00:02I just want to clarify first of all what we're talking about here with GP home visits.
00:05So some people might remember back in the 90s when you were sick, a doctor, your doctor
00:10would come to your home and do the treatment there.
00:13Now that's quite different to what we see sometimes now where you might call up a generic
00:17sort of hotline and get a locum doctor.
00:19Now that's a doctor that's not known to you, it's a casual doctor, so quite different to
00:24the traditional sort of home visits that we used to see.
00:28Research by the University of New South Wales has actually found that there's been an 85%
00:33decline in GP home visits in the past 30 years.
00:36So in 1994, it was close to 4 million and 2024, it was just over half a million.
00:42So that's pretty huge.
00:44Now, GPs I've spoken to about this particular issue say there's a bunch of reasons why this
00:49is happening.
00:50Predominantly, it's a lack of remuneration, so they're not getting a Medicare rebate that
00:54can cover those travel costs, the time it takes to leave the clinic.
00:58There's also some concerns about personal safety when visiting people's homes, that's increased.
01:03And on top of that, we know there's this perennial issue with there not being enough GPs in general,
01:09so let alone GPs leaving the clinic to go to people's homes.
01:13Now we have seen telehealth kind of plug the gap somewhat, but that's just not suitable
01:17for patients that have very complex and chronic health conditions.
01:21Telehealth really won't cover that sort of problem.
01:23So how's this affecting them?
01:25Exactly.
01:25So by them, we're talking about the elderly, we're talking about people living with dementia,
01:30disability or chronic mental health problems.
01:33Now they can't leave their home to go to a GP clinic.
01:36Mobility issues, let alone people might suffer some sort of stress in a clinic, so it's just
01:40impossible for them to go.
01:42Now, we've been speaking to aged care advocates or workers and disability workers who say it's,
01:48you know, their biggest challenge for looking after these people in their home is getting
01:51that medical help.
01:52There is one GP that I interviewed for this story, his name is Dr John Crimmins.
01:57He does still visit people in their homes, he's one of the very few doctors that does.
02:01He focuses on people with disability and chronic health conditions.
02:05Here's what he has to say about that impact.
02:08Currently, the state health has not got the capacity to see every patient.
02:14GPs see most patients as it is.
02:16So outreach has to be done by GPs.
02:20And if you don't have outreach, it means there's a large group of patients, you know, for example,
02:26those in palliative care, those with severe disabilities, those with severe mental health,
02:32who are being missed in terms of early diagnosis, early management, and then ongoing care.
02:41That's Dr John Crimmins there.
02:42Now, what that means is these people end up in hospital, and as we've been hearing about,
02:46there's bed blocks, and that's a huge issue, so that's contributing to that particular problem.
02:51And then often, the elderly end up in residential care, and this is often not what they want.
02:56It's also very much not what the government says it wants, because it's said very publicly over the
03:00past few years that it wants to keep more people in their home.
03:04So, as a result, GPs and the Royal Australian College of GPs have said they want an increase
03:10to the Medicare rebate for those GPs that do home visits.
03:13They think that would really help this situation.
03:15The federal government in response, the health department, has said that it is currently reviewing
03:20the Medicare benefits schedule, and as part of that, it is going to look at the remuneration
03:25for primary care, including home visits.
03:28So, hopefully, that will work something out.
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