‘Don’t tar us all with same brush’ - outrage over GP selling priority appointments

NOT all doctors at Gunnedah’s Rural Health Centre will charge up-front fees for patients to “jump to the front of the queue”.

The decision by Doctor Chris Gittoes to effectively sell priority positions ‘on-the-books’ to 1000 patients for a $140 up-front fee has caught the Gunnedah Rural Health Centre board by surprise, and outraged many in the community who donated toward getting the Centre built.

The board of Gunnedah Rural Health has moved quickly to “dissociate itself from the ‘priority patient plans’ being proposed by Dr Gittoes”, while Dr Grahame Deane, who has been part of the efforts to build the centre for the past seven years, said he was concerned other doctors would be “tarred with the same brush”.

“This is a decision by one individual doctor,” Dr Deane said.

“At this point, I am concerned this will create a negative impression of the Rural Health Centre.”

Dr Gittoes however stands by his proposal to sell ‘priority patient plans’ for $140 every two years, to be paid up front as well has his decision to only allow patients who purchase the plan onto his books.

About a fortnight ago, patients and prospective patients of Dr Gittoes began receiving letters “thanking them for the opportunity to become you regular doctor”.

In the letter, Dr Gittoes explains there is a critical shortage of doctors in Gunnedah “and patients often find it difficult to see a regular doctor”.

‘’I intend to book up to two weeks in advance,” he wrote.

“I am happy to see any patient, however, while I cannot guarantee you will get a timely appointment every time … I will endeavour to give priority appointments to my regular patients.

In order to become a ‘regular patient’ however Dr Gittoes will charge an up-front fee of $140 every two years.

“Please understand, I have more than enough patients and I am in no way trying to expand my practice,” he wrote.

“In fact, I intend to reduce the number of regular patients on my books to those who want and value a Preventative Health Care Approach.

“This is similar to when you board an aeroplane and the pilot has a checksheet to prevent the plane from crashing. Your healthcare is no different.

“The fee for your investment in your health will be $140. Unfortunately Medicare will only pay for a GP Management Plan specific for a Chronic Disease. Please understand you will have to pay for the Preventative Health Care Plan yourself.”

Dr Gittoes says he will “of course see other patients as time permits” and “I am happy to continue treating you on that basis, whenever I can fit you in”.

While some in the community see the investment as good value 

for money, many will not be able to afford the extra costs, effectively limiting Dr Gittoes patients to those able to pay.

Dr Deane, who  was involved in the GRHC from the first committee meeting on July 28, 2005, said the proposal is in conflict with the GRHC’s objectives of equitable and timely access for all patients in this community-owned, not-for-profit centre.

“The community raised a lot of money toward the centre,” he said.

 “Speaking only for myself, I always have, and will continue to bulk-bill the financially disadvantaged in the community.”

Centre Practice Manager Helene Walsh confirmed most consultations at the GRHC are in fact bulk-billed.

“As a snapshot, exactly 64 per cent of all consultations over the past month were bulk billed,” Ms Walsh said.

“What has been splashed around over the past several days is only half the story.”

Gunnedah Rural Health Board Chairwoman  Penny Crawford said the letter, which was printed on GRHC letterhead “has not been endorsed by the board and does not have its support”.

She said the board was only made aware of Dr Gittoes’ approach, when a patient who received the letter complained.

“The board wishes to emphasise that this contravenes both GRH policy and the Federal Government’s GP Super Clinic objectives of accessible and affordable services,” Ms Crawford said.

“This doctor is an independent medical contractor and is not an employee of the Gunnedah Rural Health Centre.

“While health care prevention schemes are a laudable initiative, this particular proposal remains the individual initiative of Dr Gittoes.”

Ms Crawford said Dr Gittoes’ proposal made a mockery of the intents of the Gunnedah Rural Health Centre.

“We are concerned that it will exclude members of the community who are struggling already to cover medical costs,” Ms Crawford said.

“As a GP super clinic, we received $4.3 million in funding from the Federal Government. That funding was also granted because we were able to demonstrate a strong level of community support.

“A third of the project cost was raised within the community of Gunnedah and the people and business organisations within this town have a right to feel they have worked hard towards achieving affordable, accessible health care.

“Additional fees for services, which are within the normal scope of services provided by a GP, make a mockery of those objectives.”

Dr Gittoes had originally agreed to speak to the Namoi Valley Independent on Thursday, however, postponed and has since been unavailable for comment.

He did tell the Sydney Morning Herald at the weekend, doctors were entitled to some incentives to live in communities without the services and comforts offered by larger towns.

He said he could not make a living from bulk-billing patients.

‘’If I bulk-billed, I’d be earning less than a 24-year-old driving a truck at one of the local mines.’’

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