This is an opinion piece by Dr Kwan Lee, founding doctor of Manningham After-hours Emergency Care. The views are his own and reflect a decade of practice across emergency departments, after-hours and aesthetic medicine.
A doctor's view of the 2026 after-hours landscape
When I trained, "after-hours" meant a tired GP from the daytime practice taking call. The model worked when populations were smaller, patient expectations were lower, and after-hours demand was sparse. None of that is still true. Bulleen, Doncaster, Templestowe, Heidelberg and Ivanhoe together have over 200,000 residents. Demand for non-critical after-hours care doesn't fit the on-call GP model anymore.
The Australian Government has tried to fill the gap with Medicare Urgent Care Clinics. They've worked — 2.5 million visits since 2023 is a real success. But MUCCs mostly close by 10 pm. Between 10 pm and 8 am the choice has been ED or wait. That is the gap private after-hours clinics fill.
The MBS rebate gap, in dollars
Let me put numbers on this. A standard after-hours GP consultation generates about $70–$95 in Medicare rebate. A properly staffed urgent-care shift (doctor, nurse, admin, premises, equipment, indemnity, consumables) costs many multiples of that per shift, regardless of how many patients walk in. The rebate funds about a third of the actual cost. The remaining two-thirds has to come from somewhere — either patient fees, philanthropy, or volunteer labour. In the long run, only patient fees are sustainable.
What sustainable looks like
A sustainable after-hours clinic in 2026 needs four things:
- Predictable revenue per visit — enough to fund the shift even on a quiet night.
- Doctor-led clinical governance — consultant supervision is what makes the difference between an after-hours GP service and an urgent care clinic.
- Narrow but real scope — defined ATS Cat 4 and 5 only, with clear onward referral pathways for anything beyond.
- Transparent pricing — patients should know the number before they arrive. No facility-fee complexity.
Trade-offs we accept
This model is not perfect. The trade-offs include:
- Smaller patient base than a bulk-billing clinic — many patients can't or won't pay a private fee, and that is a legitimate choice.
- More public-system reliance — we lean on Box Hill and Austin ED for anything outside our scope, and on the patient's regular GP for follow-up.
- Higher communication overhead — every visit needs a clear discharge letter to the GP to maintain continuity.
What we deliver in return
- Open every night — 6 pm to 8 am, weekends and public holidays included.
- Under-60-minute visits for most Cat 4 and 5 presentations.
- Real procedural scope — suturing, splinting, dressings, foreign-body removal, urinalysis, ECG.
- Honest triage — we tell patients on the phone, before they pay, when ED is the right answer for them.
What's next for Australian urgent care
I think we'll see three things over the next five years:
- Continued MUCC expansion with longer opening hours pushing closer to midnight.
- Growth in private after-hours filling the genuinely overnight window that MUCCs cannot economically cover.
- Better integration — phone triage, electronic referrals between MUCC, private and ED, common medical records, faster GP follow-up.
The system doesn't need any one of these to win. It needs all three working together. The patient who can choose between three appropriate settings — free in-hours MUCC, private overnight, public ED for emergencies — has a better system than the patient with only one choice.
A closing note
Running a small private after-hours clinic is not a path to riches. It is a path to keeping the lights on for the patients who genuinely need somewhere to go at 11 pm. For me, that has always been the point.