Page 2642 - Week 09 - Wednesday, 7 August 2013
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However, you should also note that category 5 presentations to Canberra Hospital, whilst rising in 2010-11—which was the year the walk-in centre was opened—have reduced by 11 per cent over the past two years from 7,825 presentations down to 6,999. And the figure has been more dramatic at Calvary Public Hospital—when you talk to the doctors there they will tell you that—which has seen a reduction in category 5 presentations by 34 per cent. Considering that the walk-in centre is primarily targeting category 5 patients, or that cohort of patients, the data could suggest that people are opting to use the walk-in centre over presenting to the emergency department for minor illnesses and injuries.
Furthermore, presentations to the walk-in centre have grown substantially, with over a 26 per cent increase in presentations in 2012-13 compared with its first full year of operation. So we have seen presentations to the walk-in centre grow from just over 15,000 to over 20,000, and the rate of referral to the emergency department from the walk-in centre remains very low at 4.8 per cent. They are the facts. That is the reality.
Mr Hanson can quote from a particular document; he can link it to ED timeliness if he chooses, but what we are actually seeing in the two years since it opened is a very significant reduction in category 5 patients and an increase in presentations overall to the walk-in centre with similar increases in presentations to emergency departments at both Canberra and Calvary hospitals, despite Calvary not having a walk-in centre located on its site. That is the reality of what we are seeing.
Mr Hanson does not acknowledge that the author of the report he uses to further his argument of hostility towards a nurse-led model of care actually wrote a letter to the editor of the Canberra Times. I think she was probably feeling a bit concerned about the way the debate had gone, because it is politicised—the Liberals say the walk-in centre is bad; we say it is good. She wrote:
The ACT nurse-led walk-in centre is an innovation bringing the ACT up to speed with its international colleagues. Use of findings from the evaluation … can only strengthen this and future models of care.
She also said the ACT is the leading jurisdiction rectifying the lag in nurse-led models of care. Again, put in perspective an academic’s analysis of a perfect world with a perfect model. If I had a perfect world here, I would have opened a walk-in centre somewhere off the Canberra Hospital site and it would not have had such a tight scope and practice for the nurses that has led it to be really an advanced practice nurse model rather than a nurse practitioner model. However, that was not the environment we were working in. We were getting representations and concerns were raised with me by medical practitioners about the safety of the service. They made it very clear that in the early days of the service, from a service safety point of view, they did not want to see a new model of care that had never been tried in the ACT being implemented away from medical governance structures. That is the reality.
I had the choice of having doctors campaigning against a nurse-led walk-in centre or trying to find a solution. So I found a solution—the solution was to establish it on the grounds of the hospital, to have it come under the clinical governance structure of the
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