Public hospitals ‘privatised by stealth’

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A report showing public hospitals are increasingly giving preferential access to privately insured patients confirms that the public hospital system is being privatised by stealth, Australian Private Hospitals Association (APHA) CEO Michael Roff says.

A new Australian Institute of Health and Welfare (AIHW) report has found the number of private patients seen annually in public hospitals had grown by half a million over the past decade – an average increase of 9.6% a year. This was almost three times as fast as growth in public hospital services overall, Mr Roff said.

One of the biggest areas of growth has been ‘emergency’ admissions of privately insured patients into public hospitals, which grew an average of 11.7% per year over the past decade. Same-day emergency admissions grew the most, at an average 20.3% each year.

“These data are clear evidence of public hospital staff trawling though emergency departments, triaging patients by their insurance status,” Mr Roff said.

This was to the detriment of public patients, he said.

“A public hospital emergency department should be solely focussed on the clinical care of the patients who present there, it is not the place for hospital administrators to pressure and blackmail patients in an unseemly cash-grab.

“If the rate of growth of public hospitals chasing insured patients continues as we’ve seen in the past five years, half of all patients in the public hospital system will be private by 2035. At the same time, public patients will increasingly be forced to play the waiting list lottery.

“Is this really the public hospital system we want in Australia, a system that is effectively privatised by its addiction to insurance payments?” he said.

Minister for Health Greg Hunt said the Government was very concerned about the growth in private health insurance (PHI) charged by public hospitals for treatments that should be free.

“This practice is driving up private health insurance premiums and is blowing out public hospital waiting lists,” he said.

“What we’re seeing across Australia is that private patients are being treated in public hospitals with shorter waiting times. Some of the differences in wait times are shocking. On average, the wait time for public patients is more than double.”

The AIHW said the report, “Private health insurance patients in Australian hospitals, 2006–07 to 2015–16: Australian hospital statistics” showed private health insurance was funding (either entirely or in part) a growing proportion of hospital admissions in both public and private hospitals – increasing by 5.6% on average each year since 2006–07.

AIHW spokesperson Jenny Hargreaves said in 2006–07 about one in seven private health insurance-funded hospitalisations occurred in public hospitals, increasing to about one in five in 2015–16.

“Private health insurance-funded hospitalisations in public hospitals were more likely to be for patients aged 75 and older, and patients aged 19 and under (30% and 12%, respectively), compared with 21% and 5% respectively in private hospitals,” she said.

Mr Roff said the AIHW figures also provided more information on the “unconscionable practice” of allowing private patients to jump the queue for elective surgery while public patients were forced to wait longer, often with conditions that affected their quality of life, mobility or capacity to work.

Public patients waited a median of 113 days for a cataract extraction, compared to only 29 days for privately insured patients. Even for the most urgent cases, public patients were disadvantaged, the research showed.

“For example, cancer patients without health insurance wait 40% longer and those needing a heart bypass wait twice as long as their insured counterparts.

“Public hospital advocates and state health ministers will twist and turn in their efforts to justify these outrageous practices, but they must know they are abandoning one of the key principles of Medicare – access to public hospital care based on clinical need, not the ability to pay,” Mr Roff said.

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