UCCs may be cheaper to run than emergency departments, and general practices are also considered in the cost debate.
Scope of the upcoming investigation
The audit, which will be tabled in March next year, will examine three specific facets of the UCC program: whether the Department of Health, Disability and Ageing properly established it, whether it effectively developed and managed grant funding, and whether it handled federation funding agreements with states and territories.
It will not comment on the merits of government policy, but it will assess whether implementation was efficient and whether intended benefits are likely to be achieved. The ANAO criteria are set, yet submissions are still welcome. Both the AMA and RACGP have already lodged theirs.
The royal college of GPs said concerns about potential mistakes made during the establishment of UCCs remain widespread among its members.
Specialist GPs argue that services provided by UCCs could be delivered more efficiently through local general practices if adequate funding and support were available.
While UCCs now have a role within the health system, their integration with broader care pathways and long‑term cost‑effectiveness require ongoing evaluation.
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Government pressure to establish services quickly has not been matched by sufficient governance arrangements, creating risks to patient safety and placing unsustainable demands on the workforce. The RACGP recommended embedding greater consistency, accountability and quality across the UCC program and implementing forthcoming standards.
College president Dr Michael Wright told the outlet that the college was continuing to engage constructively with governments and that the standards form part of this work.
The concerns detailed in the submission primarily relate to the initial planning, governance and implementation of Medicare Urgent Care Clinics as they were established at pace.
The college also questioned the geographic placement of UCCs, noting that a disproportionate number have been established in Labor‑held electorates, roughly two‑thirds of the total. Similar questions have been raised about the number of clinics in marginal seats.
Given the lack of transparency regarding commissioning decisions, it is difficult to view the chosen locations objectively. The RACGP recommends the ANAO audit the locations and independently assess them against locally determined need. All communities deserve equitable access to high‑quality urgent care.
Questions on cost and funding models
In its submission to the ANAO, the AMA sought clarification that Medicare UCCs provide GP‑led, short‑term care for urgent, non‑life‑threatening conditions while preserving usual general practice as the preferred setting for routine, ongoing and after‑hours care.
UCCs should be more than a publicly subsidised walk‑in substitute for GP care, the association argued, pointing to perceived shortcomings identified by the interim UCC evaluation.
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Claims of ED avoidance should rely on linked service‑use data, including transfers and subsequent ED presentations, rather than patient‑reported intentions about where they would otherwise have sought care.
The AMA noted that attendance figures, or reductions in Category 4 and 5 presentations, cannot alone demonstrate reduced hospital pressure.
The program evaluation should assess whether care substitution improves patient access or shifts activity into a more highly subsidised and less continuous model. It also argued that the cost‑effectiveness of UCCs has never been adequately investigated.
The current comparison is incomplete because it tests Medicare UCC care against ED care. The Second Interim Evaluation report estimated federal funding at about $206 per Medicare UCC presentation and about $236 per presentation assessed as avoiding an urgent‑care‑equivalent ED visit.
When compared with the estimated $617 for equivalent ED care, these figures indicate a significant cost saving. However, they do not fully answer the value‑for‑money question. A robust assessment must add a third comparator: equivalent urgent or after‑hours care delivered through community general practice. This would show whether Medicare UCCs represent better public value than strengthening existing general practice capacity, not merely whether they cost less than an ED presentation.
AMA president Dr Danielle McMullen told TMR that ANAO audits are an important process to assess value for taxpayer funding. “The government has committed billions of dollars to urgent care clinics, and so it’s really reasonable to ask whether that investment is delivering the outcomes promised,” she said. “We need clearer expected outcomes and more transparency and accountability.”
