Patient Assistance Transport Scheme

03 Jul 2013 archivespeech

This speech is in relation to the Patient Assistance Transport Scheme, otherwise known as PATS, and the poor systems which are more than likely denying country patients access to funds they are entitled to.

The Hon. J.M.A. LENSINK (15:45): I rise to speak about the Patient Assistance Transport Scheme, otherwise known as PATS, and the poor systems which are more than likely denying country patients access to funds they are entitled to.

The PAT Scheme entitles people who live more than 100 kilometres from their nearest treating specialist to subsidies, including a fuel subsidy of 16¢ per kilometre and an accommodation subsidy of $30 a night. A person who is accompanying the patient, known as an 'escort', can also receive a subsidy separately. The number of nights that patients and their escorts are entitled to is not clear, and this is the reason for me raising this issue.

Together with Troy Bell, the Liberal candidate for Mount Gambier, I met with a gentleman last week who outlined his experience with the PATS. He pointed out to us that the physical booklet, which was published three years ago, states that both patients and their escorts are entitled to up to 90 days within a 12 month-period, that the forms do not contain any information and that the website, under the section Patient Assistance Transport Scheme Clinical Criteria for Escorts, states the following:

Accommodation costs for patients are limited to three months. Accommodation costs for escorts when the patient is hospitalised are generally not supported because the hospital provides active support, and emotional support is not eligible. Accommodation costs for escorts are paid when a patient is hospitalised in a life threatening situation for up to seven days.

The 24-page information booklet on the website does not mention the number of nights but that 'the medical specialist must state on the form the number of nights of accommodation required'. The FAQ booklet on the website, which interestingly is dated May 2013, uses the same discouraging language.

This particular chap I met with Troy Bell last week underwent treatment in February-March and lodged his original application in the second week of March. He received payment for fuel and accommodation but not for his wife as his escort. He phoned PATS and was told that, as his condition was not life threatening, they were not eligible, and he was told to get the specialist to resubmit the form. PATS said that in the original form the specialist used standard medical abbreviations, so the specialist wrote out those things in full.

Several phone calls and visits later, this gentleman was finally paid for 14 days. More calls led to him being paid an additional seven nights, even though his specialist had sought 35 days, so he sought the assistance of the Health and Community Services Complaints Commissioner, who is as frustrated with PATS as this gentleman. The explanation PATS gave to the commissioner is interesting. They define life threatening situations as, for example, 'in an intensive care unit', whereas this gentleman had aortic valve surgery—a fairly serious thing to undergo.

Part of the mix-up, they said, was due to the inclusion of 'medical terminology' rather than PATS terminology, and I found that quite surprising as somebody who spent the first years of my professional life working in the public hospital system. Medical terminology is fairly standard and anybody, from medical specialists through to allied health nursing and ward clerks, understand it, so how PATS has different terminology is really beyond me. Furthermore, they state:

If a patient in these circumstances had been accessing their health services through a public hospital, PATS could have sought clarifying information from the hospital.

This indicates that private patients are treated differently, which I think is a form of very strange discrimination. The gentleman has had to chase up PATS on several occasions. Until recently, they never used to actually notify people of the success or otherwise of their claims. This is a lot of money for pensioners with health problems, and it is just through the determination of this gentleman that he has been able to get some of his entitlements.

His chief issue is that there is conflicting information and that the terms of the scheme may be being changed by PATS. Certainly, their verbal advice is in conflict with their printed advice. It is welcome that there is a review being undertaken; however, it does not include the overall funding amount, as it states that it is 'costed within the existing PATS funding envelope', and we know what that means. Interestingly, the dynamic link from the Country Health SA website did not work and told me that the page was not available. Clearly, for a number of country patients this is like pulling teeth.