WALWA MEDICAL CLINIC CONSULTANT REPORT FINDINGS

An important planning report for future GP services in Walwa and surrounding communities has recently been prepared for the Walwa Medical Clinic (WMC) and the Walwa Bush Nursing Centre (WBNC) by Melbourne and Canberra based consultants, Burgell Consulting. The key report recommendation includes the Medical Clinic and the Bush Nursing Centre joining as a combined business operation with Dr David Hunt employed in a transition period up until his retirement sometime into the future.

As an introduction, Burgell comments that, "Over long years that Dr Hunt has lead the medical practice it has been fashioned into a very effective agent of care for families and individuals of the district. Moreover it operates as a financially viable business entity. Patient care has been characterised by ready, personalised and detailed attention to individual needs which frequently has involved time intensive clinical activities. Dr Hunt, with support from a committed practice staff group and on occasions assistance from some additional GP capacity, has ensured a 24 hour medical coverage for the community. Commendably this care has been provided on a Medicare bulk billing basis which means there is no direct cost to those seeking help from the doctor."

"A pivotal reason why Walwa has experienced long term sustainable GP service is because of Dr Hunt’s preparedness to work consistently long hours in the interrelated tasks of providing accessible patient care and managing the financial requirements of WMC to function as an economic business organisation," Mr Burgell said.

"The strong and enduring partnership forged between the Walwa Bush Nursing Hospital / Walwa Bush Nursing Centre and the WMC has also been a major factor in enabling the Walwa district population to receive continuous and well integrated medical and other primary health care including rapidly activated emergency and after hours provision".

However the report goes on to say that, "the very successful model of operation that Dr Hunt has shaped for the WMC is unlikely to have longer-term viability in the case of new full-time medical practitioner arrangements for Walwa".

"This observation is not a criticism of what is presently a highly effective medical practice but rather a commentary about some rapidly changing conditions in the health sector which have far reaching implications," said Mr Burgell.

"The substantially solo practitioner, working long hours and taking financial responsibility for managing their own business is a fast disappearing version of medical practice. Changing expectations of new generations of doctors coupled with intensifying health care cost pressures are forcing new models of GP service provision on local communities and especially those in remote localities."

Burgell lists some of the factors which work against the current WMC model being able to continue in its present state in the future as follows:

"Younger doctors are seeking a balance between work and family life, they and their spouses are increasingly reluctant to have weekends and nights frequently interrupted by patient demands, (increasing numbers of doctors also want to work part-time).

Many newly qualifying GPs want to practise medicine and offer quality care without taking on the additional burden of managing a medical practice as a business entity.

Increasing numbers of doctors are prepared to work as salaried employees or similarly remunerated contractors that ensures the continuity of their income stream."

He describes the expectations with many doctors that if a rural community wants an accessible medical service it should provide via the municipal council or similar local organisation a "walk-in" medical premises, equipment / infrastructure or management support. These "walk-in" incentive measures he says are attractive GP recruitment "magnets" as they offer doctors the immediate opportunity of getting on It with the job of patient care unburdened by capital, asset and other planning decision pressures usually associated with commencing work in a new locality.

He also describes the present "sellers" market in the demand for local doctors, especially in rural areas, where local communities are facing competitive pressures to offer increasingly attractive conditions in order to attract medical practitioners.

Recommendations:
Getting down to the recommendations of his report and on realistic future options, Burgell says that, "a future Walwa based medical practice will be best sponsored via a locally accessible multi-service health care organisation which is able to directly employ a full-time salaried or contracted doctor to serve the district".

"The capacity of such an organisation to provide a good GP service will be directly linked to whether it:
(a) has or can access a suitable local medical consulting premises,
(b) is able to offer other types of health care which complement services provided by a doctor and
(c) is able provide a management capacity which supports the functioning of a medical service."

Burgell says that the, "population of the Walwa district has steadfastly and decisively expressed a desire for its health care services to be delivered from within the district and under local community management arrangements such as embodied by WBNC."

"WBNC possess suitable medical consulting rooms as evidenced by WMC being successfully co-located within the Bush Nursing Centre during the last three years. Likewise WBNC provides a spread of other health care services to back up the care available from a doctor. It similarly shows an effective service management potential to address the financial, administrative and service co-ordination demands associated with running a medical practice."

"Consequently WBNC is recommend as the preferred organisation for auspicing a future Walwa based GP service."

The Burgell report also examines in some detail the many issues still to be addressed by the WMC/WBNC if his recommendations are to be taken up.

The WBNC Board has discussed the report in some detail and has passed a motion supporting the recommendations. Dr David Hunt is also supportive of the report and its recommendations.