AS we observed here yesterday, this region's GP Access After Hours service has been a resounding success across the 20-plus years since it began as a trial at Maitland in 1998.
So successful that the federal government used the Hunter model in a national roll-out of similar services.
Even so, the Hunter operation has had various funding threats over the years.
Now, for reasons that are not yet fully apparent, the service is again in straitened circumstances.
As a result, it says it intends to leave the Calvary Mater entirely and to cut its hours at the John Hunter, Belmont and Maitland hospitals, and at Toronto.
We repeat our regret, expressed yesterday, that the cutback announcement was the first the public had heard of the latest funding problem.
Although the after-hours service is managed by a not-for-profit private company - Hunter Primary Care (HPC), it is almost entirely funded with taxpayers' money.
On that basis, the public is entitled to ask why HPC did not speak out earlier in the piece.
On one hand, the announced reduction in after-hours services can be interpreted as the HPC board deciding to fold its tent rather than mount a public battle against either the federal government, which provides the bulk of the funding, or the state government, which is apparently reducing its contribution.
On the other hand, the funding bodies may well view the cuts announcement as a crude attempt to force enough extra money to have the threatened services "reinstated".
Regardless of the intentions, the outcome must inevitably be a greater degree of scrutiny across the entire operation.
As important as it is, the service must also provide value for money.
HPC says the service cost $7.74 million in the year to June 30 last year.
Another organisation, Hunter New England and Central Coast Primary Health Network (previously Medicare Local) says it provided $5.36 million of that amount.
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These do not appear to be huge sums for a service that held more than 49,000 appointments in 12 months, with its paid after-hours shifts filled from a roster of more than 200 doctors.
The region does have some private after-hours services but nothing on the scale of GP Access.
It is time for all involved to lay their cards on the table and work to an outcome that serves the public that pays for these services with its taxes.
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