NSW — PEOPLE with
disabilities are being forced to lie on floors to undergo
basic medical procedures because most GPs don't have
suitable examination beds for patients who have limited
limb movement.
In some cases, wheelchair-bound
patients, and those who can't climb onto the fixed-height
beds, have to pay extra to see a specialist for basic
medical checks that could be performed by a GP.
Only 5 per cent of GP clinics in
Australia have height-adjustable examination
beds.
"We've heard from many people who
have had to lie on the floor to have prostate
examinations and Pap smears," says Sheila King, secretary
of disability support group Access for All Alliance
<http://www.accessforall.org.au/>.
"A lot of people also pay extra to
have a home visit, and that's the only way they can get
any procedures done where they really have to lie down,"
King says.
"Others just avoid going to the
doctors and miss out on getting checkups and necessary
medical care. One woman had to have lumps on both legs
biopsied and had to have the procedure while still
sitting in the wheelchair. It's dangerous and
humiliating."
King surveyed 3553 medical centres
nationally and found there were 14,008 fixed-height beds
and 719 adjustable beds.
"We're not asking for a medical
centre that has four doctors to have four adjustable
beds. Even if they just had one that they could share, it
would help."
King says patients in rural areas
often need to travel long distances to hospitals to get
access to a height-adjustable bed.
"None of the surgeries surveyed in
Katherine, Tennant Creek or Alice Springs were equipped
with height-adjustable exam beds. In the area of Western
Australia covering Perth, south to Mandurah and north to
Lancelin, in the 36 post code areas surveyed, there were
no surgeries equipped with an adjustable height
examination beds." In NSW there were only 125 adjustable
exam beds, compared with 3518 fixed-height
beds.
When it's time to have a Pap smear,
28-year-old Sydney woman Denise Beckwith has to get a
referral from her GP – who does not have a
height-adjustable bed – to see a gynecologist. She
then waits several months and pays $250 to have the
examination.
Beckwith, born with cerebral palsy,
has limited movement in her legs prohibiting her from
climbing onto the fixed-height beds.
"When I had my first Pap smear at
age 18, I had it done on a fixed bed, in a GP clinic. My
legs went into spasms, and the doctor tore me and I bled
profusely. So now for something that would take 10
minutes in a GP's office I have to get a referral to the
specialist who has the right bed.
"I got a referral in May but I
can't get an appointment until August and it costs $250.
I don't mind, but I shouldn't have to pay extra for a
procedure that a GP could do if they had the right
equipment."
Beckwith says the lack of suitable
examination beds makes it difficult for her to have
regular health checkups. "I have a disability and I don't
want to be sick with any other additional problems. I
want to stay as healthy as possible, so I try to go to
the doctor for any check-ups I need. But it's hard for my
legs to bend, so this is an added problem."
Australia's Human Rights
Commissioner Graeme Innes says the lack of adjustable
beds "is probably a breach of disability discrimination
legislation".
"People with disabilities could
lodge complaints against doctors around the country who
don't have these beds," he says. "We think that would be
an unproductive and negative way to deal with the
problem. We would prefer doctors and the Government to
work together to make these beds available in doctors
surgeries."
Innes says the lack of adjustable
beds also poses a health threat for the medical staff
required to lift patients onto fixed beds.
"If the exam table is not at
wheelchair height, a patient who uses a wheelchair may
need to be lifted up onto the table. This can cause back
and other type of injuries to the GP and his or her
staff. It's a serious Occupational Health and Safety
issue for doctors and staff who have to lift patients, so
there are good reasons to act."
Innes, who met federal Health
Minister Tony Abbott to discuss the matter, says
disability support groups will continue to hold meetings
with doctors' groups and health authorities to resolve
the issue. A spokeswoman says the minister has asked the
federal health department to consider the
problem.
But Australian Medical Association
Council of General Practice chairman Rod Pearce says
doctors can't afford the beds in addition to all the
other medical equipment they need.
"The adjustable beds cost between
$2000 to $3000 – 10 times more than the fixed beds,"
Pearce explains. "GPs are expected to have all the latest
equipment for every type of medical problem."
Pearce acknowledges that the lack
of height adjustable beds is less than ideal. However, he
argues that unlike other medical specialists, GPs don't
receive financial assistance to set up their
practice.
"It's an anomaly that the
infrastructure funding for general practice comes out of
fees, whereas for most other specialities, a lot of
funding for equipment comes out of private health
arrangements, or state and commonwealth
funding.
"It's ironic that the most diverse
type of medicine, where doctors need a big variety of
equipment, they have to get all of their funding from the
Medicare fees.
"The infrastructure for general
practice has been lacking for a long time and if the
community wants a robust general practice it needs to
acknowledge that investing in infrastructure is what is
going to take to get that. It's a huge cost coming
straight out of fees – and people complain if we put
up our fees by even a dollar."
However, King argues that unlike
some medical equipment, adjustable beds could be used by
all patients.
"Everyone, even patients who don't
have disabilities, could use the adjustable beds. In
Harvey Bay, in Queenland, where I live, there are no
doctors that have adjustable beds. A manufacturer of
adjustable beds donated one to us to sell at whatever
price we wanted to try and raise money. I wrote to all
the local doctors and we offered it for $1000 and no one
took it up, and we ended up selling it to a beauty
salon."
King says ongoing meetings with
doctors during the past three years has not resulted in
the introduction of more height-adjustable beds since the
study was conducted in 2003.
People With Disability Australia
<http://www.pwd.org.au/>
president Heidi Forrest says the lack of
height-adjustable beds isn't just a problem for people
with permanent disabilities.
"This is an issue that also affects
older people, frail people and those with temporary
disabilities. It means these people are unable to access
preventative health care and that can lead to long-term
health problems. This leads to greater long-term health
costs to the community. Doctors are only looking at the
short-term costs, but in the long term, this will reduce
healthcare costs."
