Many people are no doubt confused by the controversy over the Medical Clinic, not least because the Premier, who wishes to close it, and the people who want to keep it open both make good cases in support of their own viewpoints.

The former Indigent Clinic was set up in the late 1960s to give medical help to people who could not afford health insurance, or doctor’s visits.

It would appear that since then it has waxed and waned and waxed again, although the irony of the current row is that it seems to be currently providing a good service to the people who need it.

The opponents of the closure argue that it provides an affordable alternative to people who are too poor to have health insurance, and is, in effect, a one stop shop, where patients can be quickly referred to the different services that they need.

Certainly, it seems to be popular, with something like 1,500 people on its books, and surveys of patients suggest that it is well served. It employs four nurses and two physicians, with other general practitioners giving their services as well.

One concern — and its popularity suggests that this might be going on — is that it could be abused by people who could afford health insurance but choose instead to make use of the clinic.

Dr. Brown initially argued that it was demeaning for people to use the clinic, but judging by the protests and direct interviews, the patients are either unaware of this, or simply don’t feel that way. The natural instinct is to believe the latter, rather than decide what’s good for people without consulting them.

Dr. Brown then argued that this was a question of patient choice, and he has now claimed that close to 30 GPs will now be taking former clients of the clinic on. However, because there will be an effort made to ensure that the patients are shared out among the participating doctors, it is hard to see how much choice they will actually have.

Dr. Brown also said that the clinic is too expensive at $500,000 per year, but has not said how much the subsidised care will be.

It can also be argued, as Dr. Bert McPhee does in a letter today, that claiming the patients in the clinic receive better care than those in the private sector, means those who pay for their care are treated worse. That is hard to believe, but it is not proven, so further study is needed. Assuming that clinic patients get the same level of care as those in the private sector, as they should, then it comes down to a question of cost. Can the same or better services be provided for $500,000 a year or less? No one seems to know, and id they do, they are not telling.

Dr. Brown’s strongest argument concerns abuse.

This will now be solved through a series of means tests conducted by the Department of Financial Assistance. Assuming any of the patients get through what has the potential — and that word is emphasised — to be a bureaucratic quagmire, they will then get the subsidised care they need.

But this same screening could and should be done at the clinic, so although any reduction in abuse is welcome, there does not seem to be a need to close the clinic to accomplish it.

What is most concerning about this is the total lack of consultation that has gone into this. Dr. Brown first aired the idea in his leadership campaign when many people were barely aware of the clinic’s existence.

What has been revealed since is that the “Indigent Clinic” was renamed years ago, and that it seems to be popular and effective.

Dr. Brown has admitted that there was minimal consultation with patients and has apparently been surprised by the depth of opposition.

Nor has he provided the figures that would make a financial case for its closure. Yes, the clinic is expensive, but what will the cost to the taxpayer be when the HIP subsidies, transport costs and additional government staffing needs are added up? No one is saying.

Acting Health Minister Sen. Philip Perinchief yesterday promised continued consultation, but Dr. Brown seems to have made up his mind, and one suspects that when that happens, Dr. Brown has his way.

When Dr. Brown was elected as leader, he said: “You will be tired of the public access and the public discussion we will generate.”

That does not seem to be the case here.