Healthscope: Six health funds to no longer cover major Sydney hospitals
Members of six health funds will no longer be covered at 42 hospitals including several major Sydney ones, in a decision that’s set to leave patients with extra out-of-pocket expenses or forced to travel for care.
Manly
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Members of six health funds will no longer be covered at 42 Healthscope hospitals including several major Sydney ones.
In a statement to members the Teachers Health Fund stated that it was still in negotiations but that Healthscope had moved to terminate its contract, along with five other health funds.
“Unfortunately, their new terms included higher charges for our members’ hospital admissions, and this would’ve had an adverse impact on premiums,” the statement said.
It also said that Healthscope wanted additional charges to comply with industry minimum standards for rehabilitation and mental health.
“We want the best quality of care for our members and we expect industry minimum standards to be met as a baseline,” the statement said.
Healthscope hospitals in NSW include Campbelltown Private Hospital, Mosman Private Hospital, Nepean Private Hospital, Newcastle Private Hospital, Northern Beaches Hospital, Norwest Private Hospital, Prince of Wales Private Hospital, Sydney Southwest Private Hospital, The Hills Private Hospital, The Sydney Clinic, Tweed Day Surgery, Hunter Valley Private and Lady Davidson Private.
A Healthscope spokesman said they rejected the Teachers Health Fund’s characterisation of the negotiations over rehabilitation and mental health services.
“The fact is the fund was seeking a 50 per cent increase in rehabilitation treatment hours for their members but were not prepared to pay the cost of those extra hours,” the spokesman said.
“We advised that we were not prepared to have our clinicians work extra hours at no charge.
“Neither the proposed new hours, nor the fund’s previous span of hours represent any breach of treatment or clinical protocols, and we are disappointed the Teachers Health Fund would imply our doctors, nurses and clinicians provide anything less than outstanding patient care.”
One northern beaches resident and member of the Teachers Health Fund, Rhiannon Lever, 25, of Belrose, said all her family were in the fund including her elderly grandmother, who lived closed to the new Northern Beaches Hospital.
“It’s really disappointing,” she said.
“We will only go there now for emergency care.”
Ms Lever said her family has written to Health Minister Brad Hazzard over the issue.
In the letter which she forwarded to the Manly Daily, she said she was concerned about the claims around mental health and rehabilitation services.
“I have significant concerns regarding this situation and my family’s confidence about using our local hospital for both public and private services,” she said.
“We will definitely now be putting more burden on Royal North Shore due to both concerns regarding service standards and also costs over and above our private health fund expenses just to use the local hospital / facility.”
The five other funds that have also been unable to reach a deal include: CUA Health; Commonwealth Bank’s CBHS Corporate Health; Australian Unity, CBHS Health Fund and Reserve Bank Health Society Ltd have been given 45 days notices of Healthscope’s decisions to not proceed with a new contract.
The ending of the Healthscope agreement does not impact emergency hospital admissions and private patients in one of the impacted funds can still claim for hospital admissions but there may be out-of-pocket costs.
A Healthscope spokesman said contracting arrangements with private health insurers need to appropriately reimburse “us for the work our people do every day, and allow us to invest in our facilities and equipment so we can continue to deliver world-class care for patients”.
He said that the “rate offered was simply not enough to allow our hospitals to meet their costs, such as paying the salaries of our nursing and other hospital staff” and “was also significantly out of step with what other health insurers pay”.