Regional access to quality health care

Mother and daughter on farm

Regional Australians attempting to access quality health care can often encounter challenges unexperienced by their city counterparts.

The demand versus the more limited supply means that options can be fewer, distances travelled much greater and costs prohibitive.

While access to doctors isn’t always an issue, access to specialists can be difficult.

This was the issue facing Gulgong’s Garry Stanford.

After an angiogram at Orange Base Hospital in 2016, Mr Stanford was informed that he would need heart surgery after the scan uncovered a serious heart condition.

The serious nature of Mr Stanford’s condition meant that a trip to Sydney for treatment was inevitable as he required the services of a cardiothoracic surgeon to replace his aortic valve.

Garry had an initial consultation with a cardiothoracic surgeon recommended by the cardiologist, however an unpleasant shock was waiting.

Garry and his wife Ros, both members of Westfund Health Insurance, had spoken with a customer service consultant in Garry’s local Mudgee Care Centre to discuss options and importantly costs of his procedure.

Although much of the cost was covered by his policy, there was still a chance that Mr Stanford would pay significant out-of-pocket costs due to specialists and anaesthetists charging above the scheduled fees, not to mention the costs incurred specifically due to travel and accommodation needs.

The couple had been informed of Westfund’s ‘Access Gap Cover Scheme’, a scheme doctors may choose to participate in that will reduce the out-of-pocket costs to the patient when charges exceed the Commonwealth Medical Benefits Schedule fee.

"We encourage all members to take advantage of our knowledge when facing the prospect of surgery or hospitalization," said Westfund Regional Manager Sarah Willoughby.

When meeting with the recommended cardiothoracic surgeon, who was proposing to do the procedure at the Prince of Wales Hospital, Garry and Ros weren’t convinced.

“…We weren’t real happy with him, with his attitude and what he said. He kidded that he didn’t even know what the Gap was,” said Garry.

“He said you’ll have to ask my secretary about that. I rang her and she said no. That’s the price tag, take it or leave it.

“They wouldn’t give us a quote. It could be somewhere between $5,000 and $7,000, could be a bit more, could be a little bit less depending on what we need to do”.

Garry and Ros returned to Westfund Mudgee and were shown a directory of Access Gap Cover participating doctors and surgeons.

“They (the staff) guided us the right way,” said Garry. In addition, Westfund’s unique Advanced Surgery Benefit also offered Garry and Ros additional financial relief.

The couple looked for an alternative – and found one with a connection very close to home.

In a twist common for Australians who hail from a small town, the Stanfords settled on Dr Graham Meredith, a former Gulgong resident.

The Gulgong connection was a comforting one for both Ros and Garry.

“I worked at the hospital when he was born and he went to school with our daughter,” said Ros.

“His grandfather always said to Garry he (Graham) was going to be a great surgeon,” she said.

A few short phonecalls and Garry was booked in for his surgery at Westmead Private Hospital, much to the relief of both Garry and Ros.

“Another thing that was stressing me too if we went to Prince of Wales – I have no idea how to get around Sydney. No idea at all. And that was stressing me out a bit,” said Ros.

“Whereas Westmead it was in a good location, there was accommodation there if you want it”.

Garry has recovered well from his surgery, and apart from check-ups at Westmead Private Hospital life has resumed as normal for he and Ros.

The difference between regional communities and city communities has really been emphasised by their experience, with both Garry and Ros loving the fact that they can experience personalised care from their local Westfund Care Centre.

"You feel comfortable in going to someone that you know, you can ask them anything or do whatever and … if they don’t know they’ll check-up straight away and find out," said Garry.

“We’ve always been given the right advice and you always feel comfortable when you come out that everything’s been done,” said Garry.

They are also extremely grateful to Dr Meredith and the great care Garry received at Westmead Private Hospital which has underscored the importance of their private health cover.

“It’s not ‘oh you could get it (surgery) done in six months’, it’s ‘when do you want it done’”, said Garry.

And without cover?

“I might be still waiting until I had a heart attack,” he said.

“Graham did tell me after he did the operation, that if I hadn’t have had it done, he said ‘you would have been dead in 12 months’”.

Learn more about Access Gap Cover and how it can help you.