Quick questions on Equity and access to health care: HSC Health and Movement Science Focus Area 1

Remote and very remote Australia has fewer GPs per capita, fewer specialists, longer travel times, fewer hospitals and limited allied health. The Modified Monash Model classifies locations by remoteness, and workforce data show steep falls in service density from major cities to remote areas.

Out-of-pocket costs, gap fees, transport costs, lost income from time off work, and the cost of services outside Medicare (most dental, most allied health). Even small co-payments deter use by lower-income groups; the AIHW reports cost-related deferral of care, dental visits and prescriptions.

Limited cultural safety in mainstream services; staff that do not reflect the communities they serve; English-only health information; clinical encounters that miss culturally specific concerns. This is particularly significant for Aboriginal and Torres Strait Islander Australians, recent migrants and refugees.

Working-hours-only services, long appointment waits, complex booking systems, and services concentrated away from where people live or work. Affects shift workers, carers, parents and the time-poor.

Understanding the system, knowing when and where to seek care, navigating online booking, telehealth and the My Health Record. Digital exclusion (no smartphone, no data, low digital literacy) creates a second-tier barrier.

Real and perceived discrimination in services (racial, gender, sexuality, disability, mental illness, weight) delays presentation and reduces continuity.

Commonwealth payments to GPs who bulk-bill concession card holders, children and pensioners, including the tripling of the bulk-billing incentive announced in 2023, specifically targeting financially sensitive groups.

A regulated workforce category, trained and embedded in ACCHSs and some mainstream services, providing culturally safe primary care, health promotion and clinical assistance. Combined with Aboriginal Health Practitioners (a separately regulated profession), this workforce is central to the NACCHO model.

Delivers emergency aeromedical retrieval, GP and primary care clinics, dental, mental health and telehealth across remote and very remote Australia. Long-standing example of a service designed around geographic equity.

Medicare-funded telehealth, expanded significantly during the COVID-19 pandemic and partly retained, lowers the geographic and time barriers for many consultations. Limits: requires connectivity and digital literacy; not appropriate for physical examinations and acute presentations.

State-funded refugee health services in NSW, Victoria and other jurisdictions provide initial health assessments, immunisation catch-up, mental health support and translated information; Translating and Interpreting Service (TIS National) supports clinical consultations.

Dedicated services (e.g. ACON in NSW, Thorne Harbour Health in Victoria) provide community-led, culturally appropriate primary care, mental health and sexual health services for LGBTQI+ Australians, addressing documented stigma in mainstream care.

Women's health centres and dedicated men's health initiatives address differing presentation patterns (men present later, women carry more unpaid caring load, gendered conditions need dedicated services).

Distinguish between equity and equality in health care, using one example. [3 marks]

Identify three barriers to access for Australians living in remote areas, and for each, describe a strategy used to address it. [6 marks]