Page 1091 - Week 04 - Thursday, 22 April 2021

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Nevertheless, Mrs Jones’s motion brings the Assembly’s attention to the important issue of waiting times for endoscopy procedures in the public system in the ACT, and we do have challenges in our system. Some of these challenges are unique to the ACT and some are national. Nationally, waiting times for endoscopy procedures are a challenge for all jurisdictions. This is due in part to the high number of referrals received through the national bowel screening program. Over the last few years these referrals have grown rapidly.

The latest AIHW report on participation in the national bowel screening program shows that, in 2017-18, the ACT had a participation rate of 45 per cent compared to the national average of 42 per cent. This is good news. In the ACT, this means we receive about 150 referrals per week through the national bowel screening program. This is in addition to routine referrals through GPs. The program is an excellent initiative, as Mrs Jones has said, but it does drive a significant increase in demand for colonoscopies. These referrals from the national bowel screening program are cases which need to be prioritised and this does have an impact on wait times for category 3 patients on the list. As per the national bowel screening registry, the average rate of cancer in the National Bowel Cancer Screening Program is about 0.7 to one per cent, and significant non-cancer polyp around three per cent. All jurisdictions are having to shift and adjust their infrastructure to account for the increasing referral numbers, and this has presented significant challenges across the country.

Another factor more recently has been the impact of COVID-19, which paused all but the most urgent endoscopy procedures in the second quarter of 2020. That is why additional scopes were specifically factored into our funding boost to catch up on elective surgery and procedures from 1 July 2020.

Locally, as members present would know, the public health system is part of the broader health system, and we also face unique challenges locally with accessibility and affordability of the private sector. Nationally, according to the commonwealth Department of Health, more than 80 per cent of both gastroscopies and colonoscopies have no gap when completed in the private system. However, in the ACT, the jurisdiction with the highest private health insurance coverage in the country, that number is just 42 per cent and 34 per cent of patients respectively for gastroscopies and colonoscopies who do not pay a gap. Just so no-one is in any doubt, no other jurisdiction is below 70 per cent. In addition, for those that do pay a gap, which for Canberrans is more than double the rate nationally, the ACT is the most expensive jurisdiction for both procedures.

In a policy reality where the commonwealth encourages private health insurance uptake through taxation policy and subsidies to reduce demand on the public health system, the high out-of-pocket cost reduces the likelihood of the use of private health insurance in the ACT. Ultimately, this puts further pressure on the public system as the only financially accessible option for many Canberrans.

However, there are elements that the ACT government can control. I am happy to say, Mrs Jones, but I know you will be disappointed to hear, that we are working on this. To address the impacts I have outlined, Canberra Health Services is proactively


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