Latest news with #RachelDavid
ABC News
08-06-2025
- Health
- ABC News
Calls for changes to mental health funding as Toowong Private Hospital announces closure after nearly 50 years
The financially strapped Toowong Private Hospital in Brisbane will close this week amid concerns seven other private mental health hospitals across the country are at "imminent" risk of collapse. Australian Private Hospitals Association chief executive Brett Heffernan blamed "rapacious profiteering" by health funds over three years as the over-arching reason for the 58-bed hospital's closure and the potential loss of more private psychiatric facilities. But Rachel David, Private Healthcare Australia's CEO, who represents health insurers, rejected the accusation. She's calling for a new model of funding for mental health care, saying psychiatrists were not admitting as many of their patients to hospitals. "Even if we were to double what we paid hospitals it still wouldn't stop the closure of more stand-alone mental health facilities," Dr David said. "There is a strong preference … only to treat the most severely unwell patients in hospital." For Toowong Private Hospital patients, such as Rebecca Kuenstner, who has been going to the facility in Brisbane's west for almost nine years, it has been a place of healing. "This has probably been the best thing that's ever happened to me," she said through tears. "It gave me a family pretty much. It's given me that sense of belonging really. "Especially when you live alone, it's quite difficult not having that support." Ms Kuenstner, 37, a former member of the Australian Defence Force who was medically discharged in 2014, has benefited from being an inpatient at Toowong Private Hospital, as well as completing courses there designed for people with post-traumatic stress disorder (PTSD). "I do come here quite regularly," she said. "You can come back and it's a very open space where you don't feel judged at all so you can go back and enjoy a cup of tea and chat to them. "That connection is probably the most important one after you're discharged so you're not left on your own. That was a very important part of my journey." She said she was barely able to leave home when she first started attending the hospital in 2016. The Toowong hospital, which treated 3,000 patients annually and would have celebrated half a century of operation in May next year, was expected to close on Wednesday. Its administrators said in a statement they were still investigating the reasons for its failure but "it is understood that the hospital was operating at a loss for several years". Mr Heffernan, who represents more than 600 private hospitals across Australia, said one major health fund had refused to renegotiate an annual contract with the hospital for 13 months. Another group had "simply refused point blank to contract with the hospital at all". The Toowong hospital closure comes as a cloud also hangs over 37 private hospitals run by Healthscope, which went into receivership late last month after its lenders withdrew support. However, Mr Heffernan said it was important to differentiate the Healthscope financial woes from the rest of the sector. "It's fair to say that Healthscope has had its own unique problems over a number of years in terms of its financial position and its financial management," he said. "What the rest of the sector is facing is a rampant health insurance industry." Mr Heffernan described Toowong Private's closure as "a massive loss to mental health". "We have a mental health crisis in this country and for an exemplar hospital to be forced out of business due to purely and simply the greed of the health insurers and the negligence of a federal government, that has known about this for two-and-a-half years but refused to act, is unfathomable," Mr Heffernan said. "Toowong is just the tip of the iceberg moving forward. We've been advised by eight of our members, in addition to Toowong, that they are in a similar situation facing imminent closure, seven of those are mental health facilities. Mr Heffernan did not want to name the hospitals publicly for fear of distressing patients and staff. He said the Toowong hospital had opened its books to Federal Health Minister Mark Butler more than two years ago to explain a shortfall in its funding. "Two months ago, the federal health minister laid down the gauntlet to the insurance industry saying you need to fix your house, you need to pay more of what you are taking to the actual providers of health care, being the hospitals," Mr Heffernan said. "We're two months down the track, nothing has changed. Our expectation at this point is that the federal government has no choice but to act, to intervene and to regulate the private health insurers to ensure that the traditional ratio of at least 88 cents in the dollar from premiums flows through to the actual providers of health care rather than just filling health insurers' coffers." In a statement, Mr Butler said he had called on insurers to "urgently increase the amount they pay out for hospital services and restore funding equilibrium across the sector". He said the federal government would continue to work on "long-term reforms to support the sustainability of the private health sector". "Ultimately, the solutions lie with insurers and hospitals working together," Mr Butler said. He has created a forum of private hospital and health fund CEOs with the Australian Medical Association and some patient groups to discuss potential solutions. "I've put a range of ideas that I want them to consider seriously about changes, particularly to mental health services," Mr Butler said. Dr David, who has represented health funds including big insurers such as Bupa, Medibank Private and NIB since 2016, would like to see them able to fund some of the costs of outpatient specialist appointments. She said some consumers were avoiding seeing a private psychiatrist in their consulting rooms because of fees of up to $988 for a first consultation. "We need a funding model that takes account of the fact that because of improvements in medication and techniques and medical understanding, a lot more mental health treatment is taking place in the community now than it did in the 1980s and 1990s," Dr David said. "I think that health funds do need the opportunity to be more flexible in how they fund mental health care, given we are in … a mental health crisis." While she's "still shocked" at the hospital's pending closure, Rebecca Kuenstner said she was yet to feel anger, adding with a laugh: "I've had a lot of therapy". "Moving forward, I haven't found where I'm going to be going to or where my support's going to be in the future … if I need help," she said.
News.com.au
05-06-2025
- Business
- News.com.au
‘Up for thousands': Medical costs see ‘huge variability' around Australia
Private Healthcare Australia CEO Rachel David discusses the 'huge variability' in medical costs around Australia. 'There is a huge variability around the country, if you live in an area where household incomes are high and the number of doctors are constrained … you're much more likely to have a high out of pocket cost,' Ms David told Sky News Australia. 'In some specialties too … people were being charged upwards of $900 for an initial consultation and maybe half that for future consultations.'
The Advertiser
30-05-2025
- Health
- The Advertiser
Insurers accused of 'playing people for mugs'
Health insurers are spending more but leaving Australians with higher out-of-pocket expenses, sparking scorn from private hospitals. A record $12.3 billion was dished out by private health insurers in the year to March, according to official data released on Friday. But the same data shows the average Australian is paying $470.80 per hospital visit, about $46 more than a year earlier. The average gap for general treatments rose $3 to $61.64 per service. Insurers also covered less for services like accommodation, nursing, medical services and medical devices in the March quarter, compared with the December quarter. Private hospitals - already suffering workforce shortages and rising costs for supplies - say insurers were being unfair to patients by allowing gaps to increase. "Welcome to private health insurance in the modern era, too tricky by half in trying to play people for mugs," Australian Private Health Association chief executive Brent Heffernan said. "If it costs me $10 to provide a service and you pay me $8, I'm $2 out of pocket. "Next year it costs me $15 to provide that service and you pay me $10, so I'm even worse off despite you paying me more than you did last year." Insurers say they are spending $61 more per person from last year to this year. This is despite technology and changing clinical practice meaning people have shorter hospital stays. They laid the blame for higher out-of-pocket claims on specialist doctors, whose consultations cannot be covered by health insurers. "Several trends have been dampening demand for private hospital care, including the high cost to see a specialist doctor in the community," Private Healthcare Australia chief executive Rachel David said. "A 7.7 per cent increase year-on-year is a good result for private hospitals that have had a hard time due to the pandemic and inflation." Almost 12.5 million people in Australia have hospital cover, or about 45 in every 100 people. About 15.1 million have general treatment cover. More than 81,000 people signed up for hospital cover in the first three months of 2025, with the largest increase coming from 40-44 year olds. The data from the financial regulator comes after the collapse of major hospital operator Healthscope after lenders voted to stop support for their parent company Brookfield. Healthscope treats 650,000 patients a year and has 19,000 staff across 37 hospitals in the nation. Insurers say they are optimistic the private system won't crumble. "We have a good supply of private hospital services across most parts of the country, so we are confident people with hospital cover will retain access to high-quality services near their homes," Dr David said. The Commonwealth Bank threw Healthscope a $100 million lifeline while fellow lender Westpac pledged to help the company sell to a new owner. Health insurers are spending more but leaving Australians with higher out-of-pocket expenses, sparking scorn from private hospitals. A record $12.3 billion was dished out by private health insurers in the year to March, according to official data released on Friday. But the same data shows the average Australian is paying $470.80 per hospital visit, about $46 more than a year earlier. The average gap for general treatments rose $3 to $61.64 per service. Insurers also covered less for services like accommodation, nursing, medical services and medical devices in the March quarter, compared with the December quarter. Private hospitals - already suffering workforce shortages and rising costs for supplies - say insurers were being unfair to patients by allowing gaps to increase. "Welcome to private health insurance in the modern era, too tricky by half in trying to play people for mugs," Australian Private Health Association chief executive Brent Heffernan said. "If it costs me $10 to provide a service and you pay me $8, I'm $2 out of pocket. "Next year it costs me $15 to provide that service and you pay me $10, so I'm even worse off despite you paying me more than you did last year." Insurers say they are spending $61 more per person from last year to this year. This is despite technology and changing clinical practice meaning people have shorter hospital stays. They laid the blame for higher out-of-pocket claims on specialist doctors, whose consultations cannot be covered by health insurers. "Several trends have been dampening demand for private hospital care, including the high cost to see a specialist doctor in the community," Private Healthcare Australia chief executive Rachel David said. "A 7.7 per cent increase year-on-year is a good result for private hospitals that have had a hard time due to the pandemic and inflation." Almost 12.5 million people in Australia have hospital cover, or about 45 in every 100 people. About 15.1 million have general treatment cover. More than 81,000 people signed up for hospital cover in the first three months of 2025, with the largest increase coming from 40-44 year olds. The data from the financial regulator comes after the collapse of major hospital operator Healthscope after lenders voted to stop support for their parent company Brookfield. Healthscope treats 650,000 patients a year and has 19,000 staff across 37 hospitals in the nation. Insurers say they are optimistic the private system won't crumble. "We have a good supply of private hospital services across most parts of the country, so we are confident people with hospital cover will retain access to high-quality services near their homes," Dr David said. The Commonwealth Bank threw Healthscope a $100 million lifeline while fellow lender Westpac pledged to help the company sell to a new owner. Health insurers are spending more but leaving Australians with higher out-of-pocket expenses, sparking scorn from private hospitals. A record $12.3 billion was dished out by private health insurers in the year to March, according to official data released on Friday. But the same data shows the average Australian is paying $470.80 per hospital visit, about $46 more than a year earlier. The average gap for general treatments rose $3 to $61.64 per service. Insurers also covered less for services like accommodation, nursing, medical services and medical devices in the March quarter, compared with the December quarter. Private hospitals - already suffering workforce shortages and rising costs for supplies - say insurers were being unfair to patients by allowing gaps to increase. "Welcome to private health insurance in the modern era, too tricky by half in trying to play people for mugs," Australian Private Health Association chief executive Brent Heffernan said. "If it costs me $10 to provide a service and you pay me $8, I'm $2 out of pocket. "Next year it costs me $15 to provide that service and you pay me $10, so I'm even worse off despite you paying me more than you did last year." Insurers say they are spending $61 more per person from last year to this year. This is despite technology and changing clinical practice meaning people have shorter hospital stays. They laid the blame for higher out-of-pocket claims on specialist doctors, whose consultations cannot be covered by health insurers. "Several trends have been dampening demand for private hospital care, including the high cost to see a specialist doctor in the community," Private Healthcare Australia chief executive Rachel David said. "A 7.7 per cent increase year-on-year is a good result for private hospitals that have had a hard time due to the pandemic and inflation." Almost 12.5 million people in Australia have hospital cover, or about 45 in every 100 people. About 15.1 million have general treatment cover. More than 81,000 people signed up for hospital cover in the first three months of 2025, with the largest increase coming from 40-44 year olds. The data from the financial regulator comes after the collapse of major hospital operator Healthscope after lenders voted to stop support for their parent company Brookfield. Healthscope treats 650,000 patients a year and has 19,000 staff across 37 hospitals in the nation. Insurers say they are optimistic the private system won't crumble. "We have a good supply of private hospital services across most parts of the country, so we are confident people with hospital cover will retain access to high-quality services near their homes," Dr David said. The Commonwealth Bank threw Healthscope a $100 million lifeline while fellow lender Westpac pledged to help the company sell to a new owner. Health insurers are spending more but leaving Australians with higher out-of-pocket expenses, sparking scorn from private hospitals. A record $12.3 billion was dished out by private health insurers in the year to March, according to official data released on Friday. But the same data shows the average Australian is paying $470.80 per hospital visit, about $46 more than a year earlier. The average gap for general treatments rose $3 to $61.64 per service. Insurers also covered less for services like accommodation, nursing, medical services and medical devices in the March quarter, compared with the December quarter. Private hospitals - already suffering workforce shortages and rising costs for supplies - say insurers were being unfair to patients by allowing gaps to increase. "Welcome to private health insurance in the modern era, too tricky by half in trying to play people for mugs," Australian Private Health Association chief executive Brent Heffernan said. "If it costs me $10 to provide a service and you pay me $8, I'm $2 out of pocket. "Next year it costs me $15 to provide that service and you pay me $10, so I'm even worse off despite you paying me more than you did last year." Insurers say they are spending $61 more per person from last year to this year. This is despite technology and changing clinical practice meaning people have shorter hospital stays. They laid the blame for higher out-of-pocket claims on specialist doctors, whose consultations cannot be covered by health insurers. "Several trends have been dampening demand for private hospital care, including the high cost to see a specialist doctor in the community," Private Healthcare Australia chief executive Rachel David said. "A 7.7 per cent increase year-on-year is a good result for private hospitals that have had a hard time due to the pandemic and inflation." Almost 12.5 million people in Australia have hospital cover, or about 45 in every 100 people. About 15.1 million have general treatment cover. More than 81,000 people signed up for hospital cover in the first three months of 2025, with the largest increase coming from 40-44 year olds. The data from the financial regulator comes after the collapse of major hospital operator Healthscope after lenders voted to stop support for their parent company Brookfield. Healthscope treats 650,000 patients a year and has 19,000 staff across 37 hospitals in the nation. Insurers say they are optimistic the private system won't crumble. "We have a good supply of private hospital services across most parts of the country, so we are confident people with hospital cover will retain access to high-quality services near their homes," Dr David said. The Commonwealth Bank threw Healthscope a $100 million lifeline while fellow lender Westpac pledged to help the company sell to a new owner.
Perth Now
30-05-2025
- Health
- Perth Now
Insurers accused of 'playing people for mugs'
Health insurers are spending more but leaving Australians with higher out-of-pocket expenses, sparking scorn from private hospitals. A record $12.3 billion was dished out by private health insurers in the year to March, according to official data released on Friday. But the same data shows the average Australian is paying $470.80 per hospital visit, about $46 more than a year earlier. The average gap for general treatments rose $3 to $61.64 per service. Insurers also covered less for services like accommodation, nursing, medical services and medical devices in the March quarter, compared with the December quarter. Private hospitals - already suffering workforce shortages and rising costs for supplies - say insurers were being unfair to patients by allowing gaps to increase. "Welcome to private health insurance in the modern era, too tricky by half in trying to play people for mugs," Australian Private Health Association chief executive Brent Heffernan said. "If it costs me $10 to provide a service and you pay me $8, I'm $2 out of pocket. "Next year it costs me $15 to provide that service and you pay me $10, so I'm even worse off despite you paying me more than you did last year." Insurers say they are spending $61 more per person from last year to this year. This is despite technology and changing clinical practice meaning people have shorter hospital stays. They laid the blame for higher out-of-pocket claims on specialist doctors, whose consultations cannot be covered by health insurers. "Several trends have been dampening demand for private hospital care, including the high cost to see a specialist doctor in the community," Private Healthcare Australia chief executive Rachel David said. "A 7.7 per cent increase year-on-year is a good result for private hospitals that have had a hard time due to the pandemic and inflation." Almost 12.5 million people in Australia have hospital cover, or about 45 in every 100 people. About 15.1 million have general treatment cover. More than 81,000 people signed up for hospital cover in the first three months of 2025, with the largest increase coming from 40-44 year olds. The data from the financial regulator comes after the collapse of major hospital operator Healthscope after lenders voted to stop support for their parent company Brookfield. Healthscope treats 650,000 patients a year and has 19,000 staff across 37 hospitals in the nation. Insurers say they are optimistic the private system won't crumble. "We have a good supply of private hospital services across most parts of the country, so we are confident people with hospital cover will retain access to high-quality services near their homes," Dr David said. The Commonwealth Bank threw Healthscope a $100 million lifeline while fellow lender Westpac pledged to help the company sell to a new owner.
Sky News AU
27-05-2025
- Business
- Sky News AU
'No amount of money' could have saved Healthscope during 2024 private health insurance attack, Rachel David declares
There was 'no amount of money' that could have saved Healthscope as it was waging war against private health insurers in 2024, a leader in the medical industry has declared. Healthscope was forced into receivership on Monday after the debt-laden hospital operator was handed from its Canadian owners Brookfield to its lenders earlier this month. Commonwealth Bank of Australia has issued the company a $100m lifeline to ensure all of Healthscope's hospitals will remain open and operate as usual. The collapse follows Healthscope launching an aggressive advertising campaign in 2024 to allege private health insurers were not paying their fair share to fund private hospitals. Private Healthcare Australia's CEO Rachel David on Tuesday hit back at Healthscope when questioned about the operator's campaign on Sky News' Business Now. 'There is no amount of money that health funds or the government could have thrown at Healthscope at that point which would have made up for the terrible business decisions made by Brookfield,' Ms David said on Tuesday. She singled out Healthscope's $5.7b sale, which was regarded as overvalued, in 2019 to Brookfield and the decision to sell 22 hospitals for $2.5b to foreign investors before leasing them back to the operator for high rents. 'In a situation like that, there is no amount of money that health funds could have put their hands on that would have resulted in a different outcome,' Ms David said. 'We have to be mindful that … consumers have got to be able to afford their premiums. 'The advertising campaign was a misstep, but now that we're in a situation where new owners can take over ... myself and the private health insurance industry is incredibly optimistic that the private hospital sector will come through this and be able to deliver much more modern and attractive models of care for our patients.' Healthscope faced troubles during the pandemic when patients halted their elective surgeries, leading to major downturns for private hospitals. The uptick in at-home treatment, which was bolstered by private health insurers, also came as a sting to Healthscope as lengthy hospital visits became less necessary. The company has also been marred with controversies, including the death of a two-year-old boy last September, a cancer patient having the wrong side of his colon removed in 2019 and the death of a 17-year-old boy suffering from anaphylaxis in 2021. Healthscope's CEO Tino La Spina told reporters on Monday he is confident there will be a buyer to take over the business. 'I think we're confident that there is interest in taking the Healthscope business as a whole. We have 10 non-binding indicative offers,' Mr La Spina said. 'Some are for the whole (business) and others potentially could include the whole (business) under certain circumstances. That is the focus.' Health Minister Mark Butler said Labor will not bail out the embattled healthcare company amid its financial troubles. 'We remain steadfast in our view that an orderly sales process that maintains the integrity of the entire hospital group will provide the best outcome for patients, staff, landlords and lenders,' Mr Butler said. However, he did stress the hospitals operated by Healthscope 'remain a critical part of our healthcare system'. 'The government does not want any of these important assets to be put in jeopardy to satisfy international investors,' Mr Butler said.
