24-05-2025
A pilot program brought down waiting times for paediatric patients, but its future is in doubt
A pilot program designed to reduce paediatric wait times in Tasmania was abruptly ended six months early, according to one of the doctors involved.
The General Practitioners with Special Interest (GPwSI) project was part of a broader strategy to address wait times in outpatient clinics across the state.
The idea was to place doctors with a specific interest in a range of outpatient clinics like antenatal, cardiology and mental health services to come up with new models of care.
The GPs would be working between half a day to two days a week.
According to the Health Department, the funding for the entire program was equivalent to employing two full-time GPs for two years.
The ABC has been told that while doctors were offered shorter contracts, some were led to believe the pilot program would run for two years, until June 2025, and were shocked when it ended sooner than expected.
Tim Jones is one of the doctors who was employed as part of the pilot in mid-2023.
He was placed at the Royal Hobart Hospital (RHH) paediatric clinic.
"Because of my natural scope being more linked to younger kids, I prioritised seeing any child of seven or under who was on our waitlist here in southern Tasmania," Dr Jones said.
While not a fully qualified paediatrician, Dr Jones was able to provide broader assessments, looking at the child's environment, family and school and then linking them up with the support they needed.
"We could tease out which kids needed which layer of support," he said.
"That meant the kids that did need to go through and have a full formal ADHD [or autism] assessment, we could screen them out and make sure they then got that assessment, whereas kids who needed other pathways, we made sure they got timely access to those services."
Often, Dr Jones said, the primary problem was not attention deficit hyperactivity disorder (ADHD) or autism, but things like poor sleep patterns, inadequate supports in school and dyslexia.
By managing to filter out those who could be assisted by other services, it meant children who needed more complex assessments could see a paediatrician in a more timely manner.
Then in November, Dr Jones was told his position could no longer be funded, and his contract would not be extended and would end in January.
Dr Jones said he had been told from the beginning, including during the interview, that the program would run until the end of June this year.
The ABC understands other GPs with specific interests were told similar things.
"What we found was that a lot of the GPs were able to …integrate well with the systems and start to deliver some outcomes, so it came as a shock to all of us that we received limited notice that the funding was not to be continued past the 18 month mark," DrJones said.
According to the Health Department, wait times in Tasmania for a non-urgent patient to see a public paediatrician can last close to two years.
That varies depending on where in the state the person is.
The private system is no better, as Anna Nottage knows. When her daughter Lottie was aged two, she tried to get her into a paediatrician, concerned about her delayed development.
She was referred to a private clinic and the public one at the Royal. Both had extensive waitlists.
In the meantime, Ms Nottage and Lottie were able to see Dr Jones, who was working at the developmental clinic at the RHH.
While Lottie turned out to be one of the complex cases who did need to be seen by a paediatrician, Ms Nottage said being able to discuss her concerns with Dr Jones was reassuring.
"He was a great support," she said.
Labor's Shadow Health Minister Ella Haddad said it was disappointing for Tasmanian families waiting in that system that the program had ended.
"This is a program that was actually having a tangible effect on [those long waitlists]," she said.
"For that to be cut, we know the wait times are just going to get longer and harder for Tasmanians who already need these services early.
In April, the state government opened a specialist service for children and young people with suspected ADHD in the south, and there are plans to expand statewide.
It also includes funding for two GPs with special interests in ADHD.
But that service will not help kids like Lottie, who was eventually diagnosed with autism and is now seeing one of the new paediatricians at a private clinic.
"There are a lot of parents probably going through the same thing," Ms Nottage said.
"They haven't got a paediatrician and need that stopgap for children with behavioural or developmental needs.
In a statement, a Health Department spokesperson said they acknowledged the positive impact the GPwSI model of care pilot had caused for "some patients, particularly in paediatrics".
The spokesperson said an evaluation of the broader pilot was being finalised, which would provide guidance on how the department "can best utilise the state's highly-skilled GPwSI and rural generalist workforce across our health service".
