Labor's urgent care clinics are struggling with workforce shortages and lack after-hours access to X-ray and pathology services, sparking concerns they are not doing enough to ease pressure on hospitals.
A new independent report has found while the walk-in Medicare clinics are cost-effective relative to hospital care, workforce strains and gaps in diagnostic services remain a problem.
The shortages are particularly acute in regional and rural Australia, with one commissioner responsible for overseeing clinics describing the search for nursing staff as a "bit of a nightmare".
The Albanese government has committed $1.4 billion over seven years to fund 137 of the bulk-billed clinics designed to treat urgent but non-life-threatening conditions and divert patients away from hospital emergency departments (EDs).
The second interim review released this month has examined the first 87 clinics opened between June 2023 and December 2024, tracking their performance through to September last year.
The Coalition has warned Labor's model appeared to be "displacing" rather than "supplementing" private primary care, with more than half of patients indicating they would have gone to a GP rather than ED if the urgent clinic was not available.
But the Albanese government has seized on the same data showing 45 per cent of clinic patients would have otherwise gone to hospital as proof their plan is reducing the burden on EDs.
Mixed results for hospital EDs
Using several models, the report has estimated urgent care clinics had reduced the number of presentations to hospital EDs by up to 10 per cent.
But it found there was "no clear evidence" that ED waiting times, or the proportion of patients seen within recommended benchmarks, had improved as a result.
The clinics had more than 1.8 million presentations as of August, with the national median waiting time between triage and treatment just 13.2 minutes.
The review has suggested it would be more accurate to record the wait time from the moment a patient entered a clinic.
The busiest days for urgent care clinics are Sundays and Mondays, with wait times the longest between 9am and midday compared to any other three-hour period.
Health Minister Mark Butler said the report confirmed the clinics were "providing exceptional care" and "taking pressure off hospitals".
"Medicare Urgent Care Clinics are providing Australians, particularly families with children, with a free, accessible alternative where they can be treated for urgent conditions when and where they need it," he said.
Newer data beyond the scope of the report shows there have now been 2.5 million presentations to urgent care clinics.
Persistent workforce shortages spark expansion fears
The review included interviews with urgent care clinic commissioners, who raised concerns about whether the 50 additional facilities funded by Labor at the election last year could be "adequately" resourced.
"Nursing is a big issue … which is going to be an even bigger concern having two urgent care facilities coming on board in the region," one commissioner said.
"[It's] actually going to be a bit of a nightmare."
Staffing was a particular concern in rural and regional areas where the "existing workforce is already stretched".
"As the Medicare UCC footprint expands, there is growing apprehension that the same pool of staff will be expected to support additional sites," the report said.
Changes were made in August to improve the "flexibility" of the minimum workforce to include paramedics, nurse practitioners and registered nurses.
But the report said "systemic barriers" such as Medicare billing rules and training accreditation must be resolved to fully unlock these staffing options.
Clinic opening hours falling short
At the 2022 election, Labor pledged the clinics would be open 8am to 10pm seven days a week, with after-hours access to diagnostics such as X-ray and pathology services.
But Coalition analysis of 118 clinics identified 52 that were not meeting the operational guidelines for weekday operating hours as of January this year.
There are no clinics in South Australia and Tasmania open the full 14 hours a day, while only about half of the facilities in Queensland, NSW and Western Australia are meeting that guideline.
Most clinics in Victoria are open at least 14 hours a day.
The report found access to diagnostic services also continued to be uneven, with many clinics lacking imaging and pathology across all operating hours.
In some areas, emergency departments remain the only option for after-hours X-rays.
Shadow Health Minister Anne Ruston said the Coalition supported urgent care clinics because "when done right", they could fill a genuine gap in the health system.
"But good intentions are not enough," she said.
"This report makes it clear that Labor is simply not delivering what it promised."
Senator Ruston said the government must do more to tackle pressure on hospitals and ensure the clinics functioned as intended.
"Given most clinics are already unable to meet their promised extended hours due to staff shortages, Labor needs to explain how it will staff and operate an additional 50 clinics without pushing after-hours access even further out of reach," she said.
Urgent clinic care more cost-effective than hospital
For the 2024-25 financial year, the average cost per presentation for the initial tranche of 75 clinics was $206 per visit.
The average funding required specifically for patients who reported they would otherwise have gone to a hospital ED or called an ambulance was about $236.
Compared to the estimated cost of $617 per urgent care equivalent hospital visit, the new clinics are saving about $381 per presentation.
Depending on modelling assumptions, the annual net savings are estimated between $36 million and $99 million.
The cost to taxpayers of a patient visiting an urgent care clinic remains significantly higher than attending a GP.
With only 65 per cent of urgent care clinic patients having a handover provided back to their regular GP, the report recommended an increase in communication and coordination between the health systems.
