It is vital that Vanessa Hughes is close to doctors so she can access medication for her young twins at short notice, but the closure of a GP clinic north of Hobart will potentially add hours – or even days – to their waiting time.
Brighton Doctors, which services a wide area, will close on September 23, meaning its active patient list of 3,000 will need to travel elsewhere for care.
Ms Hughes's two four-year-old children, Zac and Tanner, were born premature and are highly susceptible to tonsillitis and ear infections, making it vital they have access to a GP close to their home in Kempton.
It was already tough finding a regular GP, but now it will be even more difficult.
"For the last couple of years, I was seeing a regular doctor, then he left," Ms Hughes said.
"Since then, it's just been constant GPs coming and going and you can't get that connection with your doctor, it's been pretty bad lately.
"I'm struggling to get into any doctors that are close, everyone just turns around and says there's no place for any new patients, and they don't say, 'We can put you on a waiting list'.
"For someone that needs antibiotics quickly … the last option is after-hours and the last time I went there I was told it's a three-hour wait, that I had to go home and then come back.
"With a sick kid at that time of night, I'm not able to do it."
Travelling to after-hours clinics in Moonah or Hobart – or even the Royal Hobart Hospital – also added to petrol costs for the family.
The closure of Brighton Doctors comes after ratepayers in Glamorgan-Spring Bay area are having to pay a levy to keep GP clinics open, while the closure of the only clinic in Ouse left more than 1,000 patients having to travel far out of town to see a doctor.
'No new GPs coming in'
The Brighton Doctors was last year faced with introducing restricted hours and had a heavy reliance on locums after losing two permanent doctors in quick succession.
The lack of a permanent GP for a year was a key factor in the decision to close, according to operations manager Eliza Taylor.
"It's been a really, really difficult decision for us to make," she said.
"We want to be able to provide a service to the community, but without a GP, we're just not able to do it."
Ms Taylor said the other clinic in the area – Brighton Regional Doctors – was not taking new patients, while clinics in New Norfolk were in a similar position.
"That is the main problem at the moment. There is a shortage of GPs, there are no new GPs coming in, doctors are retiring early," she said.
"Clinics are just not able to take on new patients at the moment."
Closure 'highlights need for Medicare reforms'
The closure reflects a trend occurring throughout Australia, and highlights the need for Medicare reforms, according to the Royal Australian College of General Practitioners (RACGP).
RACGP Tasmanian chair Tim Jackson said Medicare funding had been failing to keep up with costs for GP clinics, particularly in areas with a higher dependence on bulk billing.
"General practice is a business like any business. So if the income doesn't keep up with the cost of running the practice, staff wages, insurances, leases, etc, then it puts pressure on the business," he said.
"And what we've seen is that Medicare rebates have not kept up with the costs of providing good service."
Dr Jackson said one short-term fix could be allowing nurse practitioners and pharmacists to do more for patients.
"Provided it's within the practice team, I think that's a good outcome," he said.
"We don't want to see fragmentation."
Dr Jackson believed there was a role for the Tasmanian government to play by blending financing for general practice, which occurs in Victoria and NSW, helping GPs to provide urgent care.
"A similar model of blended financing general practice would help long-term sustainability, particularly in outlying and rural areas," he said.
Tasmanian Premier Jeremy Rockliff said the government had put forward a proposal to add rural and regional GP and primary care services in areas where they were not financially sustainable.
"This pilot would continue to be funded by the federal government, but run by the state, and fully integrated with Tasmania's single public health and hospital system," he said.
"This proposal has been raised to start the conversation with stakeholders, including the Australian government, general practitioners and the community about how we can deliver the services they need, and Tasmania will continue to work with the federal government to progress reforms like this."
Mr Rockliff also pointed to the government's community rapid response service, GP after-hours support initiative and new rural medical workforce centre as measures in place to attempt to ease pressure on the health system.
