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An interim report into Medicare urgent care clinics (UCCs) shows that they are five times more expensive than a GP consult according to the Royal Australian College of General Practitioners (RACGP).
The Department of Health and Aged Care recently released an interim report evaluating the UCC program.
But the RACGP has said it doesn’t see the value of these clinics, stating that it’s cheaper to see a GP.
“The report confirms what we already knew, urgent care clinics are an expensive model of care, which could be better and more efficiently delivered through existing general practices,” RACGP President Dr Michael Wright said.
“The Government’s election commitment to roll out more urgent care clinics will mean more than $1 billion will be spent on setting up these clinics, and the report states that each presentation costs $246.50,” he said.
“This sum is cheaper than a visit to a hospital emergency department; however, it’s significantly more expensive than a standard GP consult, which costs taxpayers a little over $42,” Dr Wright said.
“So, your average urgent care clinic visit, seeing a GP who you may not even know, is more than five times as expensive as a consult with your regular GP,” Dr Wright said.
The federal government has announced an extra 50 bulk-billing clinics by 2026 if it wins the upcoming election.
The investment, worth $644 million, will be for new clinics in every state and territory.
Despite the criticism about the UCCs, Health Minister Mark Butler stands by them, saying that they take pressure off already-crowded emergency departments.
“They were opposed by doctors’ groups, by the College of GPs and by the AMA. But I’m convinced they are the right thing to do. They’ve already seen about 1.3 million patients across the country since we started opening them about 18 months ago, every single one of them is bulk-billed,” Minister Butler said.
“And the vast bulk of them tell us that if the clinic wasn’t available, they would otherwise have gone to the hospital ED [emergency department] [where] they’ll spend hours and hours waiting in a crowded hospital emergency department,” Mr Butler told ABC Northern Tasmania.
The UCC program kicked off as a pilot in June 2023 in response to recommendations arising from the Strengthening Medicare Taskforce. The aim was to take pressure off emergency departments in the nation’s hospitals by offering alternative GP-led care for non-life-threatening conditions.
The interim report showed that the mean wait times at the UCCs were much lower than emergency departments, at 14.5 minutes, and almost double in emergency departments with a mean of 31 minutes for triage category four and 24 minutes for category five.
While waiting times for patients are shorter at UCCs, the RACGP argues for accessing urgent care through general practice.
“All specialist GPs are trained to perform urgent care, and all practices and GPs routinely provide urgent care to their patients. Accessing urgent care through general practice improves patient health outcomes because continuity of care is embedded,” Dr Wright said.
“The best, most cost-effective way to increase access to urgent care and ease pressure on hospitals is to support existing practices [to] expand their current services, including offering more after-hours services,” he said.
“If the funding dedicated to urgent care clinics instead went to practices, we could be doing much more to help patients with urgent care needs. There’s no substitute for the high quality care provided by a GP who knows you, and your history, including in urgent care situations.”
The RACGP also said that GPs had raised concerns about a lack of communication between the urgent care clinics and a patient’s usual GP.
“The report reveals that only 68% of patient presentations to urgent care clinics had an electronic discharge summary [sent] to their usual GP. This constitutes inadequate clinical handover; because without this information, a GP may not even know that their patient went to an urgent care clinic, let alone what health issue they were being treated for,” he said.
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Dr Gordon Reid,member for Robertson and sometimes Emergency Dept MO at Wyong Hospital,when recently asked by me did he think it was fair that an UCC Dr gets $240 per hour told me that GPs were not able to practice urgent care medicine and the UCC Drs were entitled to higher than GP renummeration . He also said Labor were going to open 80 more clinics “soon”.
This is what what GPs are up against
Rural GP having worked and run rural EDs, worked in UCC and General Practice I can say that 100% of the presentations in UCC can and should be managed in General Practice – but with the workforce shortage after COVID and the 2019 changes to visa applications for doctors, as well as the change in training and professional developments there have simply not been enough GPs to fill the clinics that already exist: The creation of the UCC has further eroded GPs from GP clinics – and millions of dollars wasted on a scheme that does not reduce ED presentations, as very few of the UCC patients would ever seek EDs for treatment:
Thankfully with the new expedited pathway for GPs to come from NZ, UK and Ireland we are going to see these GP clinics filed with quality GP specialists who will have available appointments:
Just for the record for a person who previously posted UCC give IV fluids and antibiotics – The clinics I worked in would never do such things, if a patient needed IV therapy they would be sent to the local hospital
As David Mountain suggests, the cost comparison of GP visits at $42, UCC visits at $246 and $616 at an ED is comparing averages, not the specific patient groups involved. And Julie Panetta has said, the ability to book UCC appointments online does defeat the purpose, as they are then booked out by people who won’t wait 2 days to go to their GP, not by people who are on their way to ED.
As the report specifies, one of the main difficulties is getting an accurate answer to “where would the patient have gone otherwise?”. If they would really have gone to their GP a day later then it hasn’t saved the ED anything. If they would have gone to ED as a category 5 patient it hasn’t saved the ED much, as they won’t be complex patient and may well be told its ok to go to the GP tomorrow anyway.
A better model would be co-locating UCCs near hospitals, with no online booking. This will help to deter the GP-avoiders, and mean that two-way referral of patients in the grey zone can occur more seamlessly.
Hi
AMA(Australian Medical Association) and others have been critical
About these Urgent Care clinics And have called for an independent evaluation of the clinics due next year before further clinics are built with Medicare money going to large corporate medical center providers
its estimated that a visit to Urgent Care clinics costs $285 for a minor injury
does anyone see a problem with a measure of success being cost-effectiveness on a $1billion plus project when you aren’t going to measure that until the end of the third year of the project ? and being the main driver of Mr Abanese’s election pitch
Bill the builder
Ironically the Urgent Care Clinics will lead to less bulk billing of quotidian GP services, as yet another subgroup of consultations is cherry picked away.
Whoever is advising government needs to realise that general practice has to remain general; instead the fragmentation is leaving the remaining GPs in the system stuck with the grind of the complex patients which are simply not viable under a bulk billing model.
When the procedures are cherry picked, the acute episodic medicine is cherry picked, the repeat scripts are cherry picked, what is left for practice owners and managers to budget for?
There is a total disrespect and misunderstanding of what should and could happen in GP consultations.
It appears to me that those writing policy have developed a distaste for everyday general practice, so it is little wonder we have the recruitment and retention crisis we find ourselves in.
Financial coercion of blended payments, patient registration and practice accreditation is not cutting through.
If the rebates for GP consultation items were priced properly (this means triple to quadruple the current rebate) the UCCs and a lot of the fragmenting side-hustle GP industries that have developed would not be necessary.
GPs and RACGP are dishonest when they argue UCCs aren’t cost effective and aren’t doing anything that conventional GP practices couldn’t do:
a) GPs are bogged down in chronic disease management so can’t see urgent care cases urgently;
b) GPs don’t want to see urgent care cases as they disrupt booked-patient flow and take an unpredictable amount of time to manage – they are not a good business move;
a) GPs can’t do what UCC doctors do (fellowship prepares GPs for the basics of urgent care, but it is a subspecialty: how often do GPs treat pyelonephritis with IV Abx, or severe migraines with IV treatments, or assess XRs for fractures, and then cast and devidse a follow up plan, or suture nail bed lacerations; or perform urgent CTBs for head injuries – and so the list goes on!
b) GPs (would) charge more than $42 for helping UCC types presentations (the fact that the RACGP claims it wouldn’t, is an admission that they have no idea what urgent care does (e.g. have you seen the item numbers for a distal radius fracture, and incision and drainage, and removal of embedded corneal FB, laceration repair > 7cm; and are you aware that the highly experienced nurses in UCC cannulate, cast and suture?).
EDs are dishonest when they argue that UCCs aren’t helping:
a) UCCs are not supposed to solve EDs problems: they are supposed to help those patients who would be made to wait unreasonably long in EDs for urgent but not emergent health problems, so that ED resources can be re-directed to emergent cases; and so that these patients can return to being a productive member of society quicker.
b) EDs make $200 just for parking the patient on a seat, and $700 as soon as they’re admitted; thus EDs don’t want to lose these patients as they’re ‘easy money’ and they boost numbers which helps advocate for more funding (a bigger part of the real truth behind EDs ‘pretending’ to want fewer patients. The cost effectiveness of urgent care reaches far beyond the initial cost at treatment time: a carpenter who lacerates their forearm at 7am, gets back to work by 9am if seen in urgent care, generating wealth for themselves and our country (when extrapolated to to a population basis). Could ED or GP do this? NO!
c) EDs argue that UCC just send all their patients to ED anyway: what rubbish! 2-5% of all patients. And I can tell you now, that GPs would send more like 30-50% of UCC type patients to ED if they walked through their doors.
d) Urgent Care is simply returning non-lifethreatening urgencies to their rightful home of primary care. It was an accident that evolved over decades that EDs became the home of urgent issues (chronic disease management taking over mainstream GP and the business remodelling to reflect this and the associated deskilling in urgent matters; and EDs (as mentioned above), licking their chops at this kind of case to boost numbers, funding, and political bargaining leverage.
RACGP and GPs are naive in failing to recognise how healthy urgent care is for the specialty of GP:
a) Many medical students are uninspired but what they see during GP rotations; but are thoroughly inspired by what they seen in urgent care – I would go as far as to argue that a major factor in increased GP trainee numbers is because of urgent care being seen as an exciting opportunity;
b) many GPs themselves find greater motivation to work their regular GP hours precisely because they also have an inspiring and refreshing urgent care shift to look foreard to each week – thus it is keeping many GPs motivated;
c) Urgent Care legitimises General Practice to the general public. Remember the diplorable RACGP add campaigns like “Specialist in Life” and “Not ‘just’ a GP”? These were evidence of the decades of GP struggles to convince the public (and subsequently the politicians) of its purpose (for complex reasons); Urgent Care is a very clear and effective demonstration of what GPs are in the system for, and it is already helping the RACGP win over the publics’ and the politicians’ favour.
To argue (as someone here has) that urgent care should be staffed by Emergency Physicians, is frightfully wrong:
– with all due respect to Emergency Physicians for the incredible critically important work they do, they (of course as a generalisation) are not fit for purpose in urgent care: they would over investigate and over treat the urgent care population, as they are used to a high probability of serious aetiology, and as such lack the General Practice accumen on common things being common; they are trained to perform all investigations that might be relevant rather than those which are high yield and cost effective. In summary, they would at very least, lead to greater cost and more referrals to EDs rather than fewer. We need these amazing ED doctors for true emergencies, and in EDs where the presenting population is the one they’ve trained to know.
Could they not modify the discharge summaries they create so that as well as describing what happened ie laceration to right arm – sutured with 2/0 vicryl, DTP given etc, the discharge summary provides a comment at the bottom of the page along the lines of ‘your taxes paid $246.50 for this occasion of care’. Once people know the costs, they may value this more or hopefully value their GP consultation more which only costs $43. I know many patients are surprised when they buy a Mirena for $31.50 on the PBS and look at the dispensing label to find out the actual cost is $192.
As an Emergency physician and administrator The costings are really wrong;
The urgent care clinics incur all the 260$ costs to provide a service- that is all they do and wouldn’t be there otherwise.
An ED visit is supposedly 600$ but is not what it costs in real terms for these visitis
For a start these patients are at the very lower end of acuity, cat 4-5, v high discharge rates1-2% only get admitted to hospital so actually the cost paid per activity/ visit by govts is around $250-300 (600 is the average ED cost. In addition we don’t put extra staff, rooms., capacity on for these vists-as we already need to be open and have the resources ready 24/7, so the additional cost for us to see one of these patients is often small e.g.50-100$ (24-7), As pointed out by other ED physicians above – these pts are only in the wait room/ fast track areas, so don’t create ramping/access block and the other blights to patient safety and emergency care
I am a retired GP with a few kids who are struggling these days with mortgages, rents , school fees etc etc and if they contact me with a simple medical problem I advise them to seek treatment at a UCC as they can ill afford the $40 or$ 50 out of pocket expenses which to my way of thinking are over the top.(I did very well in Solo Practice for 20 years and never charged more than $ 5 over the rebate and bulk billed all procedures although I did not drive a Mercedes or BMW )
I appreciate the cost discrepancy but that’s a Government issue
My wife had a fall onto a concrete path on a Friday evening a few weeks ago. We thought our now corporate run GP practise was open on the Saturday morning, however due to their not updated website we found it closed. We attempted to go to another two GP practices but they both wanted her to be seen as a new patient as a double appointment and had no capacity to see her. As an alternative, one of the receptionist’s suggested the Marion Urgent Medicare Practice. We went and waited several hours for her to be seen by the attending GP. He very quickly confirmed her massive hemotoma on her shin, mainly because of her Axipan blood thinners. By the evening she had substantial blistering of the wound. We managed to get her reviewed again by a GP on the following Tuesday at our usual GP practice who said she should attend immediately at ED at Flinders Medical Centre or seek a very urgent consultation with a plastic surgeon. This we managed to do on the Wednesday morning, he however confirmed the hemotoma and surgically drained/aspirated it the following week. The MUMP was packed with a huge number of patients, particularly paediatric bubs and clearly there is a need for more such clinics and better staffing levels as we only ever saw the one GP there!
I agree with the comment of Dru Haywood. There is a monster here that cannot be slayed, the idea that has taken hold amongst the public that healthcare should be free. The current government feeds this monster, because they make things free by accumulation of debt rather than forcing todays taxpayers to pay more tax to fund this “free” care. Future generations of Australians will be the ones paying for the free care we enjoy today.
It really is true, the old builders adage. There is cheap, fast and good, but you can only ever have two of the three at once. Healthcare is no different. If you want it to be good and fast, it won’t be cheap. If you want it to be cheap, you have to sacrifice quality.
To Government.
Put UCC millions of dollars into ED – both personel and resources and communication.
Do not fragment care even further.
All out of hours issues should come under same umbrella which has a stream-lined communication with GPs.
Only acute issues should be addressed
All patients without a healthcare card should pay for visit to ED/UCC.
Then set about restoring General Practice
I am an emergency medicine senior staff specialist. Urgent Care Clinics do NOT reduce the ED waiting times AT ALL.
Their usual patients represent to us the ‘easy to see patient’, who is less sick than most others, who is rarely admitted and who does NOT add to either ‘Ambulance Ramping’ – waiting to get in; OR ‘Access Block’ – waiting to get out of the ED. So Urgent Care Clinics have absolutely NO impact at ll on the overburdening of EDs nationwide.
Urgent Care Clinics are nothing more than an expensive political spin, to pretend the Health Minister is ‘doing something’. I would much rather that the decision makers: PUT THE MONEY INTO THE HANDS OF GPs and REWARD GPs APPROPRIATELY FOR WHAT THEY ARE ALREADY DOING
Reliably accessible usual care is likely to be a far more important predictor of lifetime health than accessing fragmented episodes of “urgent care”. The situation is compounded by depriving usual care of resources in order to fund a model that is politically superficially attractive but in reality will prove disastrous for our nation’s wellbeing and productivity.
It might be cheaper to visit a GP for the government. But it is definitely cheaper to the patient to visit a UC clinic over a GP, and cheaper for the government over a visit to the ED. Then there is the possibility that the patient still gets sent to ED by the GP, because the GP doesn’t have the time of kit to sort something out, with the patient still paying the gap of the GP. GPs also set their prices. What’s stopping them from putting the government and public at ransom when in 2 years they say that the additional support to free-standing clinics to widen services isn’t enough? Just call it what it is, GPs don’t like competition, and will say anything to shoot it down.
From a patient-centered point of view, the argument that UC clinics are less effective than GPs doesn’t stand up to scrutiny. The need is there, and it was created by GPs in free-standing clinics when they started charging people large sums of money to spend 5 minutes with them.
Yes, it would be cheaper for everyone to see their GP for emergencies like fractures and lacerations. The problem is it’s almost impossible to get an appointment on the day. Often there are no appointments until several days later, with ANY of the GPs at the practice. More money to expand existing practices may or may not be welcomed by GP practices and GPs on particular. I’m not a GP but have accessed an Urgent Care clinic myself when I fractured my foot. I couldn’t get in to see my GP or any doctor at the practice, so was advised to go to the UCC. Otherwise I would have had to go to ED. Another thing: although you can apparently just walk in to these UCCs, they do have an option to book online which really defeats the purpose I think.
A sporting competition I’m part of promotes visits to local UCCs for minor injuries on Saturday playing days. GP clinics aren’t open, and no-one wants to sit around in an emergency department when you can be seen and treated much quicker at the UCC. This has worked well for the community and diverts people away from hospitals when they are already busy.
Western Sydney EDs start the day with 50+ admitted patients with no bed available on a ward.
These patients can’t go home and need admission, so the argument that UCCs are going to relieve the pressure on EDs was always a lie, these patients simply are not GP/UCC patients!
If only they took that money and funded Medicare rebates for GPs and to open more ward beds in hospitals.
Almost as our politicians will do everything but listen to the actual front line experts.
It is appalling to see MOH not listening to GPs and RACGP.One person from NZ,who reckons he is an expert in UC and wrote a thesis than pushed by some cooperate practices for UC as they knew they will get millions in funding with no concern on continuity of care
UC clinic is based on NZ system which is completely different.UC in NZ is private billing and ACC supported like Work cover scheme which is a rip off anyway in NZ.
Every doctor in GP practice can manage such a patient who go to UC.Because GP practices are not funded as in NZ ,it is medicare based so most clinics cant have open bookings and can not provide service beyond hours. If money given to UC is given to GP practices they can open after hrs and weekends thus saving millions.
It is the patients from GP practices who seek service from UC at a cost of $264 per visits. THIS AUTOCRATIC GOVT IS RUINING GP. What happened to Super clinics will happen to urgent care after govt change.Thus leading to billions of dollars being wasted for nothing.
Interesting costings. And my experience is that UCCs also don’t perform the role they should. They will often refer onto EDs if the patient needs a minor procedure (e.g. suturing), is a child etc. The care is not between that of a GP and an ED. Often its below that of an experienced GP. Perhaps their employment of only GPs needs to change. The GPs are better employed in a general practice. UCCs would perform better with nurse practitioners and/or Emergency doctors.
The point is though, that urgent care centres are free to the user. That’s what people want. And that’s what I, as a GP, will not commit to. It wouldn’t matter what kind of incentive the federal government gave me, I wouldn’t commit to it. With its little treats like bulk-billing incentive, the government is attempting to be a powerful partner in an abusive relationship with GPs. “Come back to me, I love you, I won’t hit you again.” But I’m wiser now.
The interim report on Medicare Urgent Care Clinics confirms what medical groups have been warning: these clinics are an inefficient use of public funds, costing over five times more than a standard GP visit, without delivering better care. The ALP’s rollout appears more like an election strategy than genuine health reform, with over $1 billion funneled into setup costs rather than frontline services. These clinics duplicate existing GP services, disrupt continuity of care, and lack proper communication with patients’ regular doctors.
Rather than funding expensive alternatives, government investment should go toward supporting existing general practices, extending after-hours care, and educating the public on appropriate use of emergency departments versus GP services.
Our healthcare system needs strategic, evidence-based reforms—not short-term political fixes.