An urgent care clinic aimed to rescue this GP-starved city, then the liquidators came
The promised wonders of the Federal Government’s urgent care clinics when they were first announced back in 2022 were a big deal in one regional city.
Mount Gambier in SA was facing a general practice crisis when news came it was among the chosen ones.
Local GPs were fully booked out, which probably explained why around half the presentations to its only ED were being classed as non-urgent or semi-urgent.
There was nowhere else to go.
The contract following a tender process went to an established GP company, Paion Medical, run by GP Dr Richard Try.
In November 2023, it managed to open the doors of its urgent care clinic (UCC), which was situated in Wavell House, an old orthopaedic consulting clinic.
There was no onsite radiology or diagnostic imaging service — patients were sent to Benson Radiology in Mount Gambier.
It was meant to open from 8am to 10pm, seven days a week.
After five months, the Assistant Minister for Rural and Regional Health, Emma McBride, had declared it a success, referring to the 2300 patients it had treated.
But the celebrations proved premature.
This year, the Federal Court of Australia appointed liquidators to Paion Medical. By June, the UCC was closed, and health authorities were searching for a new operator.
Paion’s GP clinic was sold off to former staff — for very little money, they say — in the hope they could make it work.
But there were outstanding questions.
Liquidator Alan Scott from SV Partners told AusDoc last month he is now conducting a “significant investigation that involved money and how it had been dealt with”.
“There are matters that we are still looking into, including what has happened with the money and who has it,” he added.
He would not elaborate any further.
Dr Try’s solicitor told AusDoc that the liquidator’s report to creditors said that its investigation had revealed “improper financial management reporting of the company” by persons other than Dr Try.
“Dr Try was not aware of these activities until shortly prior to the appointment of liquidators,” the statement said.
“Dr Try is devastated by what has happened. Dr Try was aware that the liquidators were seeking to negotiate a sale of the UCC with several interested parties, but terms were unable to be agreed, following which the UCC was closed.
It said the GP continued to work at the UCC during the sale process but resigned once it became apparent the UCC would not continue.
“The UCC provided a much needed service and its closure is a loss to the community,” it added.
One of the staff members who bought the Paion Medical GP clinic was a former employee at the UCC, Monique Pearce.
She told AusDoc she could not comment on the finance issues at Paion Medical, which were “done above my head”.
But she said she could explain the reasons why the UCC’s existence, despite the desperation for primary health care in the town, was so fleeting.
In short, it seems to go back to the attempt to treat the clinic’s services as something clinically distinct from what local GP practices were doing.
Despite Mount Gambier being classified as a large rural town under the Modified Monash Model, the practice was expected to provide services similar to those in a metropolitan clinic, she said.
“That scope wasn’t necessarily the right fit because larger metro areas have more GP clinics, more walk-in clinics, more access to specialists and to healthcare in general.
“We have such a gap here … I don’t think that was really thought through.”
For example, the clinic was expected to reject requests for renewed prescriptions, sending those patients to their regular GP, because this fell outside the Federal Government’s service specifications.
“But here in Mount Gambier, you have an eight-week wait to see your GP and get those prescriptions,” Ms Pearce said.
“So those patients who needed their hypertensive medications or their depression medications would end up in the ED anyway.”
She estimated at least 20% of UCC patients needed ‘regular GP’ care but could not secure an appointment “in a reasonable time frame”.
When patients presented in a mental health crisis, like a major anxiety attack, the UCC was ill-equipped and could do little for them, she said.
“We couldn’t give S8 drugs because we didn’t have the manpower to monitor someone, we’d given lorazepam … while also trying to see the 30 other people waiting.
“We would have to divert that patient to ED, because even though we had the skills to provide the care, we didn’t have the manpower.”
The service specification from the government for each shift was one GP, one nurse and one administrator.
“We tried to have two nurses and one GP just to give us an extra set of clinical hands,” Ms Pearce said.
“But when you had someone who was more clinically trained instead of administratively trained, that meant sometimes the paperwork fell through the gaps a little.”
She said medical staffing was not initially a massive problem, and the clinic was able to open from 9am to 10pm.
“We had several doctors who would come and rotate through. We were open and we were seeing people.”
At one time, there were 10 staff employed by the clinic.
However, when Paion’s financial position deteriorated, the clinic fell into crisis.
“I was getting lots of overdue notices, basically the recruitment agencies saying, ‘Hey, where’s our money?’ … eventually that meant they didn’t want to work with us anymore,” Ms Pearce said.
“If you don’t have recruitment agencies wanting to work with you, you can’t bring the locums in to be able to keep the doors open.”
Posts on the UCC’s Facebook page show it frequently had to shut at short notice due to staff shortages in its final months.
Ms Pearce was heartbroken when the liquidators came knocking.
“I felt passionate about the UCC because it was something the community needed … we tried our best to keep the doors open.”
She expressed gratitude that her colleagues had the opportunity to save the GP practice, which they bought for a tiny sum.
She believes it is the only clinic in Mount Gambier taking new patients.
“We’re doing our absolute best to see as many people as we possibly can. But people are waiting outside the ED at the moment because there are no seats. It is bad.”
The administrators are continuing their investigations into what happened to the money.
In the meantime, local practice Hawkins Medical Centre has been chosen as the new UCC operator for Mount Gambier. However, because it needs to establish a new site for the clinic, a reopening remains months away.
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