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Health co-op model keeps
BY PETER WATERMAN
Canberra pharmacist Brian Frith knew the shortage of doctors in his area
was critical because of the amount of triage work he and his staff were
undertaking at his pharmacy in Charnwood.
Investigating further, he found there was
one GP servicing some 19,000 residents
– and with other concerned community
leaders, he decided to do something
They convened a public meeting
in September 2004 from which the
Charnwood Community Health
Committee (later the West Belconnen
Community Health Committee)
A survey of some 8,000 homes in six
suburbs assessed community needs.
A committee tested various health
delivery models before settling on
the co-operative model, which has
grown into the National Health Co-op.
It now has five clinics in Canberra
and a medical staff of more than
30 including 22 doctors as well as
nurses, nurse practitioners, dietitians,
diabetes educators, psychologists,
physiotherapists and clinical assistants.
Co-op Managing Director Adrian Watts
said when it was developed, the concept
of a health co-op in Australia was
‘ With one GP for 19,000 people in the
area, this was not an ideal scenario
by any means. After the community
meeting the leaders contacted David
Bailey from Professional Management
Solutions who with his wife Anne Davis
ran a consultancy establishing and
reviewing GP practices and seeing what
worked efficiently. This was his area
of expertise and he is now our Chief
Development Officer,’ Mr Watts said.
‘After a lot of work the group came
across the model of a health cooperative
and for five years we developed and
refined it until in January 2010 we
opened our doors with one doctor who
David recruited from England.’
David Bailey says he had to look overseas
because there was no interest locally.
‘ This was an untested model and we
were not getting much support. In fact
the opposite was occurring because
all the doctors had moved out of the
area to join the big corporates. This was
understandable as they moved to where
they could make the money but what
we do is the opposite. What we do is we
work for the members. We want better
healthcare, that’s more affordable and
accessible – and this wasn’t always
appealing when we were looking for
staff,’ Mr Bailey said.
‘For instance in our business, our profits
are reinvested. In most practices
any allied health professional is on a
contract running their own businesses.
We actually employ the dietitians,
the physiotherapists, the nurse
practitioners and so on and they
are paid a wage which gives us the
overarching ability to set the business
parameters and ensure we’re affordable.’
Mr Watts says the model was immediately
accepted by the community.
‘We opened our doors in January 2010
and our books were full immediately.
By the end of the year we had opened
our second practice. We doubled our
business in the first practice and then
opened a second practice, all within a
year, which is phenomenal. We have
grown since then and now have five
practices, all of whom are at capacity.
‘In the first three years our patient
growth rate was in excess of 10% a
quarter and now it is still at 8% a quarter.’
David Bailey says the sourcing of
overseas doctors is now a key to the
‘Some 85–90% of our doctors are
from overseas or are registrars.
Our philosophy is not about getting
the most amount of money per GP.
We are not into six-minute consults.
The maximum we do is four an hour
per doctor, and a couple of our doctors
do two an hour. We know we can be
profitable without resorting to the quick
consult and churning people through.’
A point of difference, and a source of
pride, is that the co-op has a medical
director for the five clinics. The medical
director spends about 30% of his time
on education and clinical governance.
Mr Watts explains: ‘He oversees
the other doctors to maintain high
standards. Having a clinical director
also means we have the ability to
employ, supervise and train overseas
doctors and we aim to have all these
overseas-sourced doctors achieve
General Registration within 24 months,
so Australia gets more fully trained and
qualified doctors through our model.
‘But this is not a business model that
makes a big profit. Employing overseas
doctors takes a lot more management
time and the Medicare rebate is much
lower – roughly $21 for an overseas
doctor who is not a Fellow compared
with $37.50 for a Fellow. So if you’re in
the business of medicine to make big
money, this is not your model.
David Bailey & Adrian Watts
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