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House of Assembly - Fifty-Second Parliament, Second Session (52-2)
2012-11-14 Daily Xml
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COUNTRY HEALTH SA

Mr BIGNELL (Mawson) (14:26): My question is to the Minister for Health and Ageing. Can the minister inform the house about the progress on the contract between SA Health and rural GPs?

The Hon. J.D. HILL (Kaurna—Minister for Health and Ageing, Minister for Mental Health and Substance Abuse, Minister for the Arts) (14:26): I thank the member for Mawson for this question. I acknowledge his great interest in country health, as my parliamentary secretary on health, and his particular involvement in country health issues. I can inform the house that the new agreement between the Rural Doctors Association of South Australia (which represents, I understand, the vast majority of rural doctors) and Country Health SA was announced on 14 August this year, and that followed 18 months of negotiations.

The agreement provides up to three on-call allowances of $150,000 for each private GP practice in each health service to cover emergency, obstetric and anaesthetic services on a 24-hour basis. In addition, GPs are paid a fee for inpatient care provided. So, there is $150,000 for each of those sets of skills that can be shared amongst the doctors who provide the services to a particular hospital.

The agreement also makes South Australia the first state to offer a safe working payment, which provides some reimbursement for doctors if they have to cancel private patients following after-hours emergency work the night before. Therefore, no GP is required to be on call for 36 hours, as has been suggested a number of times in the media just recently. I am also pleased to announce today that 93 of the 102 medical practices invited to sign the agreement have indicated a willingness thus far to do so.

Country Health is continuing negotiations with the nine remaining medical practices, and that includes four at Victor Harbor. The existing arrangements in Victor Harbor have been extended until 31 January next year whilst these negotiations continue. Currently, the South Coast District Hospital in Victor Harbor relies on ad hoc arrangements with local GPs for after-hours callouts for obstetrics and anaesthetics and daytime emergency. I am told what happens is that there is a general agreement to provide the service, but you have to ring around to find a doctor who will do it. It is not a certain process.

There is a locum service, which is also provided, for after hours emergency care. The new on-call proposal aims to provide certainty of service and guaranteed care for patients when it is needed, so we do not have these ad hoc arrangements in place. We are happy, of course, to have a degree of flexibility, so long as patient care is guaranteed. For example, we would be happy for Victor Harbor doctors to subcontract out part of the roster to a locum service. Locum service happens now, but it is run by us rather than by them. However, the Victor Harbor GPs need to guarantee the availability of a GP when required, regardless of how the GP is provided.

There has been no reduction in funding on offer to the Clare Medical Centre as a result of the new agreement. Pursuant to the agreement, doctors at the Clare Medical Centre would receive $150,000 each year to provide an after-hours emergency care roster in Clare, with an additional $75,000 if they travel to Snowtown to attend emergency callouts in person.

The new arrangement requires face-to-face consults with Snowtown patients (which we think they deserve) rather than over the phone consultations in order for the doctors to receive the additional $75,000. The Clare Medical Centre has chosen to no longer provide the Snowtown consult service on this basis. They are happy to take the money if it can be done over the phone, I understand.

The Clare Medical Centre has advised that they will sign the standard general practitioner agreement for the services they provide in Clare but not the additional roster to cover Snowtown. Country Health will pursue alternative models of care where agreement cannot be reached so that country patients continue to receive the same level of care. The arrangements under the new contract will ensure the consistency of after-hour public health services across the state and ensure that patient care is foremost.

It is important to keep to the standard contract in order to maintain fairness and equity for patients and GPs right across this state and, as I understand it, this is the view of the overwhelming number of GPs who work in country South Australia. It is certainly the view put to me by their representative organisation, the Rural Doctors Association, so I would encourage all the services that have yet to sign the contract to talk to us, work with us and try to come to an arrangement within the contract bounds that have been settled on with the Rural Doctors Association.

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