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Legislative Assembly for the ACT: 2004 Week 10 Hansard (26 August) . . Page.. 4380..

MS DUNDAS (continuing):

resources need to be in place to support people so they do not get these ongoing diseases in the first place and do not need extra support from our health system.

In the State of the ACT health system report the government has mailed out, there are four dot points about promoting good health versus all the other dot points about what is happening in the hospital system and in mental health; and there is further discussion about community health. I think this shows that we need to step back, take a deep breath and see what more we can do in areas of preventative health to help divert people away from the emergency systems in our hospitals in the first place. That can be done through supporting GPs and ensuring that we have GPs who are willing to practise into the future.

I had an interesting discussion with a GP the other day. This doctor talked about the fact that people do not want to set up GP practices any more because they are far too expensive to run. The practices are not able to make a living sufficient to look after the doctor, maintain staff and cover the other costs of running an office, whilst trying to make sure that the practice can see patients. That was just one doctor's view, but I think there is work to be done towards the support of our GPs to reduce the pressure they currently face.

We could, of course, be using nurse practitioners. We have cleared the way, through legislation, for nurse practitioners to work with groups and take over simple tasks like writing medical certificates, taking pathology samples and providing referrals to specialists. The minister has spoken about nurse practitioners working in our hospitals as part of the package of solutions to the situation in hospitals at the moment, but that needs to be backed up by funding.

Although the legislation has been cleared for about a year, we have not seen the funding come through to put nurse practitioners on the books and get them operational. I believe that is something that needs to be addressed urgently. I have had calls to my office from people who are willing to be assessed as nurse practitioners, people who think they have the qualification as it stands. They just want to take on the role; they are willing to take on the responsibility, but things seem to be getting stuck.

We could have more discussions with pharmacists about the work they could do to reduce the burden on doctors. They could take over some of the responsibility for the authorisation of repeat prescriptions, and be the first point of contact when people have concerns about medication interactions. There is scope and the funding available for a pharmacist to prescribe as a trial, but I do not think the ACT government has started talking to the federal government about how we can make that work here in the ACT. We have seen extra federal funding targeted to support bulk-billing in Canberra but the ACT government could be doing more to encourage additional doctors to bulk-bill patients who cannot afford normal GP services. These are the patients who end up in emergency departments.

We could look at how many doctors are requiring a gap payment for consultations because they cannot afford to function on just the scheduled fee. There are a number of things the ACT government could do to entice non-practising GPs back into the work force. They could offer assistance with retraining and look at the costs of accommodation currently faced by groups, to see what could be done there.

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