The ACT Government has often accused the Canberra Liberals of not supporting the nurse-led walk-in centre model, but Labor itself tried to walk away from it, the opposition claims.

Under Freedom of Information, shadow health minister Leanne Castley has obtained correspondence from Rebecca Cross, Director-General of the ACT Health Directorate, to ACT health minister Rachel Stephen-Smith.

At the 2022 election, federal Labor pledged to set up an Urgent Care Clinic (UCC) for Canberra, part of a $493.5 million investment to establish 58 UCCs across Australia. UCCs aim to “reduce pressure on hospital emergency departments and make it easier for Australian families to see a doctor or a nurse when they require urgent but not life-threatening care”.

In September 2022, the ACT Health Directorate wrote to the federal Department of Health and Aged Care (DHAC), proposing a system-wide trial where GPs and Consultant Medical Officers (CMOs) would provide face-to-face and telehealth services at all five ACT Walk-in Centres. The model would “preserve and optimise” the nurse-led walk-in centre model, and patients would only be referred to doctors after an initial triage.

Mark Butler MP, Federal Minister for Health and Aged Care, expressed his in-principle support for the proposed trial that December, subject to further negotiation, including how GPs could be integrated into a nurse-led environment.

An ACT Government spokesperson explained that the consultation paper proposed including a GP after-hours and on weekends, located in one walk-in centre, and providing support across the walk-in centre network through telehealth.

“The clearly articulated intention was for the GP to work as part of a team approach that would preserve the nurse-led model,” the spokesperson said. “This proposal built on the experience of providing care to people with COVID-19 during the pandemic under a similar nurse-led model of care.”

Ms Cross noted in January 2023: “Concerns may be raised that the ACT model erodes the nurse-led WIC [Walk-in Centre] model by integrating a GP. Clear managing will be provided on rollout to highlight that ACT UCCs preserve and optimise the nurse-led WIC model.”

DHAC offered the ACT Government $750,000 every year for the UCC, and additional funding of up to $7 million for providers to claim the MBS rebate from publicly funded walk-in centres.

However, the ACT dropped its plans for GPs at walk-in centres. Canberra Health Services’ consultation with stakeholders revealed “strong sensitivities between medical and nursing representatives over the proposed model”.

“This consultation found that this model was not widely supported by either the workforce or external stakeholders,” the government spokesperson said. “In addition, it was apparent that advanced practice nurses and nurse practitioners could treat the vast majority of conditions the urgent care centres was being set up to treat.”

Ms Castley believes this was when Canberra Health Services “floated the absurd proposal of having a non-advertised GP out-the-back of walk-in centres”.

“The Health Minister was up to her eyeballs in this,” Ms Castley said. “While accusing the Canberra Liberals of not supporting nurse-led Walk-in Centres, the Health Minister was herself clearly walking away from them.”

In May 2023, DHAC told the ACT to consider an alternate model to extend Nurse Practitioner coverage across walk-in centre sites in place of GPs. The ACT Health Directorate presented that model in June 2023, with additional equipment and Advanced Practice Nurses. The Directorate advised medical stakeholders of its decision to proceed with a non-GP-led model.

“Labor has not been upfront about Walk-in Centres,” Ms Castley said.  “This was highlighted just recently when the Canberra Times revealed their real cost is closer to $200 per presentation than the $110 claimed by the government.

“We know the Health Minister and Labor-Greens government do not respect or prioritise GPs and are more interested in taxing them instead of working closely with our hardworking GPs to ensure Canberrans have access to important primary healthcare.”

The Canberra Liberals have opposed the government’s introduction of a payroll tax for GPs, which they believe limits Canberrans’ access to essential healthcare.

“The ACT Government is pleased to have received the Federal Labor Government’s support for our nation leading nurse-led Walk-in Centres,” the government spokesperson said. “By contrast, the Canberra Liberals have never supported this popular and successful model of care and have never committed to maintaining it if they are elected.”