Page 3455 - Week 09 - Thursday, 21 August 2008

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MS GALLAGHER: Our emergency departments do not have any GPs either, Mrs Burke. It is simple, actually. There are emergency department specialists. Occasionally we have GPs, but they are employed as emergency department specialists, not as general practitioners.

As to the walk-in centres, I welcome the opportunity to talk at length again about the policy the Liberals have tried to adopt, but done in such a terrible, problematic way. The walk-in centres will be run as outposts of the emergency department. In fact, a group have just come back from the United Kingdom where they have witnessed how these walk-in centres work.

They often work inside hospitals, but they also work in community settings. There is a clinical governance structure set up which operates across the health system. The idea behind the walk-in centres—this is the fundamental point that Mrs Burke fails to understand—is that they are being set up because there are not enough doctors around, but also because the health workforce needs to diversify and roles need to change. The use of the nurse practitioner, the advanced practice nurse, is a critical component of how we will deal with the broader health workforce problem in years to come.

It also creates wonderful opportunities for nurses to operate in a nurse-led centre dealing with less urgent conditions. There is a lot of sense to it. It gives nurses the autonomy to practise. Of course, there are constraints on nurse practitioners practising outside the hospital system because they are not able to access MBS and PBS as the doctors are able to do. So we need to set them up as outposts of the emergency department.

Yes, the ACT government would fund it. But that is quite a different arrangement to any arrangement such as the Liberals are trying to mislead the community about with the model they can establish. There is no bulk-billing in these walk-in centres because the costs are fully met by the ACT government, whereas the Liberals are trying to run away with a policy that says, “We will bulk-bill the ACT government.” I am at a loss to understand how they are going to do that unless they are going to create their own Medicare benefits regime here in the territory solely for the use of these three clinics that they are supposedly going to be able to set up.

The idea behind the walk-in centres is precisely that. They are nurse led. They deal with less urgent conditions. They take some of the burden off our medical workforce because these conditions do not necessarily need the attention of a doctor. If they did need the attention of a doctor, then there would be protocols established in the walk-in clinics to trigger that. Of course there would be clinical governance over these arrangements, just as there are over every aspect of public health.

There is a fundamental difference between the clinics that the Liberals are saying they are going to establish and the reality of the fact that these can be established. We are able to staff them and they will offer a very comprehensive service in response particularly to the needs of the Tuggeranong community, which is where we will be establishing the first of these walk-in centres—hopefully within the next year.

MR SPEAKER: Is there a supplementary question?

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