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Emergency co-payment a bad idea: AMA

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The AMA has attacked suggestions that patients who turn up at hospital emergency departments looking for treatment for minor conditions be charged an up-front co-payment.

Criticising what he said was “crazy” speculation about what would be in the Federal Budget, AMA President Dr Steve Hambleton said the idea that charging such a fee would relieve pressure on emergency departments was ill thought out and misconceived.

News Limited papers last week cited an anonymous “senior Government source” as confirming the proposal for an emergency department co-payment as part of moves to introduce a $6 GP co-payment.

“If you do something around GPs, then you would have to do something around the emergency departments,” the source was quoted as saying. “People need to be discouraged from going to the hospital with a stubbed toe.”

Former Coalition Government health policy adviser Terry Barnes, who proposed the GP co-payment in a submission to the National Commission of Audit, said the emergency department co-payment would need to be set at $36 if it was to encourage patients to see their GP instead.

 But Dr Hambleton said the proposal was wrong-headed.

“Category 4 and Category 5 emergency department patients are not necessarily GP patients – they are the patients who can safely wait for care,” the AMA President said. “They are not clogging up the emergency departments, so the proposal is trying to solve a problem that does not exist.”

Dr Hambleton said the problem emergency departments faced was a lack of beds within hospitals, which blocked the movement of patients out of emergency and into inpatient beds.

The idea has been given short shrift by some State governments, who are responsible for public hospitals and would need to implement the charge.

South Australian Health Minister Jack Snelling said the key to reducing demand for hospital services was to improve access to GPs, and he told The Australian “I’m not interested in colluding with the Commonwealth Government on its plans to implement a GP tax – I don’t think that is the answer to dealing with the problems that our health system is facing”.

Queensland Health Minister Lawrence Springborg told the Courier-Mail his State would not charge an emergency department co-payment.

“We remain committed to a free public hospital system, and fixing the problem is about more than a co-payment,” Mr Springborg said.

Federal Shadow Health Minister Catherine King said she was “deeply concerned” that an emergency department co-payment might deter people from seeking needed medical treatment.

Greens Senator Dr Richard Di Natale said putting price barriers in the way of patients looking to see their doctor or go to hospital would “cost us more in the long run”.

And Dr Di Natale questioned who would determine which ailments were legitimate reasons to seek emergency department treatment, and what criteria would be applied.

“As a doctor, I don’t want a bureaucrat with a mandate to find savings in charge of making that call,” he said.

The office of Health Minister Peter Dutton has refused to comment on the speculation.

Adrian Rollins