Covid cripples A&E clinics
Plummeting patient numbers and coronavirus uncertainty have urgent care clinics concerned about keeping their doors open.
Hamilton’s Anglesea Urgent Care and Tui Medical – which has two urgent care clinics – desperately want to keep providing services but have been hit hard financially.
While GPs get some government funding for each enrolled patient, urgent care relies on people coming through the door for income – and patient numbers reduced by at least half in level four.
‘‘We always believed patients would return, they need us,’’ Anglesea Clinic Accident and
Urgent Medical general manager Julie Karam said.
‘‘It was a question of when, not if. The problem we encountered was would we still be here when they did?’’
They’re not alone in struggling; Accident and Medical Clinic Association secretary Dr Alistair Sullivan said at the end of lockdown that clinics were ‘‘hanging by a thread’’.
The association surveyed 46 clinics at the end of April and found 43 per cent of them were very likely to have to close within a month if the situation continued.
Karam said the 24/7 clinic at Anglesea lessens demand on ED, and provides support in the community. Normally, an average of 180 patients come through a day; there were just 54 on its quietest lockdown day.
Patient volumes were down 53 per cent on average over lockdown, staffing numbers had to be reduced, and safety measures for Covid-19 created extra costs.
The clinic was buffered by the Government wage subsidy and got vital Waikato DHB support to redeploy staffers, for example to community-based assessment centres.
‘‘If it hadn’t been for this, our doors would have surely closed,’’ Karam said.
She wants to do everything she can to prevent a closure, but is concerned about what happens if there is another downturn or return to lockdown.
Already limited cash reserves have been reduced and it will take years to correct, Karam said.
The Ministry of Health did not respond to a request for comment before deadline.
Tui Medical has urgent care clinics in Te Rapa and Rototuna, and patient numbers are down about 65 per cent. It’s hard to financially justify, Tui Medical managing director and GP Navin Rajan said, and accountants would tell him to close the urgent care.
‘‘I don’t want to be perceived as an organisation that runs away at the first sign of trouble,’’ he said.
While the crisis had pushed the health system to be more efficient, he said he’d have to consider reduced hours or closing a clinic at least temporarily if things don’t change for another month.
It’s far from the only business or sector struggling, Rajan said,
and he doesn’t want to come across as whingeing.
He has already reduced hours for some staff members, placed some on leave, and flagged redundancies.
‘‘It’s very tough to do, but I’ve got to make sure that the majority of people keep their jobs, that the business keeps trading,’’ he said.
Tui Medical will have to inject some capital from other parts of the business into the urgent care area.
The clinics can’t get the Government wage subsidy without splitting into a separate business, as income hasn’t dropped by 30 per cent across the whole organisation.
GPs have also taken a financial hit and Pinnacle – which covers 85 practices in the Waikato and surrounding areas – has put some money into its practices to help counter it.
A survey showed the average practice income drop since lockdown was 23 per cent, Pinnacle chief executive Helen Parker said.
Extra Ministry of Health funding covered some initial costs – IT systems for video consults could cost $10,000 to $15,000 for those practices not already set up.
Many practice owners are personally taking a hit and keeping staff on, Parker said, but they know small businesses in other sectors are in worse positions.
‘‘Their biggest concern is being able to maintain the level of care that patients need. Some of them have certainly been worried and concerned ... if level three continues for longer than a month, then they were starting to question if they could continue without laying staff off, for example,’’ Parker said.
‘‘I haven’t had any practice that says ‘we are going to have to close’.
‘‘And we wouldn’t let that happen, anyway.’’
Fairfield Medical Centre’s cashflow over the counter was way down, but it got Ministry of Health support and the wage subsidy.
‘‘Without that, we certainly would have struggled,’’ GP Dr Paddy Bhula said.
Despite being open throughout lockdown, they’ve been busier since the shift back to level three, he said. And the centre but can ride things out until the move back to level two – when a rush on appointments is expected.
However, if level 3 continued for a month it would put the financial pressure on.
The NZ Dental Association has also said more and more dentists – who can currently provide emergency care – are having to reduce hours and lay off staff.
A quarter said they can’t pay their April bills.