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General practitioners have been left in a state of “uncertainty and anxiety” ahead of the next stage of the Covid-19 vaccine rollout, with some fearing shortages of needles and syringes, and others saying the government’s funding model means they will lose money administering the jab.
The next stage of the national rollout, which began this week, will rely heavily on GP clinics to get 14.8m doses to higher priority segments of the general public. That includes older Australians not in aged care facilities, other healthcare workers, Indigenous Australians over the age of 55, and adults with underlying medical conditions.
More than 4,600 GP clinics have been approved to participate in the program, but, so far at least, they have received little detail about what is required of them.
In a series of interviews, GPs told the Guardian the paucity of information has left them unable to plan or order supplies. A number said the funding model adopted by the government will force them to deliver the vaccine at a loss.
Maria Boulton runs a Brisbane GP clinic, is a director with the Australian General Practitioners’ Alliance, and chairs the Australian Medical Association’s Queensland Council of General Practice.
Boulton told the Guardian that one of her chief concerns is the lack of clarity around syringe and needle supply. Clinics are expecting stage 1b of the rollout to begin in several weeks, but say they are facing shortages, rising prices, and huge demand.
The federal government has told GPs it will offer some stock from the national medical stockpile to supplement their private purchases, but it is unclear how much can be provided from the stockpile and when.
“We received a letter and a lot of clinics received a letter [this week] saying we had been chosen to participate, but already there is a shortage of syringes,” Boulton said.
“So GP clinics do not have the buying or procurement power that the government does. So we’re asking the government: surely if you can secure an Olympic Games for Brisbane, surely you can procure syringes, and needles and band-aids and everything we need for this vaccination to go smoothly.”
The rollout has already experienced some teething problems, with two elderly people erroneously given four times the proper dose, 125 Pfizer doses thrown out due to incorrect storage, and nursing homes reporting delays, cancellations, and extremely short notice.
The Royal Australian College of General Practitioners president, Karen Price, said she had also heard concerns from her members about consumable supplies. Price said understanding what could be supplied from the stockpile and when was crucial for clinic owners attempting to plan their delivery of the vaccine.
“Those details of implementation – I understand as a former practice owner – that’s what you need to run your clinic,” Price told the Guardian. “But it gets lost in some of the stuff up higher. I think we need to find out again what that commitment is and what it constitutes, because clearly that’s an important issue in affordability.”
Price says some GP clinics have also begun to express fears about the “high stakes” of any hiccups with the vaccine rollout.
Those fears were amplified this week when Healthcare Australia’s dosing error led to the standing down of its chief executive, huge government and media scrutiny, and a public savaging by health minister Greg Hunt.
Price said the episode may have proven “the final straw” for some GP clinics already worried about their participation, but was not aware of any GP clinics pulling out.
“It’s been not an easy journey for many GPs, and for those who are more skittish about it all, it might be the final straw for them,” she said. “But I think it just reflects the anxiety and uncertainty, and the stress of the whole sector. They are people under stress. They’ve been shouldering this burden for 12 months, straight after the bushfires, here we are doing another event.”
Mukesh Haikerwal, a GP in Melbourne’s western suburbs and former Australian Medical Association president, said the letter received by participating clinics this week was little more than a “holding pattern letter”.
Haikerwal said on current information, he was unable to explain with any clarity to his patients when and where they might be able to be vaccinated.
“I’m literally having these conversations every day with patients. They’re saying ‘what are we going to do with the vaccine?’,” Haikerwal told the Guardian.
“I say ‘well, I don’t know when it’s going to come, I don’t know who’s going to be providing it, I don’t know if we’re going to be able to provide it to you or not’.”
Another key source of concern was the funding model proposed by the federal government to pay GPs for participating in the rollout.
The funding model was designed for high-volume, mass vaccination type clinics, which have not experienced any hiccups delaying their delivery. Doctors say it is less suitable for smaller clinics in cities and the regions that are already running at capacity.
Boulton, for example, said the funding arrangements will force her to deliver the vaccination program at a loss.
“We will do it, but we will do it at a loss, because we believe it’s something we need to do,” she said. “But let’s not forget that it’s not just the government that’s funding this, it’s the general practice owners.”
Price said individual clinics will need to decide whether they can find a model of delivery that is viable.
Working that out, she said, can be extraordinarily complex and hugely stressful.
“You’ve got different [clinic] sizes, different staff, there are some clinics that may be banding together to do it, which makes sense, because we’ve still got to do usual business,” Price said. “We can’t just drop everything. I know my clinic will be doing it after hours, on a weekend.”
On Thursday, Hunt said clinics were getting “significantly more than is the case with the flu vaccine”.
“It’s a $55 combined payment for the two doses, with a $10 practice incentive payment for completion of a second dose at the same facility as the first,” he said.
Source: The Guardian
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