Emergency Ambulance Services

The Hon. R.A. SIMMS (16:53): I move:

That this council—

1. Acknowledges that access to emergency ambulance services is a critical health service;

2. Notes that the cost of an emergency ambulance service is $1,171, plus a per kilometre fee of $6.70;

3. Recognises that the cost of an emergency ambulance service is more than the fortnightly rate for a single full age pension;

4. Acknowledges that South Australia is the only jurisdiction in the nation that does not provide free emergency ambulance services to people on the full age pension;

5. Notes that emergency ambulance services are free for all residents in Queensland and Tasmania;

6. Notes that COTA SA is calling on the state government to provide free emergency ambulance services for all older South Australians on a full age pension; and

7. Calls on the Malinauskas government to waive the cost of emergency ambulance services for all full age pensioners in their upcoming budget.

As we age, our goal is to live well and maintain good health and independence but, unfortunately for some, declining health and chronic conditions can impact on wellbeing and quality of life. Emergency visits to hospital have become a regular occurrence for a significant proportion of older people as they manage chronic illness and declining health. The statistics clearly show the demand. Australians aged 65 and over made up 43 per cent of the 11.6 million hospitalisations and 21 per cent of the 8.8 million emergency department presentations in the 2021-22 financial year in Australia.

Emergency transportation to hospital via ambulance with the state's highly regarded paramedic service delivering treatment, has become an integral component of our public healthcare system and a lifeline for many older South Australians managing chronic and urgent medical conditions.

While emergency treatment in our public hospitals is free, funded through Medicare, and indeed going to be enhanced further following the re-election of the Albanese government, the unexpected and unplanned urgent journey to an emergency department is not free in South Australia. No other state or territory across the nation charges full age pensioners for emergency ambulance services, and Queensland and Tasmania do not make their residents pay at all for this critical service.

In South Australia, the SA Ambulance Service is a user-pays service, with emergency transportation costing $1,171 plus a per kilometre fee of $6.70. The SA Ambulance Service advises that pensioners may be eligible for concession of these fees. Ambulance insurance is available from SAAS or from private health providers. However, for many pensioners, private health insurance is already out of reach, let alone the traditional cost of ambulance cover. A recent national survey indicated that 45 per cent of full age pensioners responding did not have private health insurance and 53 per cent of respondents with cover indicated they would need to cut costs just to maintain it.

The Greens believe that every South Australian should be entitled to the best healthcare system possible and this includes access to an ambulance when you need it. We believe that ambulance cover should be free for all South Australians, but at least providing a free ambulance service for pensioners is critically important, particularly as our state continues to grapple with the cost-of-living crisis, and we know that many older South Australians are really struggling at the moment.

South Australians should not have to feel like they need to have private health insurance or ambulance cover to be able to access services or to get top quality care. We know, after much consultation with older South Australians, that cost of living is the issue most impacting on them currently, followed closely by health services.

Research from the SA Council of Social Service (SACOSS) suggests that many people are not calling an ambulance when they need one because they fear the cost. The cost of an emergency ambulance service is more than the fortnightly rate for a single full age pension. So we are asking people who might be in trouble, who find themselves in the unfortunate position of needing to call an ambulance, to pay more than the fortnightly payment they would receive for a pension if they do not have cover. That is outrageous. Whilst the Malinauskas government has done some good work during this term in terms of addressing the cost-of-living pressures faced by South Australians, this is something they should do.

Rising energy costs over the last decade, the latest cost-of-living burden and escalating insurance premiums for home and car insurance leave age pensioners on fixed incomes with very little leftover in their household budgets. Older South Australians are making hard decisions about whether they heat or cool their home, whether they put food on their table or whether they fuel their car. Many live on low and fixed incomes with little room for unexpected bills. This financial hit, whether it be payment for ambulance insurance or payment for the ambulance service, is a burden that older people living in other states and territories simply do not have to bear.

This means that a number of older South Australians will make the difficult decision not to call an ambulance when they are in need of emergency medical help. Anecdotal evidence shows that some pensioners are preferring to call cabs or are putting off seeking emergency medical help rather than footing the expense of an ambulance call-out.

It has been suggested that free ambulances for full age pensioners will lead to escalating demand for the service and compound ramping across public hospitals. I find that a ridiculous proposition. The idea that someone would call an ambulance just for the fun of it is really ludicrous. Let's keep in mind that every other state and territory provides free ambulance services for full age pensioners, and there is no evidence that this has made ramping worse in those jurisdictions. Research in both Queensland and Victoria did not find a sustained spike in call-outs linked to free ambulances for older people. The experience of other jurisdictions should be reassuring for the state government.

Currently, the SA Ambulance Service is forced to spend money chasing down people who do not pay their bill, and it writes off many millions of dollars of debt every year due to unpaid ambulance fees. Many of these bills would be in the name of older South Australians who just cannot afford to pay. Again, there are potential savings to be made for the SA Ambulance Service. It is time for South Australia to catch up with the rest of the country and ensure that no full age pensioner has to ride it out and be forced to choose between financial stability and their health.

The Greens are calling on the Malinauskas government to fund this in their upcoming state budget. I want to let members know that I plan to bring this motion to a vote during our next sitting period so that we can send the Malinauskas government a very clear message as they craft their budget.

Debate adjourned on motion of Hon. I.K. Hunter.