Mother of South Australian toddler asked to pay gap fee before being treated at Clare Hospital

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In short:

Bianca Dannenberg-Turner says she was turned away from Clare Hospital, in South Australia’s Mid North, after being asked to pay a gap fee for her two-year-old son Charlie to see a doctor.

She said she was asked to pay the gap fee up front, but acting chief executive of the Yorke and Northern Areas Local Health Network (YNLHN) denied the family was refused service.

What’s next?

The YNLHN is investigating the incident, and Health Minister Chris Picton says it will introduce a new single employer model for its regional workforce next year.

When Bianca Dannenberg-Turner took her two-year-old son Charlie to the Clare Hospital with a perforated ear drum, she did not expect to be turned away.

Charlie had been on antibiotics and pain relief for a week, but after his situation escalated, Ms Dannenberg-Turner felt hospital became her only option.

“He was pulling in his ear and saying ‘ouch, mummy’ and it was glowing red, it was obviously very sore,” she said.

“He spent about an hour just inconsolably crying. The way that I was holding him wasn’t working, I was trying to talk to him, it wasn’t working, he was in a lot of pain.

“So the only other option that I was left with was to ring triple-0 and get an ambulance to take him to the hospital.”

Ms Dannenberg-Turner said the paramedics and nurse were very helpful, but before the doctor would see her, she was asked to pay a gap fee.

“Because he’s been sick, I haven’t been able to work, so I said, I get paid on Wednesday, I can pay on Wednesday,” she said.

Ms Dannenberg-Turner was then told that the doctor would not see her son unless she paid the gap up front.

“I felt very let down and disgusted,” she said.

A woman with red hair, facial piercings and sunglasses leans on play equipment

Ms Dannenberg-Turner felt her only option was to take her son to hospital after his condition worsened.(ABC News: Isabella Carbone)

Ms Dannenberg-Turner also has a daughter with epilepsy, and said she was now worried about what would happen if her daughter needed emergency care after a seizure.

“These days, not everyone has that money on hand, and with sick kids, you take time off of work, so then that money then drops even more,” she said.

Ms Dannenberg-Turner said she was so alarmed she was considering moving to Adelaide to have better access to health care.

Acting chief executive officer of the Yorke and Northern Local Health Network (YNLHN) Verity Paterson denied the family was not seen.

“Doctors didn’t refuse service,” she said.

“We just understand that she would have been quite distressed and we would never refuse service.”

She said payments were sometimes required at country emergency departments where general practitioners provided care.

“The normal practice is that it can be billed, and that would have been the option given to the mother,” she said.

Later, in a statement, Ms Paterson apologised for “any distress this situation may have caused the family” and said she had reached out to the treating doctor, staff and family to “better understand” what occurred.

“Individual consultation costs in this instance were at the doctor’s discretion,” she said.

The exterior of the Clare Hospital emergency department

Clare Hospital is one of a number of regional SA hospitals staffed by private doctors.(ABC News)

Clare general practitioner Dr Gerry Considine told ABC Radio Adelaide that smaller regional public hospitals were often staffed by private doctors who billed Medicare, meaning patients may need to pay a gap fee.

“It’s actually the state of play across a lot of our small rural hospitals that, yes they are funded by the state government and they are public hospitals, but the GPs that work there, the staff, the ED service, and the inpatient service are not funded by the government to provide that particular service,” Dr Considine said.

“The doctor is actually entitled to not charge a fee, we can bulk-bill a patient if we see fit.”

Dr Considine said he would not turn away a child as long as the parent was “aware there may be a fee”, which could be paid on the day or later.

“I’d be advocating for kids to be seen, it’s a big call for a parent to bring their child to the hospital, so we don’t want children or parents to feel like they can’t be seen,” he said.

“But it does highlight that the state government does not fund GPs to sit in an ED and see whoever comes, that’s true in some of the bigger hospitals, but not smaller places like Clare.”

He said the South Australian government should re-consider its approach to funding for rural hospitals and how to better support GPs in regional areas.

“We really want to see general practice in the country, and that hospital work, really well recognised by both state and federal government so we don’t have this sort of thing happening,” he said.

A woman with blonde hair and blue blazer sits in office.

Penny Pratt says she thinks the government needs to invest more money into regional health.(ABC News: Isabella Carbone)

Member for Frome and opposition spokesperson for regional health services Penny Pratt said she would like to see the government re-think how it funded regional hospitals.

“I think we need to say the state government has got its priorities wrong when it comes to how it funds country hospitals,” she said.

Ms Pratt said regional hospitals played an important role in reducing extra strain on the city hospital system.

Health Minister Chis Picton said Charlie’s case was being “fully investigated” by the YNLHN.

“We recognise that we do need to improve the model of regional medical workforce, which is why we’re introducing the ‘single employer model’ for training our next generation of GPs across the state,” Mc Picton said.

He said that model had been working successfully in the Riverland, leading to an increase in the number of doctors in that area.

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