The Gunnedah Rural Health Centre no longer has any of its original doctors full-time, raising concerns about its future amid claims that GPs are not having enough say in the running of the practice.
It has also been revealed the centre lost $170,000 in the first six months of operation and has budgeted for another loss of about $20,000 for the past financial year.
The GP super clinic, which is operated and managed by a board, has just lost Dr Chris Gittoes - one of the original doctors who joined the medical centre when it opened in 2012.
Gunnedah Rural Health chairman Keith Perrett said Dr Gittoes recently resigned because both parties were unable to mutually agree on a contract.
The $6.2 million centre, which was built as a community asset, and received funding from the state and federal governments and mining companies, has the room for seven full-time doctors, however it has never operated to its full capacity.
Currently, there are three full-time GPs on the books. Dr Habib, Dr Haque and Dr Nadia - who specialises in women’s health - all work five days, as well as one locum who temporarily fills positions. Another full-time doctor, Dr Reuben, signed on this week to start next month.
There are two part-time doctors which include Dr Thornton who works one day a week and Dr Deane who recently moved from Gunnedah to the coast but holds skin clinics twice a month at the centre and works two days a month in the hospital emergency department.
Mr Perrett said the initial loss of $170,000 was before his time on the board, and puts it down to “management at the time”. There has since been a major restructure where costs were cut, including some job losses in administration, allowing things to turn around.
“In the initial stages, the loss was quite unacceptable,” Mr Perrett said.
“We’ve got to a situation where we now have doctors coming to the centre and strong inquiries about doctors coming to the centre as well. That may well mean we need extra administration and nursing staff in the future.
“We will be able to fulfil commitments to the community.
“It’s not perfect yet, but the foundation is now in place to have it work.”
The gaps in doctors however currently remains, and none of the original GPs who signed up for the centre are still there, with the exception of Dr Deane.
Mr Perrett said GPs moved around due to family reasons and schooling, however it was the centre’s management structure and the fact a board was running a medical practice that has been questioned from the start.
Dr Ken Adams, another one of the original GPs who moved to the medical centre, resigned 12 months ago due to the nature of the management structure and alleged lack of autonomy for the doctors.
He still resides in Gunnedah and works one-two weekends a month at the Gunnedah Hospital’s emergency department but has a full-time position at North West Health in Tamworth.
“The board has no training, education and experience in running a medical practice,” Dr Adams said.
He added there was a push at the centre for GPs to bulk bill, which he says could not sustain the centre, and it was unable to support him with adequately trained staff to assist with completing chronic disease care plans which he said was an essential part of how he practiced preventative health care.
Dr Adams said there was a lack of support in training medical students he had arranged from university and he wasn’t given the resources he thought necessary to train them adequately.
Mr Perrett defended the move for doctors to preferably bulk bill to give everyone, including pensioners, affordable access to health care and believes there has been “adequate assistance” for health care plans.
In recent times, however, that area has been restructured to “work better”.
Dr Adams said he approached the board to change the model and offered an alternative management structure for doctors to work within on two occasions. However, it never progressed due to an alleged lack of co-operation, although Mr Perrett said no serious offer was put on the table during his role as chairman.
“The general issue is that if doctors don’t have a vested interest in running their own practice, it’s never going to be successful and they called us ‘independent contractors’ but in essence we were employees. Our influence was no more than that of an employee,” Dr Adams said.
“The practice is never going to work until some doctors have skin in the game.”
Mr Perrett disagrees.
“A lot of what you’re seeing is this move towards doctors who don’t want to be running their own business - that’s what we’re seeing across Australia.
“It’s walk-in, walk-out. We’ve got to accept reality.
“Two doctors made it very clear when they left [the centre], that they joined eventually wanting to run their own practice. That’s not the way it’s set up,” Mr Perrett said.
Currently, doctors earn a percentage of billings at the health centre, however the original plan put to the town’s doctors by the board - before the facility opened in 2012 - was they would initially run it.
That eventually changed and as a result, at least one other doctor who originally signalled interest in moving to the centre, decided not to because they wanted to remain more independent.
Mr Perrett conceded the centre did have some high running costs and it was “trying to work with the right doctors, with the right attitude”.
“I expect within two years, we’ll be operating with seven full-time doctors. These things don’t happen overnight.
“The board is committed to making sure the people of Gunnedah have access to good quality health services when needed.
“We would hope the doctors now starting will commit to Gunnedah for a number of years,” Mr Perrett said.