Rural ar­eas pin hopes on deal with states

The Weekend Australian - Travel - - Health - Adam Cress­well

Health ed­i­tor

AS­SISTED travel schemes that help pa­tients get med­i­cal treat­ment far from where they live are shap­ing up as a key lit­mus test of the fed­eral Gov­ern­ment’s promised new spirit of co­op­er­a­tion with the states.

The schemes — of­ten re­lied on by res­i­dents of rural ar­eas, who usu­ally have to travel to cities for spe­cial­ist treat­ment — dif­fer from state to state, and were rec­om­mended for re­form by a Se­nate in­quiry last year.

The Na­tional Rural Health Al­liance says rural peo­ple are now ‘‘ par­tic­u­larly hope­ful’’ that the La­bor Party’s sud­den na­tion­wide po­lit­i­cal hege­mony will al­low a deal be­tween state and fed­eral gov­ern­ments to har­monise the op­er­a­tions of the dif­fer­ent state-based schemes, as well as make them more gen­er­ous, as part of the rene­go­ti­a­tion of the Aus­tralian Health Care Agree­ments.

Dif­fer­ences in el­i­gi­bil­ity and ben­e­fits be­tween the var­i­ous state schemes has proved a prob­lem in the past for pa­tients who live in one state but have to travel for treat­ment to an­other. The health care agree­ments, which last five years and set the rules un­der which the Com­mon­wealth and states fund and run pub­lic hos­pi­tals, are due to be rene­go­ti­ated by 30 June.

Pre­vi­ously their scope had been lim­ited to the hospi­tal sec­tor, but since the mid­dle of last year La­bor has said it wanted to ‘‘ broaden the fo­cus’’ of the agree­ments, in par­tic­u­lar to en­cour­age more pre­ven­tive health care.

Gor­don Gre­gory, ex­ec­u­tive di­rec­tor of the Na­tional Rural Health Al­liance, said the travel schemes were re­lied on by many peo­ple to ac­cess spe­cial­ist treat­ment.

‘‘ We re­gard the rec­om­men­da­tions of the Se­nate in­quiry as be­ing a good way for­ward, and we are very hope­ful that the new spirit of col­lab­o­ra­tion be­tween Com­mon­wealth and state gov­ern­ments in health will mean de­ci­sions can be agreed in the con­text of the AHCAs,’’ Mr Gre­gory said. ‘‘ The Al­liance is push­ing for th­ese de­vel­op­ments, in­clud­ing through di­rect cor­re­spon­dence with Com­mon­wealth and state min­is­ters.’’

The Se­nate in­quiry, which tabled its re­port in Septem­ber, in its first rec­om­men­da­tion said the next AHCAs should ‘‘ recog­nise the fun­da­men­tal im­por­tance of pa­tient-as­sisted travel schemes’’ and in­clude both ‘‘ a clear com­mit­ment’’ to im­prov­ing th­ese ser­vices and a clear fund­ing al­lo­ca­tion for them.

It also rec­om­mended new hos­pi­tals and treat­ment cen­tres have ac­com­mo­da­tion fa­cil­i­ties built on-site or nearby for pa­tients trav­el­ling from afar, and called for the Aus­tralian Health Min­is­ters’ Ad­vi­sory Coun­cil to es­tab­lish ‘‘ as a mat­ter of ur­gency’’ a task­force to de­velop na­tional stan­dards for the travel schemes by Septem­ber this year.

The na­tional stan­dards should cre­ate more flexible el­i­gi­bil­ity tests than cur­rent dis­tance thresh­olds, to take ac­count of other fac­tors such as road con­di­tions and avail­abil­ity of pub­lic trans­port. This might lead to a sit­u­a­tion where res­i­dents of one town were not el­i­gi­ble for the scheme while res­i­dents of an­other town, which was in fact closer to a main cen­tre but had poorer road and trans­port links, were el­i­gi­ble.

Ap­pli­ca­tion pro­cesses should also be sim­pli­fied, per­for­mance of the schemes bet­ter mon­i­tored, and el­i­gi­bil­ity should be ex­panded to cover a wider range of treat­ments, the Se­nate re­port said. Th­ese should in­clude con­sul­ta­tions un­der the En­hanced Pri­mary Care pro­gram and sit­u­a­tions where a pa­tient had agreed to do­nate an or­gan or par­tic­i­pate in a clin­i­cal trial.

Health Min­is­ter Ni­cola Roxon told Week­end Health that bet­ter rural health ser­vices were on the Gov­ern­ment’s radar, but de­clined to be spe­cific on the is­sue of trans­port schemes. ‘‘ I am will­ing to ex­plore the idea of in­clud­ing a spe­cific rural health ser­vice com­mit­ment in the next Aus­tralian Health Care Agree­ments,’’ Ms Roxon said.

A spokesman for the Min­is­ter said the Gov­ern­ment would talk to stake­hold­ers such as the Na­tional Rural Health Al­liance ‘‘ about what that com­mit­ment would in­volve’’.

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