9.           Taskforce findings

The Taskforce is satisfied that the current structure of the urgent after-hours items supports the provision of comparatively low-value medical care and does not represent value for money for the taxpayer.

In reaching this conclusion the Taskforce considered the expert opinion of representatives from professional medical organisations (including the AMA, RACGP, ACRRM and RDAA) and Medicare data on usage patterns.

The Taskforce noted that:

           In the five years between 2010–11 and 2015–16, there has been substantial growth in the number of services and benefits paid for the urgent after-hours items.

           The growth in use of these urgent after-hours items is concentrated in some areas of urban Australia.

           Most urgent after-hours services are being provided by MDSs and the growth in urgent after-hours services is well in excess of the growth in standard after-hours items.

           The growth in use of urgent after-hours services appears not to be driven by increasing clinical need for these services, but has coincided with entry of new businesses into the market with models which promote these services to consumers emphasising convenience and no out-of-pocket cost.

           Many urgent after-hours services are claimed for matters which are not urgent and could be better and more cost-effectively dealt with by the patient’s usual GP during normal business hours.

           It is not convinced by arguments that the growth in use of urgent after-hours home visits has had a significant impact on the use of emergency department services.

           The increasing use of the items by MDSs has implications for continuity of care with the patient’s regular GP.

These findings led the Taskforce to recommend changes to the item descriptors and explanatory notes for items 597, 598, 599 and 600.