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Legislative Assembly for the ACT: 2002 Week 12 Hansard (13 November) . . Page.. 3595 ..

MR WOOD (continuing):

demonstrated in the days before Medicare, when they often treated the poor for free. It is worth noting that, despite the decline in bulk-billing, just over 50 per cent of GP services in the ACT are bulk-billed.

The government is concerned that access to GP services is a problem for ACT residents, and lack of bulk-billing is a factor that reduces access to GPs for some people. But you cannot get away from the fact that the provision of general practitioner services is the responsibility of the Commonwealth government. If the Commonwealth would like to hand over Medicare payments for GPs to the ACT government, I am sure we could make a better fist of it than they have. We could not do any worse.

The Commonwealth has refused to fix the problem in the ACT. The government here has raised the shortage of GPs in the ACT with the Commonwealth, to seek their assistance. The Commonwealth has refused to help. We have now received three knock-backs from the Commonwealth to address the problems with the ACT arising from the failure of the Commonwealth's GP policies. The first of these is the refusal to designate the ACT as a district of work force shortage for GPs, which would have given us more scope to recruit GPs.

The second is exclusion of the ACT from the 2002 budget initiative to improve access to GP services in outer metropolitan areas. This initiative is restricted to the six state capital cities and specifically excludes the ACT and the Northern Territory. The third, which we have just learned of, is that the Commonwealth has rejected the proposal, developed by the ACT Division of General Practice and the Canberra After Hours Locum Medical Service in collaboration with ACT Health, for a model for improved after-hours GP services in the ACT.

The Health Minister will continue to work with his state and territory colleagues to put pressure on the Commonwealth to find a solution.

What are we doing in the ACT? While we are not able to solve the problems of GP shortages and a fall in bulk-billing, the government is working with GPs in the ACT to improve access to GP services and improve the relationship between GPs and other health services to improve access and to provide better care.

For example, the government is funding a primary care clinic at Calvary Hospital. While GP services have been declining, the number of people with less urgent conditions attending emergency departments in the ACT is increasing. The primary care clinic at Calvary is available 24 hours a day, free of charge to ACT residents, to provide services to people unable to access a GP. This is a good measure, but it will not solve the problems of after-hours access to GPs.

In this regard, the ACT is not the only territory or state which is concerned. You will be aware that all Australian health ministers meet on a regular basis. At the November meeting, the ministers placed on the agenda the issue of the impact of the decline of GP services on emergency departments. It is considerable.

Now that the Commonwealth has refused to fund our proposals for access to after-hours GPs, the government will examine funding to cover the cost of the Canberra After Hours Locum Medical Service, providing care on the graveyard shift, midnight to 6 am.

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