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Thursday, 12 August 2004
Page: 26594

Senator Allison asked the Minister representing the Minister for Health and Ageing, upon notice, on 18 June 2004:

(1) Is the Minister aware that in the 2001-02 financial year, private hospitals treated only 18 percent of all falls type patients and 16 percent of all pneumonia type patients, while undertaking over 44 per cent of all cardiac procedures and 60 per cent of lens procedures.

(2) Is it correct that only 505 000 emergency patients were treated by the private sector in the 2001-02 financial year, in comparison to 5.5 million treated by the public hospitals.

(3) Given that falls and pneumonia commonly cause older Australians to require hospital care and that the frail-aged are likely to need emergency admission due to falls and respiratory problems, does this imbalance between the public and private systems in relation to emergency treatment and the proportion of falls and pneumonia type patients treated suggest that the private health care system is not contributing sufficiently to providing a level of care for the frail-aged that is commensurate with the proportion of aged persons in the community.

(4) Are cardiac procedures and lens procedures high profit yielding operations.

(5) Is the Minister aware that over 50 percent of private hospital admissions are for day procedures.

(6) Does this bias on the part of private hospitals towards procedures the costs of which may be easily managed, such as cardiac and lens procedures, and same day treatments indicate that the elderly, who would be less likely to fit into these categories, are being left out of the private hospital system.

(7) Is it the case that in 2003 there were 106 000 nursing home type patients who made insurance claims through public hospitals, suggesting that the frail-aged are not gaining access to the private hospital system at a rate that might be expected.

(8) Does the Minister agree that, in effect, the private hospital system is being selective about the services it provides and the patients it treats.

(9) What action is the Government taking to ensure that elderly people are not discriminated against in the provision of hospital services in the private sector.

Senator Ian Campbell (Minister for the Environment and Heritage) —The Minister for Health and Ageing has provided the following answer to the honourable senator's question:

(1) The Australian Institute of Health and Welfare (AIHW) Australian Hospital Statistics 2001-02 report shows that private hospitals treated:

19% of falls type patients;

19% of pneumonia type patients;

51% of cardiac procedures; and

69% of lens procedures.

(2) The AIHW Australian Hospital Statistics 2001-02 report shows that approximately 505,000 accident and emergency patients were treated in private hospitals and approximately 5.8 million accident and emergency patients were treated in public hospitals.

(3) No. Private hospitals treat as many older patients as public hospitals. The AIHW Australian Hospital Statistics 2001-02 report shows that:

33% of patients treated in public hospitals are older than 65 years;

34% of patients treated in private hospitals are older than 65 years;

People older than 65 years accounted for 46% of the total time of all people in public hospitals; and

People older than 65 years accounted for 49% of the total time of all people in private hospitals.

(4) No. Overall, private hospitals' net operating profit for 2001-02 was 6%, according to ABS data. There is no evidence to suggest that lens and cardiac procedures yield particularly high profits.

(5) Yes.

(6) No. See answer to (3) above.

(7) No. See answer to (3) above. Nursing home type patient indicators are no longer used in public hospital data collection. However, Department of Health and Ageing data shows there were 1,600 episodes of maintenance and non-acute geriatric care for privately insured patients older than 65 years in public hospitals in 2001-02.

(8) The Government believes that a mixed model of balanced private and public health services is integral to the provision of universal access to high quality affordable health care services for all Australians, including older Australians. The essence of this system is patient choice. A patient with private health insurance may elect to be treated as a public patient in a public hospital, as a private patient in a public hospital, or as a private patient in a private hospital. A decision to admit a patient is made by the treating doctor on clinical grounds. The choice of hospital may be influenced by a number of factors which include the patient's preference as well as the specialist's admitting rights, capacity of available facilities, the location and the type and range of services provided by facilities. Hospitals and day facilities which are privately owned and operated may choose to offer particular types of services and this is a commercial decision for them. However, consistent with the Government's policy, the outcome is a wider range of choices for all Australians.

(9) As noted in the answer to Question 3 above, AIHW statistics for 2001-02 show the proportion of patients aged over 65 years treated in public hospitals and private hospitals is very similar. Elderly people, along with all Australians, who choose to have private health insurance are guaranteed a choice by this Government about where they will be treated, when they require treatment. Data from the Private Health Insurance Administration Council for the March quarter 2004 indicates that 1,048,552 people aged 65 and over had private health insurance.