The Health Consumers’ Council is often asked to comment on areas of contention in the WA Health system. With this in mind the Council has developed the following position statements listed below:
Abortion/Termination of Pregnancy
Abortion/termination of pregnancy is a procedure that should be prescribed and undertaken by a doctor in a medical setting according to accepted protocols where the health and well-being of the women is protected.
Access to termination of pregnancy should be guaranteed by statute and available in state/public health facilities.
Emergency Departments need to have the capacity to meet internationally agreed benchmarks for assessing and managing patients in accordance with their clinical need. Hospital systems should allow for the prompt movement of patients out of ED when it has been determined that admission is required. Emergency Departments should not hold patients for lengthy periods, without access to the comfort of family and provision for basic human needs for food, drink, access to the toilet, bed-covering and some degree of privacy.
Pain and distress for patients, and worry for family and friends, may lead to some level of agitation and aggression. This needs to be managed with understanding and compassion.
Euthanasia is an activity that must be decided on by the community through the democratic process.
Individual choice, expressed through Advanced Health Directives and appointed Enduring Guardians, is a vital aspect of care of the dying.
Health data bases
The Western Australian Department of Health holds extensive data bases of health information of WA citizens. The Health Consumer’s Council acknowledges the significant resource such data bases provide for researchers into health and health service planning, in turn providing government with solid data upon which to plan for the future and respond to areas of unmet need.
The Health Consumers’ Council is of the view that the holding of this information should be conditional on:
- The disclosure to the public of the fact that these stores of health information exist
- Proper and rigorous scrutiny of all requests for access to the data
- The entitlement to opt out of inclusion in a data base
- Strong penalties for misuse and optimal security protection for the data
- The identification of all data and respect for an individual’s privacy
The Health Consumers’ Council accepts that immunisation is a public good that demands some inconvenience and possible discomfort and risk for individuals, including parents and children. All immunisation programs must be found on voluntary enlistment from the public and good information, choice and affordability. Program aspects that feature coercion or penalties should be avoided. No fault compensation should be readily available where there is reasonable evidence of an adverse consequence for a person who has participated in a state-sponsored vaccination program.
Industrial Action by Health Care Workers
Any industrial action by a health professional group likely to interfere with patient care will potentially compromise the safety and quality of that care.
HCC insists it is the duty of health service managers, government and representatives of workers to tell the community honestly the extent of disruptions to patient care and to make recommendations for patients and families to follow to safeguard against possible errors and oversights due to industrial action.
HCC rejects the general response of managers to declare there are no risks to patient safety where direct carers are involved in industrial action.
HCC would assume the role of independent rapporteur to the community on the implications for patient care during episodes of industrial action.
Patients Assisted Travel Scheme
The provision of travel and transport options and accommodation for health care purposes is a government responsibility. It is the obligation of government, where private services, public transport or community services do not provide a transport solution, to make provision for consumer access to the means to attend medical appointments. The PATS program provides some cost relief for some health consumers outside the metropolitan area; however this subsidy scheme has limited application to the diversity of needs across the state. The PATS program needs to have the capacity to assist:
Private patients accessing health care funded by private insurance
With the seeking of second opinions
The exercise of choice where only one clinician is available
With meeting a greater degree of the real cost of travel and accommodation for health care
Private Health Insurance
The Health Consumer’s Council supports private health insurance as a public good that should distribute the burden of risk and cost across the community through the current community rating system (where individuals cannot have premiums set according to their level of individual risk).
The Health Consumers’ Council recognises the enormous amount of information held by insurance companies on performance of individual clinicians, facilities and procedures and supports great disclosure and use of this information for member and community benefit.
Public to private contracting of health services
The Health Consumers’ Council believes that consumers need accessible and safe services, regardless of how these are funded. When government contracts services to private, for-profit entities, consumers as citizens have an interest in knowing that these services are being operated in a safe and cost effective way. Cost effectiveness is important because wasted funds could pay for additional services. Safety is critical and requires particular contracting provisions to ensure good clinical governance of services run for government under contract. The Health Consumers’ Council is critical of health service contracting to private-for-profit entities where the standards of reporting and disclosure of error and harm are less than those required of state services. Government contract managers must address risks inherent in private for-profit contracting and make explicit arrangements to counter these.
Retention of Royal Perth Hospital (RPH)
HCC accepts there is both community support and opposition to the retention of RPH.
The decision to retain RPH conflicts with considered and deliberative long-term planning for health services in the state.
The community resources and workforce required to continue operation of RPH as a tertiary facility compete directly wit those needed for the southern tertiary hospital and all other critical areas of growth in Perth.
HCC supports the reversal of the decision to retain RPH as a tertiary hospital and the scaling down of the facility to provide other discrete health care services including urgent care services, a CBD primary care service and possibly an elective surgery facility.
Consumer and Community Participation in Health and Medical Research
The Health Consumers’ Council is strongly committed to the active participation of consumers, carers and community members at all stages and every level of health and medical research.
‘As the end users of health and medical research, consumers can provide valuable input to decisions about research policies and practices. If such research is to continue to provide high quality outcomes, it is important that consumer and community involvement in research and its ongoing development is facilitated. This includes participation by consumers as partners in the development of research goals, questions, strategies, methodologies and information dissemination. Research methods and results that are open to informed public scrutiny, and debate also help to ensure the integrity of research and accountability to the community for the quality of the research. Consumer and community participation in research brings with it responsibilities for consumers, community members and researchers – the responsibility to be respectful of each other’s knowledge, to share information with each other about research issues, and to be open about potential interests in the outcomes of research (such as a consumer’s individual health or the researcher’s financial benefits from a funder). The shared responsibility of consumers, community members and researchers is to ensure that ethical requirements are met and that there is value to the research.’
National Health and Medical Research Council Consumer and Community Participation Resource December 2004 Adopted: February 2011