Appendix A - Need and Impact Analysis

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Contents
1.0     Introduction .............................................................................................................................. 3
2.0     Location ..................................................................................................................................... 4
3.0     Determined Need ...................................................................................................................... 5
  3.1      Primary Health Network........................................................................................................ 5
  3.2      Health Care for Persons Over 65 ........................................................................................... 5
  3.3      Cooroy 2016 Census Data ..................................................................................................... 6
  3.4      Existing Medical Practices ..................................................................................................... 6
  3.5      Capacity of existing medical practices .................................................................................. 8
  3.6      Palm Lake Resort Resident Questionnaire ............................................................................ 9
4.0     Potential Impacts/Benefits to other Medical Centres ............................................................ 15
  4.1      Financial impacts/benefits .................................................................................................. 15
  4.2      Social impacts/benefits ....................................................................................................... 15
5.0     Conclusion ............................................................................................................................... 16




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1.0    Introduction
This Need and Impact Analysis has been prepared in support of Development Application
MCU18/0195 for Material Change in Use for a Commercial Business Type 2 – Medical
(Doctor’s Practice) at 15 Pearsons Road, Cooroy.
Palm Lake Works Pty Ltd have applied for a subsequent approval in addition to the Sales
Office for the existing building located at 15 Pearsons Road Cooroy.

The intention of the application is to provide a needed local community medical service in
the interim, until construction of the approved Residential Aged Care Facility commences.

Noosa Shire Council has requested further information from the applicant specifically
requesting the following information be provided in a need and impact analysis:
       a. The need for another medical centre in Cooroy; and
       b. The impact of the proposal on other medical centres in Cooroy.
This report will conduct an analysis to determine the need and impact of the proposed
Doctor’s Practice by establishing need, assessing potential impacts and identifying potential
benefits to the community.




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2.0     Location
The subject site is described as 15 Pearsons Road, Cooroy, Lot 103 SP287641. The subject
site has a total area of two hectares and features a building, currently utilised as a sales office
for the adjoining resort. The site is currently accessed via a vehicular crossover off Pearsons
Road, located approximately 130 metres from the Elm Street/ Pearsons Road intersection.

The subject site’s characteristics are illustrated in Figure 1 below.

   Palm Lake Resort Cooroy-Noosa            Trading Post Road                  Sales Office




   Railway Corridor                  Elm Street                          Pearsons Road/Entry
Figure 1: Aerial Photo of subject site (Near Map, 8 July 2018)
The subject site is surrounded by a range of different land uses and zoning. These land uses
include the approved adjoining Multiple Housing – Type 3 (Palm Lake Resort) on land zoned
community services, detached housing developments and rural land. Generally the character
of the area comprises of urban settlements to the south and rural areas to the west of the
subject site.
Cooroy Town Centre is identified as a Business Centre on Planning Scheme Strategy Map SM,
the boundaries of this Business Centre are not delineated.
Although the proposed Doctor’s Practice is located on the edge of the township, it is still
within close proximity to Cooroy and is considered to be located within the Business Centre.




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3.0    Determined Need
3.1    Primary Health Network
The Australian Government’s, Department of Health provides Primary Health Network (PHN)
profiles for regions of Australia. The PHN profile for Central Queensland, Wide Bay and
Sunshine Coast identifies a population growth of 5.47% between 2012 and 2016.

The region’s population is broken down identifying 19.14% of people are over the age of 65,
and the growth of aged persons increased by 17.56% between 2012 and 2016. Despite
overall population growth for the region being relatively low, the increase in persons aged
over 65 in the region has been significant.

In 2017-2018 the Department of Health conducted a Needs Assessment for the Central
Queensland, Wide Bay and Sunshine Coast PHN region. The report states that the significant
increase in persons aged over 65 (aforementioned above), is due to a decrease in birth rates
and increased life longevity. In 2016 1 in 5 people were aged over 65, with 15% of these
people suffering from severe or profound disabilities. The report stated that there is
currently a shortage of appropriate care options available in the PHN catchment to meet the
expected growth and demand.

People over the age of 65 within the PHN region are predicted to make up 18.4% of the
population by 2021 which is noticeably higher than the predicted 15.9% average for
Queensland.

3.2    Health Care for Persons Over 65
Persons over 65 are more susceptible to experiencing health complications than people
under 65. In 2016-17 there were just under 38 million Medicare claims for unreferred GP
attendances for people aged over 65 equating to 29% of the total claims. There were more
than twice as many claims per person for those aged over 65 than those aged under 65.

For specialists the statistics were higher. There were 13.9 million specialist attendances
claimed through Medicare in 2016-2017 for people aged over 65, representing 45% of all
specialist attendance claims. The Australian Institute of Health and Welfare identified people
aged 65 and over made 4 times as many claims for specialist services compared to those
under 65.

Many factors contribute to elderly persons requiring more frequent medical care, including
the development of diseases associated with age (arthritis, dementia, heart disease),




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prevalence of high blood pressure and cholesterol levels and general loss of bodily functions
(vision, hearing, lung capacity).

The above statistics demonstrate that persons over 65 require higher levels of care from
general GP’s and specialists than people under 65. On this basis it is determined that areas
consisting of a higher than average median age or percentage of aged persons therefore
requires more medical practitioners to appropriately address demand.

3.3      Cooroy 2016 Census Data
To assist in determining need, data has been extracted from the Australian Bureau of
Statistics (ABS) 2016 Census data Cooroy suburb profile. In 2016, Cooroy had a total
population of 3,791 persons and a median age of 46. This median age is close to Sunshine
Coast’s averages of 44, but significantly higher than the averages for Queensland at 37, and
Australia at 38.

Cooroy is considered to be a location that should be prioritising health care based on current
and predicted demographics. Cooroy’s population in 2016 consisted of 23.7% of persons
aged over 65, compared to the state average of 15.2%.

As aforementioned above in Section 3.2 persons over the age of 65 require higher levels of
medical attention from GP’s and specialists. From Census statistics Cooroy is considered to
be a popular retirement location within South East Queensland, currently consisting of 23.7%
of people aged over 65. This is 8.5% higher than the State average for Queensland.

3.4      Existing Medical Practices
Palm Lake Works have conducted a further analysis than that provided within the Town
Planning Report with regards to existing medical practices within the Cooroy locality.
There are three established Medical Practices within Cooroy providing general practice care
including:
      1. Maple Street Surgery;                                2. Cooroy Family Medical;
      3. Cooroy Family Practice;

Eden Hospital has been excluded from this analysis as it is considered to provide a different
level of care to general medical practices. Dr Adam Roache, Chiropractic and Suncoast
Podiatry have also been excluded as these practitioners require a referral from a GP prior to
treating patients.
This analysis does not take into consideration medical practices in nearby towns such as
Tewantin and Noosaville as they are considered to service different catchment areas.


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       3.4.1 Maple Street Surgery

Maple Street Surgery is located at 46 Maple Street, Cooroy and forms part of the
rehabilitation clinic for patients recovering from procedures within the private hospital.
Further to this, Maple Street Surgery provides general practice medical care including
general health checks, skin checks, family medicine and immunisations. Maple Street Surgery
also advertise that they have a number of Allied Health Professionals who attend the practice
on a regular basis providing more specialised medical services.
Maple Street Surgery has six (6) doctors, and a head Nurse and number of other employees.
Maple Street Surgery offers mixed billing with only some doctors offering bulk billing
services. General fees for a standard consultation begin at $70.00 (up to 15 mins), and longer
consultations for $100.00 (15-30mins).
Maple Street Surgery also offer home visits after hours, with most after hours support
provided to Eden Rehabilitation Hospital patients.
Maple Street Surgery is open Monday-Friday 8am to 5:30pm and Saturdays 8am to 1pm.
Maple Street Surgery is located 2.1 kilometres south of the proposed doctor’s practice at 15
Pearsons Road, Cooroy.

       3.4.2 Cooroy Family Medical

Cooroy Medical Practice is located at 8 Emerald Street, Cooroy and can provide treatment
for a number of medical issues including asthma, diabetes, child & maternal health, men’s
health, mental health and occupational health. Cooroy Family Medical is a small GP practice
offering occupational health medicals and healthcare for all ages.
Cooroy Family Medical has eight (8) doctors. General fees for a standard consultation range
from $75.00 to $90.00 (15 mins) and extended consultations from $110.00 to $125.00. Bulk
Billing is only offered to Aged Care pensioners and children with valid Medicare Cards.
Cooroy Family Medical is open Monday – Friday 8am to 5pm and Saturdays 8am to 12pm.
Cooroy Family Medical is located 2.3 kilometres from the proposed doctor’s practice at 15
Pearsons Road, Cooroy.

       3.4.3 Cooroy Family Practice

Cooroy Family Practice is located at 7 Myall Street, Cooroy and offers treatment for mental
health, women’s health, children’s health, paediatrician, seniors health and young adults
health. Cooroy Family Medical state they have a comprehensive health care team including
GP’s, Psychologists, a Dietician/Nutritionist and Exercise Physiologist.

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Cooroy Family Practice has two (2) Doctors and a Paediatrician. An Allied Health Team also
supports Cooroy Family Medical and includes a psychologist, Exercise Physiologist and
Dietitian. Cooroy Family Practice can bulk bill 100% for Medicare cardholders for general
medical appointments. Any non-Medicare card holder patient will be required to pay a fee.
Cooroy Family Practice is open Monday to Friday from 8am to 5pm.
Cooroy Family Practice is located 1.8 kilometres south of the proposed doctor’s practice at
15 Pearsons Road, Cooroy.


3.5    Capacity of existing medical practices
Palm Lake Works has conducted a capacity assessment for each of the above mentioned
practices. The data that forms this capacity assessment was obtained from each medical
practice and reported for the purposes of determining the need for the proposed Doctors
Practice at 15 Pearson’s Road, Cooroy.

Information obtained included the amount of doctors, there employment terms (full
time/part time), availability, how busy each practice is (rating between 1 not busy and 10
very busy and their opinion regarding additional medical practices.

       3.5.1 Maple Street Surgery

Maple Street Surgery has been open for 37 years and assists in further medical care for the
Eden Hospital. The practice currently has six fulltime doctors, where all their books are open
to future clients. All doctors are very busy, with new patients being required to wait 1-3 days
to secure an appointment.

Maple Street Surgery stated their practice is constantly busy, rating it a 10. The practice
believes Cooroy would benefit tremendously from more permanent doctors.

       3.5.2 Cooroy Family Medical

Cooroy Family Medical was first established in 1996 and has grown into a larger Medical
Practice over the years. The practice currently has seven doctors, three full time with the
remaining four being part time. Out of the seven doctors, two doctors books are closed and
cannot accept any new clients. Same day appointments are difficult to obtain, existing clients
generally wait 1-2 days to be seen by their doctor.

Cooroy Family Medical is a very busy medical practice and rated it a 10 due to the wait times,
appointments and large clientele. Cooroy Family Medical stated Cooroy needs more doctors,


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particularly with the estimated population growth. The medical practice is looking at
employing a few additional doctors over the next coming months to assist in keeping up with
demand, however they are experiencing difficulties encouraging new doctors to move to
‘rural’ locations and stay for extended periods of time.

       3.5.3 Cooroy Family Practice

Cooroy Family Practice has been established for seven years. The practice has three doctors
and a paediatrician, two full time and two part time. All doctors books are open to new clients.

Cooroy Family Practice also stated a level of 10 with regards to how busy the practice
generally is. Cooroy Family Medical believe it would be beneficial if Cooroy had an additional
medical practice to cater for the population.

   3.6 Palm Lake Resort Resident Questionnaire
Palm Lake Works issued a five question survey to residents of Palm Lake Resort Cooroy-
Noosa and received 49 responses. The purpose of this survey was to identify the need for an
additional practice and the benefits and impacts it may have on the local community.

       3.6.1 Question 1: What suburb is your GP located in?

The first question on the survey established whether Palm Lake Resort residents utilise
current Cooroy doctor services or continue to travel to visit their family doctors elsewhere.
The below bar graph identifies less than half of the returned responses utilise Cooroy
practices, whilst the remaining residents need to travel to neighbouring towns for the
services, in Noosaville, Pomona and Tewantin.




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                                    Current GP Location
 25



 20



 15



 10



  5



  0
         Noosaville        Cooroy             Tewantin       Pamona         Other

Figure 2: PLR residents current GP location



       3.5.2 Question 2: If your GP is not located in Cooroy, what is the reason for not
             changing to a doctor based in Cooroy?

Question two was directed at residents who did not already have a Cooroy based doctor and
to establish why they had not moved to a Cooroy doctor.




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                        Reasons for not changing to Doctor in Cooroy

                         Doctor specialty



           Doctor relocated out of Cooroy



        Havent gotten around to changing



 Family Doctor/ happy with current doctor



          Cooroy too busy / no availability


                                              0   2       4      6      8   10   12   14      16

Figure 3: PLR residents reasons for not changing doctors
From the above, it is evident that residents feel more comfortable and are generally happy
to continue to use their family doctor at this current time. However many residents voiced
they may have to eventually change doctors once they become older. This is further indicated
in the responses provided for question 4.

The survey data also identified that five residents previously visited doctors in Cooroy. In
2018 it is believed four doctors and three receptionists moved from Maple Street Surgery in
Cooroy to Noosaville to open a new practice. The five residents have followed their doctors
from Cooroy to Noosaville.

        3.5.3 Question 3: What kind of difficulties (if any) do you experience when arranging
              to meet with your doctor?

The third question asked residents if they experienced any kind of difficulties when arranging
to meet their doctor. Responses to this question were extremely positive with 55% of
residents stating they currently experience no difficulties when seeing their doctor. The
remaining residents identified doctor availability, making appointments, travel distance and
parking as issues they experience.




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                                 Difficulties visiting current Doctor

                              Driving



                      Limited Parking



 Availability and making appointments



                   Distance travelled



                               None


                                        0    5         10          15     20        25         30

Figure 4: PLR residents difficulties when visiting their doctor
There was no correlation with above difficulties and location other than the distance
travelled. This suggests that, in general, there may be limited parking reserved for patients
of medical practices and limited appointment availability times to suit patients.

        3.5.4 Question 4: Would you find it beneficial to have a doctor within Palm Lake
              Cooroy-Noosa network, and why?

Residents were asked to comment of whether they would find it beneficial to have a doctors practice
as part of the Palm Lake Cooroy-Noosa network and why. Comments were generally very positive
with 60% of residents saying an additional practice would benefit the resort community.




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                              Benefits for Palm Lake Residents




                                            19%




                                      21%                     60%




              Convenience and proximity     No benefit     Not at this stage, but in the future yes

Figure 5: Benefits to PLR residents
Another 21% said they would not benefit from the additional practice, however these were
generally residents who had been seeing family doctors long term and would be unlikely to
change doctors. A further 19% stated that although they may not benefit from an additional
practice straight away, they may find it beneficial in the future when they are older and less
mobile.

        3.5.5 Question 5: In your opinion what impacts/benefits do you think another
              doctors practice would contribute to the local Cooroy community?

Question 5 asks residents to provide personal opinions on the impacts and benefits another
doctors practice in Cooroy may have on the local community.

The below pie chart indicates that 76% of residents believe a Doctors Practice would benefit
the resort and local community for many reasons, including but not limited to:

   1.   Providing greater choice and potential for additional specialties;
   2.   Provide for the growing population of Cooroy;
   3.   Provide for the increasing level of aged persons within Cooroy;
   4.   Additional doctors to cater for the wider growing population;
   5.   Ease pressure off existing medical practices in Cooroy;



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   6. Free up doctors and provide availability for patients to make quick, urgent
      appointments when necessary; and
   7. Meet the needs of the community.


           Impacts/ benefits on existing practices and local community




                                           24%



                                                                  50%


                                          26%




       Benefit to the growing community   Convenience for Palm Lake Residents   Cooroy has enough doctors

Figure 6: PLR resident opinions on potential impacts and benefits to the community




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4.0 Potential Impacts/Benefits to other Medical Centres
The proposal has been assessed to determine any potential financial and social impacts upon
existing medical centres and the local community.

4.1    Financial impacts/benefits
From sections 3.3 and 3.4 of this report it is evident Cooroy is reaching its threshold regarding
patient to doctor ratios. All three medical practices voiced additional doctors in the region
would be beneficial to cater for the increasing demand of health care. Maple Street Surgery
stated, should things not slow down, they would look into getting another 3-4 doctors within
the next six months.

The proposed Doctors Practice will consist of one doctor practicing at any one time. This,
from a financial perspective, is a benefit for additional practices as the intensity of one
additional doctor is negligible compared to another Medical Practice that may consist of
between four and eight doctors. Further to this, current practices do not appear to be able
to take on more work without extending opening hours, this suggests that they would
experience negligible loss of income as a result of the proposed doctor’s practice.

4.2    Social impacts/benefits
Discussions with existing Medical Practices found they are extremely busy and often
experience difficulties finding time for new clients, doctors staying on schedule and the
limited room for emergency appointments.

The additional practice may socially benefit both existing medical practices and the
community by easing health demand pressures and providing more availability to new
patients within the region. These are considered positive benefits, assisting in supporting the
existing health network within Cooroy and allowing more residents to seek health assistance
closer to home. This use will be beneficial to the local community, utilising otherwise vacant
land until the approved Aged Care Facility receives Federal Government provisional
allocations as an Aged Care Provider, allowing funding to be received for the construction of
the facility . The proposed Doctors Practice is located in a convenient location that provides
ample car parking and safe vehicular and pedestrian access.

From the PLR Residential Questionnaire main difficulties when arranging to meet with a
doctor included limited parking, appointment availability and distance travelled. The
proposed practice will alleviate all of these issues providing ample car parking, greater
appointment availability and minimising travel distances.



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5.0       Conclusion
This Needs and Impact Assessment has assessed the proposed Doctors Practice to
determine:
         The need for another medical centre in Cooroy; and
         The impact of the proposal on other medical centres in Cooroy
The above findings demonstrate that there is evidential need for more medical practitioners
within Cooroy, whether they are established within existing medical centres or new practices.
This was determined by the comments from existing medical centres, local residents, ABS
Statistics, predicted population growth, and increase in ageing persons moving to the region.
The findings found that the proposal will not significantly impact existing medical centres
financially, and may result in an improvement and benefit socially. Social benefits the existing
medical centres may appreciate include allowing doctors to have longer consultations with
patients, ensure appointments timetables run on time, provide availability for emergency
appointments, take on additional new clients, and have availability to offer same day
appointments.
Further to the above, there will be no issues sourcing a medical practitioner for the proposed
Doctors Practice as the application is driven by an interested tenant.
It is therefore considered that the findings in this report demonstrate sufficient need for
additional medical practitioners and results in positive benefits to the local community and
existing medical services.




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References:

Australian Bureau of Statistics, ‘2016 Census QuickStats Sunshine Coast’, Australian Bureau
       of Statistics, last updated 23 October 2017.

Australian Government, Australian Institute of Health and Welfare 2018, ‘Australia’s Health’,
       Australian Institute of Health and Welfare, Series no 16 AUS 221, Canberra: AIHW.

Australian Government, Australian Institute of Health and Welfare 2018, ‘Older Australia at
       a glance’, Australian Institute of Health and Welfare, available at
       <https://www.aihw.gov.au/reports/older-people/older-australia-at-a-
       glance/contents/health-aged-care-service-use/health-care-gps-specialists>.

Australia Government, Department of Health, ‘Primary Health Network, Central Queensland,
       Wide Bay and Sunshine Coast Snapshot’, Australian Bureau of Statistics, 2016 Census,
       last updated January 2018.

Australian Government, Primary Health Network, Central Queensland, Wide Bay, Sunshine
       Coast, ‘2015-2016 Sunshine Coast LGA Profile’, Primary Health Network, available at
       <https://www.ourphn.org.au/our-reports/>.

Lucid Economics, ‘Noosa Economic Profile 2017 Update prepared for Noosa Shire Council’,
       Draft Version 3, available at
       <https://www.noosa.qld.gov.au/documents/40217326/40227860/Noosa%20Econo
       mic%20Profile%202017%20Feb%202018>.




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