Health officials misled the public about the cost per service at ACT's walk-in centres by burying roughly $10 million in expenses, documents obtained by The Canberra Times have revealed.
Canberra Health Services previously stated they did not record the cost of each presentation at the clinics but provided an average of "less than $110" per service.
Internal emails released under freedom of information laws showed the true figure appeared to be closer to $200.
It was also revealed officials had not measured the number of walk-in centre patients redirected to emergency departments since October 2022.
Emails also showed executives advising not to provide this information.
'Best information'
In response to a media inquiry from The Canberra Times, a government spokesperson provided walk-in centre data that was published in a May 8 article.
They calculated about $109 as the cost per service after dividing the allotted $12.6 million budget (2022-2023) by 115,000 presentations across all centres in the 2023 calendar year.
However, the public health provider failed to reveal walk-in centres ran a bill of $14.7 million in 2023 and an additional $7.6 million in estimated overheads (operating costs), bringing total expenditure to $22.3 million.
Two released documents, showing monthly expenditure, calculated the cost per service to be $194 in 2023, or $128 if overhead costs were excluded.
"Please note: Figures are based on direct cost centre level actual amounts from general ledger + an overhead estimate," one bureaucrat said in the email
"After discussing with [staff member], the attached spreadsheet is the best information we can supply," another said.
In total, Canberra Health Services did not mention an estimated $10 million in costs.
Since existing walk-in centres have never been independently evaluated, doctors calling for such a review referred to a report which evaluated the first trial centre next to Canberra Hospital between 2010 and 2011.
The 2011 report said the cost per service then was $196, which included 16 per cent overhead costs.
Months of data not measured
Documents also reveal the ACT Health Directorate had not measured "redirections" since late 2022.
This appeared to be because it did not have an "agreed methodology" to calculate this after the Digital Health Record was rolled out in November 2022.
Redirections are the number of presentations sent to emergency departments because they could not be treated at the free walk-in centres.
Taking pressure off hospitals was one of the reasons walk-in centres were introduced.
The last time redirection details were publicly reported was in the ACT Public Health Services' quarterly performance report for July-September 2022.
Internal emails showed one employee suggesting not to provide redirections data and said the measure added "little value".
Another executive said they were not "comfortable" sharing data about costs after previously denying it to another party citing lack of "accurate information".
The official response to media included a line: a decline in primary type-presentations in emergency departments averaging 1.9 per cent per year between 2013-14 and 2020-21.
Emails showed a senior executive commented on this line in a drafted response: "what does this mean? Is it less in 2021 than 13/14, or every year in between? 20/21 is not a reasonable comparator due to COVID impact."
Canberra Health Services response
Responding to the newly released information, a Canberra Health Services spokesperson indicated the organisation was not confident about latest internal data so they provided figures from previous years.
"ACT Health is working towards creating a data set for this measure in the future to facilitate reporting on walk-in centre activity and performance."
They added the emails showed a "back and forth between" several internal departments they had spoken to before replying to the media request seven working days later.
"During this process, one area developed an estimate of the cost per service at Walk-in Centres that included a range of overhead costs," the spokesperson said.
They said the cost of less than $110 per service was a "rough estimate" and used the $12.6 million budget figure (instead of the $14.7 million expenditure shown in spreadsheets) to calculate this because it was considered the most relevant figure in which they had the "most confidence".
Officials were aware of the cost including overheads estimated based on a past inquiry, but said they did not use it because it was not standard practice to include operating costs when reporting about services or businesses within CHS.
They also said the $7.6 million figure was not accurate and "could not be verified in the time available".
"Canberra Health Services does not operate the nurse-led walk-in centres on a cost per presentation model and was therefore undertaking its best efforts to provide the most relevant information," the spokesperson said.
"The organisation regularly shares performance data and includes financial reporting in the Budget and other publicly available reports."
The revelations come after years of doctors claiming there was no evidence to support setting up more free clinics and increasing their funding.
In May, leaders from the ACT Australian Medical Association and Royal Australian College of General Practitioners NSW&ACT called for a review into the free clinics to track their progress and find out the cost to taxpayers.
