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Super Clinics: little to show for $420 million

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The Federal Government is under mounting pressure to scrap its flawed GP Super Clinics program after the Commonwealth Auditor-General confirmed the scheme was badly designed and delivered poor value for money.

In a damning assessment, the Auditor-General found that although almost $420 million had so far been spent on to the $600 million program, only three of the 36 clinics promised in 2007 were completed on time, with seven still not operational, while just one of the 28 announced in 2010 was fully functional.

The Australian National Audit Office (ANAO) report showed that not only had there been serious delays in commissioning many of the clinics; several had swallowed enormous sums of money for little demonstrable public benefit.

It found that spending on individual clinics ranged between $1 million and $15 million.

In the most egregious examples of expenditure, $25 million ($12.5 million from the Commonwealth, matched by the South Australian Government) has been spent on each of two South Australian GP Super Clinics – one in Modbury, the other in Noarlunga – for a complement of 2.2 and 2.5 full-time equivalent GPs, respectively.

Echoing long-held concerns by the AMA that the program was poorly conceived and was a bad use of scarce health funds, the Auditor-General found that in setting up the clinics, there had been little attempt to assess the level of local need and what affect it might have on existing medical services.

“While…program guidelines required applications to address the extent to which a proposed clinic could impact on existing health services, this issue was not explicitly or substantively considered in the overall assessment,” the ANAO report said, noting one instance where the main patient access to an existing GP practice was funnelled through the waiting room of a Super Clinic.

In addition, attempts to assess value for money and benchmark performance were inadequate.

“Consideration of value for money was hampered by a lack of clear and specific guidance to assessment panels on assessing the value for money of physical infrastructure, resulting in a lack of clarity and consistency in how the concept was applied in the assessment and selection process,” the Audit report found.

Adding to suspicions that decisions over where to put many GP Super Clinics had been compromised by political considerations, the ANAO found that 54.8 per cent were located in marginal electorates, and devoured a disproportionate share of funding (65.7 per cent).

However, the Auditor-General pointed out that of the clinics in marginal electorates, 82 per cent from the first round were in areas of designated medical workforce shortage, as were 57 per cent of those announced in the second round.

Overall, according to the Auditor-General, there were occasions during the first round of the program when the Department of Health and Ageing’s “risk management approach in the awarding of grants, and subsequently managing risks in the early stages of clinic roll-out, lacked rigour”.

AMA Vice President, Professor Geoffrey Dobb, said the audit findings were damning, and the Government should immediately halt spending on the program and divert unspent funds to the far-more effective program to upgrade general practices.

“The report shows that the program has been very poor value for money,” Professor Dobb said. “That money would have been much better spent on the Primary Care Infrastructure Grants program, which the Auditor-General last year found to be delivering excellent results.”

Under the Primary Care Infrastructure Grants program, $117 million has been allocated over four years to upgrade 425 GP facilities.

Professor Dobb said it was time for the Government to stop throwing good money after bad.

“Obscene sums have been spent on these clinics for very little demonstrable benefit,” he said.

“It is time to put a stop to the waste and direct the funds that can be salvaged to where they will do the most good.”

Shadow Health Minister Peter Dutton told the 2013 AMA National Conference that the Super Clinics program was flawed and the money could have been much better spent.

But Mr Dutton held back from repeating the pledge he made before the 2010 election to scrap the scheme.