Page 3281 - Week 12 - Thursday, 19 November 1992
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a threshold level. Under Medicare, it is still possible to take out expensive private health insurance for private hospital cover, doctor of choice in public hospitals, and ancillary services. In 1988 the current set of Medicare agreements merged the identified health grants and the Medicare compensation grants into a single grant for public hospitals. Additional grants were made available to expand day-only surgery, treat AIDS, encourage early discharge and develop case costing mechanisms.
The current Medicare agreement runs out on 30 June 1993. There have been some changes to Medicare since its inception, but the principles of universality, equity and choice are still integral parts of Medicare. The result of Medicare has been to enable ready access by Australians to free health care based on clinical need. Despite this improved access, inequalities in health still remain, and governments need to continue to stress equity issues in accessing health care. For example, the national health strategy has recently released a discussion paper which documents the differences in health status and service use across the Australian population. This study has found that members of disadvantaged groups have significantly higher rates of use of hospitals, outpatient clinics and doctors, and low levels of use of preventative services, which correlates with their generally poor health status.
As chair of the Social Policy Committee, which is investigating aged accommodation, I have a particular interest in services available for these people. For older people there are compounding factors that make access to health care a vitally important issue. Firstly, age brings about a steep rise in the need to access health services. For example, the Australian Institute of Health found that, in 1989, 50 per cent of occupied bed days were used by people over the age of 60 across Australia. In the ACT, with our younger average population, in 1989, 34.5 per cent of hospital bed days were occupied by people over 65. Secondly, free access to health care is vital for older people because of their lower level of income. Unless we have universal health care, we have a situation where the group of people in our community who most need health care are the people least able to pay for it. If older people were to rely on private health insurance, then a substantial section of the community would miss out on vitally needed services. We should use this opportunity provided by the renegotiation of the Medicare agreement to make some fundamental improvements to our public health systems. I understand that the Commonwealth is proposing that the principles of Medicare be incorporated in complementary State and Territory legislation and that they have already introduced a Bill into the Commonwealth Parliament. The principles for Medicare are to be supplemented with a patients' charter and improved recognition of patients' rights.
A critical part of ensuring equity and excellence of service in the proposed Medicare agreement is the establishment of an independent health complaints mechanism in all States. The ACT has pre-empted the Federal Government's requirement for such a complaints unit by the announcement in the September budget of the establishment of such a unit. This unit will ensure that all members of the ACT community have access to a mechanism so that they can, firstly, receive education regarding their health rights and responsibilities; secondly, make complaints about any health care service or provider; thirdly, have a safe, confidential process for conciliation of their complaints; and, fourthly, have a mechanism to investigate quickly the more serious complaints or complaints that cannot be conciliated. In conclusion, I would like to reassure the ACT community that, through the efforts of this Government, we will maintain a high-quality health system which emphasises equity and access for all who need health care.
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