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States refuse to roll over on emergency patient charge

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The Federal Government’s Medicare funding overhaul could unravel amid a backlash by the states against suggestions the $7 GP co-payment should be complemented by a similar charge imposed by public hospital emergency departments.

Several State governments have either rejected the idea or expressed severe reservations about the emergency department co-payment, seen by some as essential if the GP co-payment was not simply to result in patients who would have seen their family doctor instead going to their local public hospital for care.

In the Budget, the Federal Government announced that it had removed the restriction preventing State and Territory governments from charging patients who visit emergency departments for “general practitioner-like attendances”.

But Treasurer Joe Hockey said on ABC radio it was up to the states to decide whether or not they imposed an emergency department co-payment.

“That’s a matter for them,” Mr Hockey said. “I don’t know – I don’t run the states. It’s up to them how they structure it.”

So far, there has been a cool reception from the states to the idea, even though they acknowledged the risk that the GP co-payment could drive a surge in patients for public hospitals.

Victorian Treasurer Michael O’Brien said that, “We don’t want to see people deciding they are not going to see their GP because of this co-payment, and they wind up clogging up our emergency departments in our hospitals with things which are really more appropriately seen by a GP.”

West Australian Health Minister Kim Hames told the ABC he was “extremely uncomfortable” with the idea of an emergency department co-payment.

“We don’t want to try to force people away who urgently need emergency care,” Dr Hames said.

South Australian Health Minister Jack Snelling rejected what he saw as a knee-jerk idea to offset the GP co-payment, which he said should “never be introduced in the first place”.

Queensland Health Minister Lawrence Springborg also voiced reservations about the idea, which he felt “in some ways goes against” the principle of a free public hospital system.

The resistance of the states has been stiffened by what they see as the Federal Government’s attempts to dump responsibility for public hospitals onto them.

AMA Vice President Professor Geoffrey Dobb was heavily critical of the idea, and the Australasian College of Emergency Medicine questioned how it would work.

“A free 24-7 emergency department is a hallmark of Australia’s world class health care system,” College President Dr Anthony Cross said. “Limiting access to emergency care and refusing to treat patients in need who cannot afford to pay is not an ethos our doctors could support.”

Dr Cross said “trying to distinguish patients who are inappropriately utilising emergency departments would be almost impossible”.

Adrian Rollins