An artist's impression of the planned new Emergency Department at Lismore Base Hospital.
An artist's impression of the planned new Emergency Department at Lismore Base Hospital.

GP co-payment could strip benefit of Base Hospital upgrade

LISMORE Base Hospital's $80 million new emergency department will be twice as big as the present ED, but it will struggle to cope with the impact of the federal government's proposed $15 GP co-payment, according to a local nurse.

It's widely predicted that people with chronic disease, the elderly and others struggling to make ends meet are likely to visit hospital instead of seeing their GP because of the payment, which will charge $15 per GP visit, and $7.50 for concession card holders.

Now, figures from the a briefing prepared for NSW Premier Mike Baird (just released by NSW Labor) have put more science into that sentiment, predicting the co-payment will push up emergency department visits across NSW by 27%.

Lismore Base Hospital ED would see another 7600 patients every year - about 20 per day - while Ballina District Hospital would see about another 4,000 per year.

NSW Nurses Association branch secretary Gil Wilson says the pressure would be "crippling" to the current over-stretched emergency department in Lismore, but also offset any breathing space provided by the new ED opening next year.


How much will the GP co-payment increase hospital admissions?
Ballina District Hospital:
April to June 2014 admissions: 3714
Add 27% more for GP-co-payment: 4716
Increase: 1002
Lismore Base Hospital:
April to June 2014 admissions 2014: 7045
Add 27% more for GP-co-payment: 8947
Increase: 1902
Casino & District Memorial Hospital
April to June 2014 admissions: 3206
Add 27% more for GP-co-payment: 4071
Increase: 865
*Source: NSW Government, Health System Information and Performance Reporting


Lismore Base Hospital medical council chair Chris Ingall agreed if the modelling was correct there would be a greater throughput of patients in the ED which would be "very counter-productive to good medical care".

"People who are triaged in category one and two would be having wait for beds occupied by less sick people," Dr Ingall said.

Dr Ingall pointed out the co-payment may not increase actual admissions to hospital beds because most people seeking GP care would be able to walk out on the same day, but it would clutter the ED.

Mr Wilson added that the excess pressure on surrounding hospitals in Casino and Ballina would push down their thresholds for sending patients to Lismore, compounding the problem.

"That [new] ED is designed to meet our current needs… not political ideology-driven policies," he said.

"It's not designed to meet political thought bubbles; political thought bubbles that don't understand health, that don't understand how people will react."

"The GP is the cheap end of health; that is the cheapest end of health we have; hospitals are the most expensive."

"Anything that forces people into our hospital system is increasing costs exponentially."

Earlier this year, the Australian Medical Association website also posted a study which found that if four patients an hour turned up at NSW public hospitals because of their inability to afford the GP co-payment, the duration of an average emergency department visit would blow out from 5.6 to 8.5 hours.

But Lismore MP Thomas George said regardless of the GP co-payments imposed by the federal government, state-run emergency departments across the state would continue to deliver free public healthcare.