Nurses speak out on Medicare changes
TONY Abbott’s prescription for health, as set out in his Government’s first Budget is a textbook example of how not to do it if you want an efficient and fair public health system.
The most generous reading of the Government’s agenda would say it reveals a profound ignorance about health.
Without doubt the biggest losers will be patients. Taking an axe to Medicare will force Australians to consider their capacity to pay before their clinical needs.
It will not only cost patients more – financially and in terms of their health – ultimately it will cost the country more.
Nurses and midwives understand well that delaying or avoiding GP consultations, diagnostics or pathology tests can lead to catastrophic outcomes and increased costs of care for the most vulnerable in our community.
Tony Abbott and Joe Hockey either do not understand these fundamentals of preventative health or else they are cruelly indifferent.
The government’s economic arguments that underpin the attack are spurious.
When it comes to health expenditure and health outcomes Australia has an efficient and enviable public health system.
Health spending in Australia comes to 9% of GDP compared to 18% in the United States. A significant amount of that spending already comes out of the pockets of patients. Government spending on health only comes to 6% of GDP.
Bloomberg, the influential American business media company, rated Australia’s health system the seventh most efficient in the world. The US system – which appears to be the favoured model of the Abbott Government – came 46th.
Ultimately embracing a user-pays model doesn’t save money it merely shifts the costs on to the community through co-payments and means testing.
There is no budgetary or economic crisis in Australia that even remotely justifies this savage attack on our health system and our living standards.
WATCH: Medicare turns 30
VOICES FROM THE FRONTLINE:
What nurses and midwives have to say about the Budget’s impact on health
“The Budget extends pressure on people who can least afford it”
– Maureen Buckley, clinical nurse consultant, Blacktown Hospital
“As a nurse in a western Sydney public hospital and a local resident I have grave concerns about what this Budget will do to the local population,” said Maureen Buckley, a clinical nurse consultant in the aged care services emergency team and a NSWNMA branch delegate.
“A lot of people around here struggle financially and the $7 co-payment will be problematic for them, regardless of the fact that it is limited to 10 GP visits per year.
“The patients I see – aged people in emergency – are usually on multiple medications. They will bear the brunt when prescription drugs go up 80c for concession holders and pensioners, and $5 for others.
“It’s a double hit because while medical care will cost more, pensions won’t be indexed to wage rises and in time they will fall further behind.”
Blacktown Hospital services one of the poorest areas of Sydney with many disadvantaged elderly pensioners, a high level of youth unemployment, a large Aboriginal population and a large refugee and immigrant non-English speaking population.
Maureen said the Budget increase in petrol excise would also hurt western Sydney workers who drive long distances to their jobs and already pay high road tolls.
“We are already disadvantaged here in the west in numerous ways so the Budget just extends the pressure on disadvantaged and marginalised people who can least afford it.”
“The Government did not think this through”
- Jackie Holmes, clinical midwifery specialist, Blacktown Hospital
Jackie Holmes, a clinical nurse specialist midwife at Blacktown Hospital’s birthing unit, described the Budget as “a quick money-grubbing venture” that will impose a huge long-term cost on the public health system.
She predicts the $7 GP co-payment will force many disadvantaged people to delay seeking medical attention.
“For many local people the $7 GP co-payment will be devastating. It will make the difference between attending for medical care early or presenting when they’re extremely ill and require admission to hospital with more expensive tests and treatments,” said Jackie, the hospital’s NSWNMA branch secretary.
“It will be a huge additional cost to the public health system. It seems the Government did not think this through, they just saw it as a quick money-grubbing exercise.
“The Budget seems to have been designed to strip money from a large proportion of the western suburbs population. I think it’s really unfair. This government is siding with big business and with people at the high end of the socio-economic scale.
“Pensioners who’ve paid taxes all their lives still can’t relax. The aged should not be in that position at this stage of their lives.”
“We already have fewer resources and lower staffing levels”
- Tania Gleeson, clinical nurse specialist, Wagga Wagga Base
Wagga Wagga clinical nurse specialist Tania Gleeson fears rural and remote health facilities will fall further behind metropolitan hospitals as a result of the Budget’s cut to federal funding of state health services.
The NSWNMA is campaigning to end the anomaly under which non-metropolitan hospitals such as Wagga Wagga Base are funded for fewer nursing hours per patient day than their big city counterparts.
“We already have fewer resources and staffing levels so cutting the health budget will only further erode services to rural communities,” said Tania, an intensive care unit liaison nurse and NSWNMA delegate and council member.
“Facilities that perform the same operations and services should have the same level of staffing – or hours allocated to those patients – regardless of which facility the patient is in.
“But this Budget means it will be harder to catch up with metro hospitals.
“Why should a patient having a hip replacement performed at Wagga Wagga Base Hospital, get fewer hours allocated to their care compared to a patient who has a hip replacement at Royal Prince Alfred Hospital?”
Tania expects a surge of patients into the already-busy emergency department once the GP co-payment is introduced from July 2016.
“Is Mr Abbott going to fund more staff to manage an influx of patients?” she asked. “The co-payment starts at $7 but they will put it up and up and before you know it, we’ve got a Americanised health care system.
There is no way this country would want to end up with a disgraceful system like that, where if you can’t pay you don’t get treated.
“This country can’t lower its standard and think that’s okay. Medicare was supposed to guarantee access to health care for everyone regardless of their income level.”
“Why are they attacking health?”
- Ursula Hollmann, registered nurse, Campbelltown Hospital
The Abbott Government’s assault on healthcare affordability will potentially have worse consequences for future generations than any Budget deficit, said Ursula Hollmann, a registered nurse at Campbelltown Hospital’s Waratah adult mental health unit.
“I think all the Government’s talk about a Budget emergency is just an excuse to do things that will increase the gap between rich and poor,” said Ursula, the delegate for the Macarthur mental health branch of the NSWNMA.
“Continually running down the public health system and making it more expensive for patients will have a greater impact on future generations than the budget deficit.”
She said Australia has one of the world’s best performing economies.
“We have low public debt, a triple-A credit rating, low inflation and fairly low unemployment relative to most other countries.
“So why are they attacking health in this Budget?”
Ursula said the Liberals promised no cuts to health spending and deceived voters by doing the opposite. She welcomed the NSWNMA’s stance in helping to lead a public campaign to defend Medicare and the public health system generally.
“We still have one of the best public systems in the world and the association needs to do what’s best for the members and best for the public in regards to defending our health care. We don’t want to go down the same track as America.”
Nurse interviews from The Lamp.
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