven by government underfunding of veteran care."
GP and former Army Major Dr Kerry Summerscales told newsGP that the inference of political motivation is both unfair and unwelcome.
"I find those comments to be highly, not only irresponsible, but offensive,' she said.
"I am sick and tired of the GP bashing. We are actually trying our best."
The Mackay-based GP, 90% of whose patients are veterans, says she will continue to accept the DVA incentive payment, but that it is coming at a cost to the practice as a whole.
"We've had long, hard discussions about how this will impact and how we can actually cover that," she said.
"It is a personal decision of mine, and the practice has been gracious enough to absorb the cost of that. From a practice point of view, it's not feasible and it's not viable. The administrative burden associated with DVA, combined with the complexities of care, often mean veteran consults are longer consults. We want to provide the best possible care for our veterans, but longer consults are not remunerated appropriately, thus there is pressure to push patients through quickly, or charge a higher gap - which one cannot do when charging to DVA".
YourGP patients have been encouraged to write to their local federal member of parliament to raise the issue or contact the DVA to discuss payment of a gap fee.
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