Patients left in lurch after shock decision by private hospitals

Private hospitals squabbles with health insurers is causing a headache for regional Queenslanders.

Jessica Preston, with 2-year-old son Carter, is pregnant and can’t use her insurance at Gold Coast private. Picture: Nigel Hallett

Regional Queenslanders who rely on private healthcare as public wait lists have blown out, will be heavily impacted by the rising squabbles between private hospitals and health insurers, the state’s peak medical body warns.

After Healthscope, the country’s second largest private hospital operator cut ties with Bupa and the Australian Health Services Alliance funds, patients have been left scrambling to find alternate insurance, pay thousands of dollars for treatment or switch to the public system.

“Private hospitals play a critical role in helping to reduce elective surgery waiting lists, however, we are increasingly seeing squabbles between private hospitals and health funds.,” Australian Medical Association Queensland president Nick Yim told The Courier Mail.

“Patients in regional Queensland are particularly vulnerable as there may be no other hospital for them to go to close to home. This is incredibly frustrating for patients who need care and for doctors who just want to get on with providing that care,” he said.

AMAQ convened a Surgical Wait List Roundtable this year to address inequitable access to surgical services in regional Queensland.

“We require both public and private health care sectors to be functioning well and in collaboration,” Dr Yim said.

The peak body is calling for the Federal government to intervene and ensure the future of the private sector.

Jessica Preston can’t use her insurance at Gold Coast private due to a Healthscope contract issue. Picture: Nigel Hallett

Australian Private Hospitals Association chief Brett Heffernan warns that private hospitals are on the brink of collapse with claims that 20 private hospitals have closed their doors over the last three years and over 70 services in other hospitals have shut down.

Over the same period, the health insurance companies have reaped record after-tax profits of over $5 billion, Mr Heffernan said.

Jessica Preston has been caught up in Healthscope’s decision to tear up contracts with health insurers.

Healthscope owns the Brisbane Private Hospital, Gold Coast Private Hospital, Peninsula Private Hospital, Pine Rivers Private Hospital and Sunnybank Private Hospital.

The contract terminations will come into effect from February 20 for Bupa and from March 4 for the Australian Health Services Alliance funds, which includes Australian Unity, GMHBA, Health Partners, Westfund and HIF, midwives, police, teachers and emergency services funds.

“I am in the first trimester of pregnancy and planned to have the baby at Gold Coast Private. This is an IVF baby and it is a high risk pregnancy. I get great care there and my son who is now three was born there,” the Gold Coast mum said.

“But when I tried to book in my C-Section for next year I was told by my insurer I was no longer insured. I have been paying out for private cover for years. Pregnancy is stressful enough without this. I just want to warn other women who are pregnant to make enquiries, especially if they are late in pregnancy. I am not sure what I will end up having to do but at least I have a bit of time to try to work it out,” she said.

Rachel David, chief executive of Private Healthcare Australia said that health funds are working hard to ensure none of their members will be affected by Healthscope’s termination of contracts.

“There is no need for anybody to find alternate insurance, pay thousands of dollars for treatment or switch to the public system at this stage.

Health funds have asked the Commonwealth Private Health Insurance Ombudsman to step in and mediate this matter as soon as possible to prevent patients being charged any unnecessary fees,” she said.

Originally published as Patients left in lurch after shock decision by private hospitals