Easy access to city radiotherapy remains a huge problem for Australian patients living in rural locations. This is particularly important for patients seeking financial assistance for cancer patients. This is given the fact that Australia is a huge country where individuals living in remote or far off locations may have a hard time getting to facilities where radiation therapy is readily available. Other than geographical constraints there may also be other factors like financial limitations, social or psychological deterrents that limit such access for individuals.
Among the various types of hindrances facing radiation therapy patients, the following needs to be mentioned:
Perhaps the most obvious of all obstacles, rural demographics have a significant role to play in accessing specialized health care treatments such as radiotherapy. Based on the 1996 censes, 29% of Australians reside in rural locations away from urban centres. This portion of the demographics is also likely to be among the lower socio-economic sections of the society.
Figures also reveal that with more than 50% of cancer patients being over the age of 65, and living in rural Australia, this further means that they are on a reduced fixed income and pension. Having to cope with the costs of radiation therapy for such a population may in itself be very overwhelming.
But pensioners aside, even those individuals who may still be in the workforce are likely to be making less money than others who reside in big urban centres. When the seven weeks of lost income pertaining to the radiation therapy along with accommodation and travel expenses are put in the mix, the financial expectations can become rather staggering for these individuals. Were any alternate methods of treatment be made available to this part of the population, their plight for seeking radiation therapy may well be reduced significantly.
Another demographic that features in this category is that of mothers with families. Here, problems may arise out of social separation rather than financial hardships, but still contribute to accessing the preferred method of treatment. Consequently, many women resort to having a mastectomy done than pursue radiation therapy.
Even if radiotherapy sessions are secured by patients living in remote locations, travelling to the facility itself poses a problem. Although there are a number of funded transport schemes available to assist rural patients, none of them meet the needs of radiation therapy patients who need to go in for daily sessions of 5 days a week for a period of 7 weeks.
It becomes very difficult for some patients to stay away from their family for prolonged periods as may be required by radiation therapy treatment. The problem may become severely aggravated for some since the cost of accommodating accompanying caregivers is not typically contributed by government funded patient accommodation and travel schemes, unless there are physical limitations requiring so.
Rural patients will naturally expect to incur extravagant costs when seeking radiation therapy in urban centres. Even though government patient assistance schemes are meant to help individuals seeking specialist treatment not available locally, the guidelines can easily differ from one state to the other. Most work on a system of partial reimbursement of accommodation and travel expenses for individuals who reside outside a specified distance from the treatment facility.
However, for radiation patients certain difficulties have been pointed out where a full upfront payment is required by the patient prior to making a claim for reimbursement. Patients are also required to pay a non-reimbursable fee of $30-$35 for every visit and can experience long delays in the reimbursement of expenses. Where there is a carer involved, there is no reimbursement for the accompanying individual.
Lack of printed material for patients
There seems to be lack of adequate information available to patients regarding their treatment options. Decisions regarding foregoing or undergoing radiotherapy can only be made when patients have access to proper material educating them about their choices. For many radiotherapy patients, this material is neither available in surgeons’ waiting rooms nor at the general practitioners’. Instead it is typically found in waiting rooms at oncology centres where attending patients have already decided to opt for the treatment.
Material should not only be available in English, but also in other languages that cater to multi-culturally diverse patients.
Educating the support staff
A common consumer complaint regards the lack of general practitioners’ and nurses’ knowledge about what is actually involved in radiation therapy and the extent and severity of its side effects. Stress needs to be laid on making more information available to such medical staff so they can thoroughly answer patients’ queries about the treatment.
Role of charitable and voluntary organisations
There are a number of organisations that work toward the goal of lowering the strain of city treatment for rural cancer patients. One such organisation is the Cancer Patients’ Assistance Scheme in NSW that operates its own city accommodation complex. The complex grants inter hospital support, side effects management support as well as supplies support to patients. Accommodation for family members is also taken care of and the organisation works toward raising money to assist rural patients with the costs involved in the treatment.
Consumer representation for rural patients
More representation should be given to rural patients at all levels of decision making. Since they are already at a disadvantage given location and financial circumstances, they need to be represented well by the government, as well as other advocacy and support groups. More funds are recommended to be made available for treatment plans for rural patients as they have to incur significant expenses for traveling and accommodation. Plus there is the fact that they also lose time that is lost from taking a leave of absence from work.
Even though circumstances for accessing radiation therapy for rural patients has improved over time, there is still a lot that needs to be done. Patients still face problems securing treatment facilities in urban centres so more needs to be done by the Patients’ Accommodation and Travel Schemes to ensure that all radiotherapy patients can be successfully accommodated in such treatment plans.