General practitioners were set to join the ACT's walk-in health centres under a proposal the territory made to the federal government that was ultimately abandoned.
The ACT proposed to include GPs and consultant medical officers across the five walk-in clinics as part of the Commonwealth's urgent care clinic rollout.
But the proposal was ditched following a consultation and the ACT government decided to retain the existing walk-in centre model but include extra services, including radiology and a range of other treatments.
ACT Health made a submission to the federal health department to trial an integration of GPs in the walk-in centres in September 2022, freedom of information documents have revealed.
The federal government initially gave in-principle support for the proposal from the government. However, the ACT changed its approach and sought further advice from the Commonwealth.
A consultation on the proposed model showed some reluctance from stakeholders on blending GPs with the nurse-led clinics.
The Commonwealth gave the territory more than $7 million to support a revised model not including GPs and the nurse-led walk-in centres were rolled into the urgent care clinics.
The territory government held a consultation on the proposed model with GPs with public health workers, general practitioners and unions.
Consultation papers showed the model would include GPs working after-hours and on weekends in the centres for advice and consultations. But nurses would still take the lead in the centres and the government would not publicise that doctors were in the centre.
"The model would preserve and optimise the current nurse-led [walk-in centre] model," consultation papers said.
"Consumers will not be able to request to see a GP and GP availability will not be advertised.
"Rather GPs will work as part of the team, extending the scope of the skills available on shift and treating patients accordingly. To do otherwise, would create significant additional demand to the centres and disrupt the provision of local GP services."
Feedback from the consultation suggested "strong sensitivities" between medical and nursing representatives over the proposed model.
The information was revealed in a freedom of information request from opposition health spokeswoman Leanne Castley. She said the government had not been upfront about walk-in centres. She said the government did not respect GPs.
"We know the Health Minister and Labor-Greens government do not respect or prioritise GPs and are more interested in taxing them instead of working closely with our hardworking GPs to ensure Canberrans have access to important primary healthcare," Ms Castley said.
An ACT government spokesperson said the proposal was built on the experience of providing care to people with COVID-19 during the pandemic under a similar nurse-led model of care.
"The clearly articulated intention was for the GP to work as part of a team approach that would preserve the nurse-led model," the spokesperson said.
But the consultation showed there was not much support for the measure, the spokesperson said.
"The paper formed the basis for consultation with the workforce and key stakeholders. This consultation found that this model was not widely supported by either the workforce or external stakeholders. In addition, it was apparent that advanced practice nurses and nurse practitioners could treat the vast majority of conditions the urgent care centres was being set up to treat," the spokesperson said.
"The ACT government is pleased to have received the federal Labor government's support for our nation leading nurse-led walk-in Centres. By contrast, the Canberra Liberals have never supported this popular and successful model of care and have never committed to maintaining it if they are elected."
Ms Castley claimed the documents showed the government was prepared to walk away from the nurse-led model. Nurses still played a leading role under the proposed model.
"The Health Minister was up to her eyeballs in this. While accusing the Canberra Liberals of not supporting nurse-led walk-in centres, the Health Minister was herself clearly walking away from them," she said.
The urgent care clinics were a commitment made by federal Labor in the 2022 election. The $135 million commitment was to trial the clinics, including a centre in Canberra.
The clinics are designed for patients needing walk-in treatment to take pressure off hospital emergency departments. The ACT launched the nurse-led walk-in centres in 2010 and they provide health care for non-life threatening injuries and illnesses.
Doctors have called for an independent review into the walk-in centres, saying this would help assess whether the centres were successful in improving primary health and redirecting patients away from emergency departments.
Separate documents recently released under freedom of information showed the cost of each presentation was nearly $200. Health officials initially told The Canberra Times it was less than $110 a presentation but the documents revealed this was based on the budgeted amount.
There was $22.3 million spent on the centres during 2023, including the overhead costs.
