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The Guardian - AU
The Guardian - AU
National
Benita Kolovos and Melissa Davey

Rural Victorian town left without bulk-billing doctor after clinic closes doors

Nurse talking with patients in waiting room
Expanded telehealth and e-prescription services and pop-up primary care clinics are being considered after Mildura’s bulk-billing clinic closed. Photograph: Dean Mitchell/Getty Images

About 15,000 patients in and around the rural city of Mildura in Victoria’s north-west have been left without a bulk-billing doctor and are struggling to access their medical records.

The Tristar medical group, which owns the Mildura clinic, went into voluntary administration in May, and after the sale of the clinic to another medical group fell through earlier in August, the clinic has closed its doors.

Tristar, which owned clinics across regional Australia and which is known for hiring international medical graduates to staff regional towns, has multiple unpaid creditors and has been under financial stress for several years.

President of the Rural Doctors Association Victoria, Dr Rob Phair, said: “We’re now in this crisis situation where 15,000 people have no access to any GP care.”

“Other clinics can’t just take them on,” he said. “It’s not like Melbourne where you can just walk down the street or just go to the next suburb across and find another GP. In Mildura, there’s literally no one.”

Phair said he had been trying to get answers about what has happened to the medical records of the patients who attended the clinic.

“There’s no medical administration at the clinic any more, so how can people get their records, who can access them currently, who owns them, and where are they?” he said.

The chief executive of the Murray Primary Health Network, Matt Jones, said a number of options were being explored such as other GP clinics employing the Tristar doctors, expanded telehealth and e-prescription services for the region, and temporary pop-up primary care clinics.

He said it is clear bulk billing is no longer a viable model for regions like Mildura.

“The cost of providing bulk-billed care to patients combined with the impact of inflation and the medicare rebate freeze means less and less bulk-billing services are available and that’s the business model that led to Tristar being the only bulk-billing service in Mildura,” he said.

“You also need to generate a lot of throughput for bulk billing to be financially viable which isn’t suitable for patients with complex needs which we have in Mildura and other regional areas.”

Jones said clinic chain Family Doctor, which bought most of Tristar’s other clinics except the Mildura one, holds the patients’ data. He said extracting the data for just the Mildura patients was proving complex, but he said the Murray Primary Health Network is urging the federal government and Family Doctor to resolve the issue as soon as possible.

In a bid to address low bulk-billing rates and a growing struggle to access primary care, the Victoria premier, Daniel Andrews, and the New South Wales premier, Dominic Perrottet, made a joint announcement on Tuesday that 50 urgent care clinics will be established across both states.

Primary health networks and existing general practices will partner together to run the clinics, which will handle issues such as mild infections, fractures and burns. They will have extended operating hours and patients will not be charged to use them.

It is hoped the measure would address pressure on state hospitals.

But the independent state MP for Mildura, Ali Cupper, said she was “incredibly disappointed” the city had not been prioritised for an urgent care clinic, given the local hospital was already experiencing overcrowding prior to Tristar’s closure.

“We farmed a desert, we’re made of tough stuff, but we need the government to get the big things right for us,” she said. “There is an essential baseline of support we need in order to survive and thrive in such an isolated part of the state.

“That’s why it’s just been so frustrating. I feel like it’s almost been like watching a car crashing in slow motion. There has been time to react.”

The Mildura Base hospital – opened in 2000 by private hospital operator Ramsay Health Care before the state government took over operation in 2020 – has been repeatedly criticised for not being large enough to serve Mildura and surrounding towns.

On Wednesday morning Andrews told reporters there was a “workforce issue” in trying to establish a Mildura urgent care clinic.

“We can’t find people to do it,” he said. “But we’re certainly looking very hard. There’s a real priority in terms of Mildura so we are working intensively with the local primary care network.”

Cupper wrote to the federal health minister, Mark Butler, to request a meeting to discuss the closure and possible solutions to address the shortage of GPs in the region.

She has suggested implementing a subsidy, similar to the one announced by the Victorian government for nurses and midwives, to subsidise the cost of undergraduate and postgraduate studies and vocational training for medical graduates who commit to specialising in general practice and working in a rural or remote area when they graduate.

Additional reporting by Adeshola Ore


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