Oncologists have made a plea to government to ease the bizarre and archaic bureaucratic rules which they say are harming cancer patients.
Despite living in a digital era of email and e-prescribing, patients with metastatic cancer have to wait up to three weeks for their urgently-needed prescription medications to be stamped and returned by snail mail from Tasmania, according to the Medical Oncology Group of Australia
In a submission to a Senate inquiry into red tape in healthcare, MOGA says the inflexible rules of the Human Services department do not even allow Express Post envelopes to be used for Written Authority approvals for patients with life-threatening metastatic cancer.
“We believe it is lengthy, overly time consuming and highly distressing for patients, families/carers, clinicians and support staff. Despite sending the paperwork on the day a clinician sees a patient, there is a delay of two to three weeks before an approved prescription is returned in the post and can be dispensed,’ the submission notes.
“The delay is of particular concern when there is an urgency to commence neoadjuvant treatment for symptomatic locally advanced disease or metastatic disease. It is not acceptable that extremely ill metastatic cancer patients should be forced to wait two weeks to receive access to high priority oncology drugs.”
Written by MOGA chair Professor Chris Karapetis, head of medical oncology at Flinders University in Adelaide, the submission highlights many other examples of administrative rules that impose a huge burden of time and expense for oncologists and act as barriers to delivery of good and timely care to patients.
It notes that the phone approval system for PBS prescriptions is fraught with problems, including long waits on hold and a lengthy pre-recorded introduction message.
“Clinicians are not available to phone and wait on hold on the phone for long periods of time during standard business hours and it would be highly beneficial if the call-in facility could be available on 24/7 basis,” the submission says.
Red tape in other aspects of the health system, such as Medicare rebates, creates barriers for many cancer patients beyond the well-know out of pocket expenses problem, Professor Karapetis notes.
“Red tape also impacts negatively on Australian cancer patients in areas including accessing Superannuation, Social Security, travel assistance and access to some health and medical services,” he writes.
He cites the example of rules that force patients to pay the whole cost (including the gap) of radiology services upfront.
“This is a cost burden that may discourage patients from undergoing diagnostic imaging procedures which could compromise their diagnosis and treatment.”
And while large public hospitals in cities can sometimes help patients overcome some of the barriers to treatment, the red tape remains a particular problem for oncologists in private practice and for patients in rural and remote areas, Dr Karapetis says.
“MOGA recommends that immediate consideration be given to implementing more cost effective and efficient administrative processes, including the use of digital communications and approval processes, such as e-prescribing,” his submission suggests.