ANGRY patients have spat at and abused receptionists at the Morisset GP Super Clinic as the doctor shortage crisis deepens in the Southlakes district.
Doctors' surgeries in the district have closed their books to new patients, and existing patients are facing waits of up to four weeks to see their GP.
And when patients arrive at the surgery for their consultation they are often required to wait until long after their appointment time because their doctor has been swamped by the workload.
All of this has proved too much for some patients who have taken their frustrations out on surgery staff.
Hettie du Plessis is managing director of Waratah Medical Services which operates three medical centres, including the GP Super Clinic.
"Our receptionists have been spat on, they've had things thrown at them, and there's lots of verbal abuse," Ms du Plessis said.
"It's horrible. It's very hard for me to listen to how some patients are treating staff."
Waratah Medical Services last year had 12 doctors. It meant that each doctor had about 1100 patients.
"Now we're down to seven - that's four doctors and three registrars," Ms du Plessis said.
"So we're currently operating at about 3000 patients per doctor."
Ms du Plessis said a combination of changes brought in by the federal government had compounded the problem.
Key among those changes had been the Health Department's reclassification of parts of the Hunter from 'regional' to 'metropolitan' using the Modified Monash Model (MMM) of Census data analysis.
The MMM is used by the government to determine an area's eligibility for a range of health workforce programs, including rural bulk billing incentives.
The change from 'regional' to 'metropolitan' had seen financial incentives for doctors to bulk bill children and concession patients fall from $9.65 per visit, to $6.40.
Ms du Plessis said the incentive payment had been available to doctors in the Southlakes district on top of the Medicare schedule fee for each consultation.
She said reducing that incentive payment would cost each doctor about $15,000 per annum, and meant a $100,000 hit for Waratah Medical Services across its three centres.
As a result, doctors were instead choosing to work elsewhere, she said.
The Southlakes area had also previously been classified as a Distribution Priority Area (DPA) by the Health Department.
Overseas-trained doctors are required by the department to work in DPAs to ensure "the equitable distribution of our medical workforce", the government said.
But in a letter to Waratah Medical Services, the Regional Health Minister Mark Coulton said Morisset was no longer within a DPA "as current service levels in this area exceed the national benchmark".
Ms du Plessis said she had also been told by the department that the number of Medicare provider numbers allocated in the Southlakes district was further evidence that the area was adequately serviced by doctors.
But she said the number of Medicare provider numbers, on it own, was misleading as it didn't take into account doctors who had retired, nor how many provider numbers were used by each doctor.
For example, one doctor at Kanwal had four provider numbers, Ms du Plessis said.
Practice manager at the GP Super Clinic, Sharon Jarvis, said the situation was dire.
"Surgeries are closing down, yet the local population is growing at a rapid rate but there's nowhere for new patients to go," she said.
"These patients are going to end up in our hospitals clogging up the system that was already clogged."
Ms Jarvis said the situation had placed the district's doctors under intense pressure.
She said doctors at Morisset had regularly foregone a lunch break in their efforts to see more patients.
Ms du Plessis and Ms Jarvis said they respectfully wanted Mr Coulton and his staff to visit the district.
They want to show how the government's well-intended policies were having unintended consequences for the Southlakes area.
"We need the government to turn these decisions around," Ms du Plessis said.
Hunter MP takes up fight on local doctor shortages
MEMBER for Hunter, Joel Fitzgibbon, has taken aim at the "crazy" federal government policies that he said had created a GP crisis in the region.
Mr Fitzgibbon told the parliament the government's Medicare policies had created doctor shortages and made it too expensive for many people to go to their GP.
"A government which fails to provide access to affordable health care risks having blood on its hands," Mr Fitzgibbon told the parliament last week.
"Facilitating access to affordable health care should be the top of a government's priorities. Too many people in parts of my electorate are now struggling to gain that access."
Mr Fitzgibbon said a new bulk billing incentive system used by the Health Department had reclassified parts of the Hunter region which reduced their bulk billing incentives.
There were also new rules making it harder for foreign doctors to practice, he said.
The Southlakes district was among the areas that had been reclassified from 'regional' to 'metropolitan', reducing the bulk billing incentive for children and concession patients from $9.65 per visit, to $6.40, he said.
This was a 34 per cent cut which meant many GPs had decided to bill privately, so patients were now incurring out-of-pocket expenses.
"The government is using a system called the Monash Modified Model which rates towns in my electorate on the same scale as Mosman on Sydney's North Shore," he said.
"This is crazy.
"In a short period of time more than one thousand people have signed my online petition calling upon the Morrison-McCormack government to revisit changes it has made to general practice and Medicare services.
"Some of these practices have ageing GPs. A practice like Waratah Medical Services in Morisset is having trouble finding doctors right now, but this is compounded by the government's new rating system."
- To access the petition visit joelfitzgibbon.com.