Croakey contributors have provided a wealth of useful advice for the new Victorian Labor Government and its Health Minister Jill Hennessey. Adding to this unofficial ‘incoming minister’s brief’ is the following piece from Dr Christine Walker, Executive Officer of the Chronic Illness Alliance (CIA). Based on a recent survey conducted by the CIA, Dr Walker highlights the often unseen transport costs faced by Victorians when accessing health care and recommends that the new Government review the Victorian Patient Travel Assistance Scheme and make a number of other changes to streamline access to parking and transport subsidies. She writes:
The Chronic Illness Alliance represents some 55 member organisations. Its aim is to build a better focus in health policies and health services on the needs of people with chronic illnesses. Over the years we have surveyed people with chronic illnesses on the topic of health care costs because people with chronic illnesses and their families report that it is a significant contributor to stress as well as being a major obstacle in accessing health care.
A survey undertaken in 2004 demonstrated that many people with chronic illnesses live in almost third world poverty. In order to afford healthcare many families go without items other Australians consider necessary to a good quality of life. These items include clothing, heating and cooling, leisure activities, school camps, food and paying bills. Parents are very likely to go without their own medicines in order to pay for their children’s medical care. We also know that any increase in co-payments by Governments will have serious effects on already financially distressed families.
Since 2004 a new impost has arisen. This is the cost of car parking at metropolitan public hospitals. Now an Australia-wide issue our latest survey shows that the high costs of parking may preclude some people from attending specialist medical appointments at Melbourne’s public hospitals. Others report that they will go without meals, save on medicines or other household items including children’s needs in order to make the trip affordable. Many people reported weighing up their priorities such as the need to keep a parent alive over the need to send children to a school camp or heat the house. Some completed the return trip on the one day by leaving home at 4 am and returning late at night. Many of these people are ill and the trips are exhausting.
Our report also shows that there are decreasing alternatives to hospital car parks. Most hospitals are in the CBD or in built up suburbs and street parking is no longer available for the times needed for a hospital visit. Infringements are enforced by local councils. There are discounts available to patients using these facilities but many people did not know about them; found them very difficult to access or considered the process of requesting discounts was humiliating.
All States offer a travel assistance scheme for rural people attending metropolitan hospitals for rural people to attend specialist services in the metropolitan area. In Victoria it is the Victorian Patient Travel Assistance Scheme (VPTAS) which offers reimbursement of 17 cents per kilometre for travel where people live 100 kms or more from such a centre; accommodation costs of 35.00 per might and some reimbursement for meals and public transport. The reimbursement is inadequate, the claim forms are difficult to complete and many rural patients are not informed of the scheme’s existence. It does not cover parking costs which are now a major contributor to these travel expenses.
Parking is now used by Victorian public hospitals as a revenue-raising tool to make up for the shortfall in funding from Governments. Our surveys show that it contributes to poorer health outcomes and poorer quality of life for the very ones hospitals are meant to be serving.
This is a long neglected issue that should be at the forefront of the incoming government’s agenda for health.
To ensure these barriers to accessing care are removed for all Victorians, Jill Hennessey, the new Victorian Minister for Health must:
- call for a review of VPTAS so that it actually reimburses patients travelling to Melbourne’s specialist centres at levels approaching ‘real’ reimbursement’;
- develop a policy and program that informs rural patients of the VPTAS;
- ensure that it is a properly administered program which includes assistance to people having difficulty completing forms for reimbursement;
- review how parking is administered at Melbourne’s public hospital;
- review public hospital funding to curtail the exploitation of unavoidable parking costs.
As they are funded by taxpayers and accept donations from citizens public hospitals must provide to their patients:
- proper discounts for parking (that is discounts that allow patients to attend the facility);
- make those discounts easy to access;
- remove infringements for patients;
- ensure parking attendants understand patient needs;
- revise policies around patient parking and discounting to remove unnecessarily humiliating demands on patients when they request discounts.