ED patient tax 'makes no sense'

A University of Wollongong academic supports a move to protect hospital emergency departments from a new patient tax.

Professor Kathy Eagar, director of the Australian Health Services Research Institute (AHSRI) at the university, said a proposed co-payment for patients visiting hospital EDs made no sense.

The ability for states to charge for emergency room access was announced in this month's budget as part of the introduction of a $7 co-payment for GP visits.

Patients with seemingly trivial complaints, such as colds, could be charged the co-payment to stop a rush of people from GP clinics to public emergency rooms.

"In practical terms it would be impossible for emergency departments to make sensible decisions about who they might consider to be primary care," Prof Eagar said. "It would cost more than $7 to set up the systems to run it."

Hospitals already classify patients according to their clinical urgency - it's called triage. However, Prof Eagar said a low-priority triage case could not necessarily be better treated by a GP.

"A percentage of triage category five patients are actually admitted to hospital," she said. "A little old lady who's had a fall may not be urgent, but her case may be really complex and she may need to be admitted to a ward.

"Many triage five patients are actually sent to emergency by their GP and a percentage arrive by ambulance."

Putting the onus on nursing staff to decide who to charge was very "resource intensive".

"It would slow down treatment times in the ED," Prof Eagar said.

An AHSRI study of patients presenting at EDs at Wollongong, Shellharbour and Shoalhaven hospitals found that only about 3 per cent of them could have been dealt with by a GP.

"There's a myth that EDs are clogged up with patients who should be GP patients - in the study all the patients perceived their problem as too urgent or too complex to go to a GP," Prof Eagar said.

"That's especially true for parents - new mums who've got a sick baby may in hindsight realise that their baby was OK but at the time they see it as urgent, and it could well be.

"We can only expect parents, or indeed any patient, to act on their own perception of how urgent their problem is; they don't have the training of a doctor."

On Thursday, Labor introduced legislation in NSW Parliament to amend the Health Services Act to prevent a charge being imposed on people visiting hospital emergency departments.

Opposition Leader John Robertson has called on NSW Premier Mike Baird to support Labor's bill.

NSW Health Minister Jillian Skinner has said an ED co-payment would not be introduced in NSW; however the state government has not opposed the proposed GP tax.


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