Nurse-led clinics promised in Australia but doctors want to 'protect their patch'

SYDNEY, Australia.- Four nurse-led clinics are promised to Australia’s New South Wales should the opposition Labor Party win a March 28 election in the country’s most populous state.The state - including Sydney, Australia’s biggest city (population: 4.5 million)—is governed by the Liberal (conservative) Party in coalition with the smaller National Party.Though the state government, led by Premier Mike Baird, leads opinion polls, most analysts maintain Labor’s rapidly strengthening position make the election too close to call.State Labor leader Luke Foley recently announced his party’s A$40 million (Cdn$39.3 million) commitment to establishing four nurse-led clinics in New South Wales.Two would be in fast-growing western Sydney.The clinics would “ease congestion” in public hospitals, Foley contends. Inspiration came from a nurse-led clinic established by Labor in Canberra, the federal capital, three years ago.Nurses’ groupings, predictably, support such clinics but doctors’ groups are strongly opposed. Neurosurgeon Dr Brian Owler, national president of the Australian Medical Association (AMA), labels them “dangerous health policy”, arguing “quality health care is best delivered by teams led by doctors.”Dr Saxon Smith, a dermatologist and the AMA’s New South Wales president, disputes claims by clinic supporters that they’ll take pressure off public hospital emergency departments by dealing with minor ailments and injuries. Pressure on public hospitals “is coming from sicker patients,” he says. What’s more, he adds, nurse-run clinics compromise patient care and safety.(Australians sometimes visit public hospital emergency departments for non-emergency treatment, provided when they say they can’t afford to see family physicians in private practice.)The still-open Canberra clinic has attracted little controversy. Supporters say it’s useful to treat minor ailments. Patients present with colds, lacerations and musculoskeletal conditions.In the 2011-2012 fiscal year, nine per cent of clinic patients were referred to family physicians while five per cent were sent to hospital emergency departments.Nurses’ associations say clinic staff also reduces pressure on doctors’ office and hospitals by writing prescriptions and performing educative roles.But doctors’ groups counter by calling such clinics a waste of money and noting that the Canberra facility hasn’t reduced hospital writing times.News reports focused on ear wax removal as a minor complaint ranked number-five as a reason for visiting the Canberra clinic. Such concentration on the trivial irks Dr Peggy Brown, the Australian Capital Territory’s director-general of health.Reasons for visiting nurse-led clinics are “not inconsequential for the most part”, she says, pointing out that impacted ear wax can indeed be a painful condition for patients.If Labor wins power in New South Wales doctors are expected to campaign strongly against the clinics. Labor leader Foley dismisses this as doctors “protecting their patch”.

Nurse-led clinics promised in Australia but doctors want to 'protect their patch'

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