In March 2011, a partnership of community service, health and rural organisations combined to run a state-wide ‘phone in’ to hear from country people who struggle to afford basic health care. The phone in found that where medical cost and transport issues intersected, people were at their most vulnerable.

The 56 calls taken over three days verified the anecdotal information that organisations had been hearing: many children and their parents were avoiding basic medical care in country areas due to their inability to pay above the gap.

People on a low income reported driving further for bulk-billing GP practices, being unable to provide an up-front gap payment to their local GP and feeling embarrassed to negotiate a payment plan in a waiting room with peers listening in.

People reported various debt-recovery practices of their GP had included

• Not passing on medical records to ‘poor payers’ when they move a different GP, until a debt has been settled.
• Refusing to see a patient with an outstanding debt unless it is an emergency and
• Insisting on pre-payment of the full fee prior to consultation

The most common themes of the calls were access to quality care and services, cost of transport/accommodation, cost of medical services and intersection of service restrictions and travel demands.

The partnership of organisations used their findings to make recommendations for improvement to the Government’s Patient Assistance Transport Scheme (PATS) scheme, which included adjusting the travel and accommodation reimbursement rate (unchanged since 2004), and calling for the draft guidelines to be circulated for public consultation.

The findings from the phone in have been made available to other UnitingCare agencies for use in their research, advocacy and policy development work.