An Illawarra medical centre which has been operating for 70 years will be forced to close at the start of next year, after it was unable to find any new doctors willing to run the business in a difficult financial climate.
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This is one of a number of changes in the general practice landscape across the region this year, which has made it harder for patients get GP appointments and decreased the availability of bulk billing appointments.
The Fairy Meadow Medical Centre, which has been operating since 1952 at various sites in the town centre, recently informed patients it would close for good due to "numerous circumstances outside of our control".
From December 30 it will operate in a reduced capacity, before closing permanently on January 27.
"We thank you for your support over the many decades of Fairy Meadow Medical Centre's operation," a message from the practice says.
"It has been an honour."
Retiring doctor Robert Yarrow, who has been a part of the Fairy Meadow practice since 1974, said he was sad the current doctors had been unable to find anyone to take over their business.
"We have been looking to try and sell the business to another doctor or doctors so that they could just take over," he said.
"We've been looking for other partners to come and join us but they're just not around, I don't know where everybody has gone but, since COVID, not only are we short of GPs but we're short of nurses and we're short of office staff."
Dr Yarrow said the federal government's decision to freeze the medicare rebate in 2012 had gradually eroded the viability of running a medical practice.
"The thing I'm sad about is that there isn't a group of people coming through who I can pass on the baton for this practice after 70 years, so that they can continue looking after the people who we have as patients and just keep the whole thing going," he said.
"That's a source of sadness, but it's a reflection on the lack of general practitioners who are being encouraged, trained and brought through.
"It is to my mind a direct result from the government deciding that they weren't going to alter the medicare rebates for 10 years.
The thing I'm sad about is that there isn't a group of people coming through who I can pass on the baton for this practice after 70 years, so that they can continue looking after the people who we have as patients and just keep the whole thing going.
- Dr Robert Yarrow
He said the current rebate rates made it "impossible to live on and run a business."
"This is a small business, we have a number of staff who are employed, and they expect to be paid irrespective of whether you're a pensioner or not or whatever and rightly so, but I think it's a shame that it's been gradually eroded," he said.
The Illawarra Shoalhaven representative for the Royal Australian College of GPs Rowena Ivers, who is a doctor in Wollongong, said doctors across the region were facing incredibly difficult conditions at the end of 2022.
She said staff shortages and rising costs have affected many practices, with more in recent weeks announcing their closure or a shift to private billing just to make ends meet.
"We are really concerned about the depletion of the GP workforce, and that lots of young doctors are not choosing general practice," Dr Ivers said.
"Basically, the biggest influence is still that the Medicare Benefits Scheme (MBS) rebates have been still frozen for the last decade, and they only cover roughly 50 per cent of the cost of doctor's appointment.
"So just to keep their businesses viable, many doctors now around Wollongong even in the last couple of months, have shifted to private billing or mixed billing.
"This has really has a big impact on the community of the Illawarra and we know that with cost of living rising, that's having a big impact on patients. GPs are really doing their best and we really value supporting the community.
"But lots of doctors are retiring and lots of practices are closing because they are just not viable anymore."
She said the current operating environment was making it harder for doctors to make their businesses viable.
"With the payments doctors get from Medicare, they have to pay for premises, staff - like nursing and reception staff, and things like computers, so really the money that you pay for your doctor really only covers a little over 50 per cent of the consult,"
"We also know that the population is getting older and medicine is more complex than it was 20 years ago, so the demands on GPs are even higher. We are dedicated to serving the community - but it's just really hard at the moment."
She said GPs wanted a big increase in the rebates for bulk billed clients, and for those who needed longer appointments, as the current rebates "comes nowhere near covering the cost of a consult."
"The MBS items value short appointments, but people with mental health problems or older people with chronic illnesses or cancer need long appointments and the MBS does not support that," she said.
"Beyond a certain point, the doctor is basically doing it for free - and actually, up to 30 per cent of GP work is done with no payment at all."
With fewer free GP appointments, more people are being driven to seek medical care at the region's struggling emergency departments which recently hit the highest average wait times on record.
In late September, two Wollongong practices on Crown Street merged, with doctors at the Crown Street Medical Centre merging into to Wollongong Medical Centre.
Additionally multiple large clinics, including those servicing vulnerable communities in Bellambi, Warrawong, Dapto, Wollongong and Corrimal have ceased bulk billing.
Earlier this year, Dr Muhammed Amir Vakil who set up Pioneer Health Centre as a bulk billing practice in 2020, explained that private billing was the only way his Bellambi practice could stay afloat.
"Staff wages have gone up, prices of consumables have gone up, insurance rates have gone up but all Medicare has given us is an additional 65 cents," he told the Mercury.
Likewise, the Dapto medical centre - which for years has been used by patients as an alternative to the emergency department thanks to its extended, 365 days a year operating hours - is now "mixed billing".
"Bulk-Billing is when the payment for your consultation or treatment with your doctor is covered entirely by Medicare, whereas services not covered by bulk billing attract a private fee and you will receive a rebate from Medicare," the centre explains on its website.
"This means there is an out of pocket cost to you."
"By becoming a mixed billing practice, we are able to meet the rising costs of running a practice to minimise wait times, retain high quality GPs, provide valuable consultations and facilitate services like women's health so that you and your family receive the healthcare that you deserve in a family friendly environment."
Kate McIlwain
For more than a decade, I've helped the Illawarra Mercury set the news agenda across the region. Currently I'm the paper's health reporter - covering the stories of Illawarra workers and residents in the wake of a global pandemic and at a time where our health systems are stretched to the limit.
For more than a decade, I've helped the Illawarra Mercury set the news agenda across the region. Currently I'm the paper's health reporter - covering the stories of Illawarra workers and residents in the wake of a global pandemic and at a time where our health systems are stretched to the limit.
