The letter, obtained by The Border Mail, puts the decision by the National Home Doctor Service that runs 13SICK, to Medicare rebate cuts coming into effect tomorrow.

“In the week leading up to Christmas, the Turnbull Government announced major cuts to Medicare rebates paid to doctors who see patients at home in the after-hours period,” it reads.

“This rebate cut amounts to just over 30 per cent. 

“As you can imagine, it is already difficult to get doctors to work in the after-hours period … but this Medicare cut has made recruitment and retention of doctors close to impossible.

“We have been forced to shut some of our services in Albury as we can no longer recruit the doctors to do the work.”

The rebate for “medical deputising doctors” undertaking home visits will tomorrow be reduced from $129.80 to $100 and the rebate will be further cut to $90 on January 1.

The National Home Doctor Service added Albury to its locations in April 2016, bulk-billing after-hours calls to patients at home and at aged care residences. 

Senator Richard Di Natale raised the service’s planned closures in Albury, Townsville, Perth and Hobart at a Senate hearing today.

“We talk about rural and regional communities being exempt, but under this change Albury and Townsville will both be subject to the reduction in after-hours rebates,” he said.

“Can you provide us with assurance you don’t expect these changes will lead to an increase in pressure on emergency departments?

“Are you concerned those closures will mean reduced access to after-hours care?”

Department of Health Deputy Secretary Mark Cormack replied that the Medicare Benefits Schedule Review Taskforce, which recommended the rebate cut among a suite of other measures, were confident it would not lead to increased traffic in emergency departments.

“A lot of the work that had been generated by a number of businesses, not just this one (the National Home Doctor Service), was work that would otherwise have been dealt with within normal hours,” he said.

“We need to acknowledge there are a range of other services.”

When the changes were announced in December, Federal Health Minister Greg Hunt said the use of after-hours Medicare items increased by 157 per cent between 2010 and 2017.

“There is no clinical explanation for the large increase, but rather the growth has been driven by a corporate model of largely advertising on the basis of convenience, rather than medical need,” he said.