“This is not just an isolated issue in NSW,” Perrottet said. “We know that other states are facing similar pressures,which is why we are also working in partnership with Victoria to expand urgent care services across both states to help take pressure off our emergency departments.”

The states are opening dozens oftheir own urgent care centres to deal with the problem while also pushing the federal government for increased hospital funding and higher Medicare rebates to increase access to bulk-billing GPs.

But health experts are also warning that hospital staffing – a responsibility of the state government – remains a crucial part of the problem.

Australian Medical Association NSW president Dr Michael Bonning said there was a constant battle between the state and federal governments that risked descending into finger-pointing.

He agreed there had been a sharp rise in triage 2 patients with urgent needs,due to an ageing population,and that Medicare rebates had not kept pace with the cost of GP services. He also agreed that many triage 4 and 5 patients did not require hospital care and were better served in the community.

However,Bonning said that in about a third of cases those non-urgent presentations were happening out-of-hours,when GPs were not available.

”As much as[the premier] might say this is about general practice,this is also about state government funding to deal with the case mix they have – increasing severity and number of presentations in an ageing population,” he said. “Fundamentally,the state health system may have funded significant capital works but[it] has not staffed them.

“We agree there’s more to be done[in general practice]. There is,however,also more to be done in the hospital system. The answer is somewhere in the middle.”

Australasian College for Emergency Medicine president Dr Clare Skinner said emergency departments were under increasing strain,with demand for emergency care across the country rising 14 per cent in five years despite population growth of just 5 per cent. Available hospital beds had also decreased by 4 per cent.

“If you need to be admitted to hospital,you are more likely than ever before to get stuck waiting for hours,or days,in[emergency departments] due to a lack of hospital beds,or a lack of appropriate,accessible,community-based care,” she said.

“Access to affordable,accessible,integrated primary and community-based care over time can keep people healthy so that they do not become so unwell that they present to the ED.”

Skinner welcomed any government policies to improve access to GPs and primary care. However,she said there would always be an overlap between primary care and emergency departments,and that the pressures on emergency departments were “multifactorial”.

“Healthcare workforce shortages are one of the biggest issues facing emergency departments ... Most EDs are consistently understaffed. There are marked deficits in nursing,especially senior nursing,” she said.

A spokesperson from Perrottet’s office said the state government had allocated $4.5 billion in its latest budget to recruit 10,000 new health workers over the next four years.

Health Minister Mark Butler said the federal government’s “strengthening Medicare taskforce” was identifying the best ways to boost affordability and improve access through a $750 million fund.

“The former government froze the Medicare rebate for six years,ripping billions of dollars out of primary care and causing gap fees to skyrocket. The Albanese government is committed to investing in general practice and strengthening Medicare,” he said.

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