Victorian ophthalmology service planning framework

28 Victorian ophthalmology service planning framework
Cost of eye care services
Affordability of ophthalmology services has been identified as a significant barrier in
both metropolitan and rural Victoria. While ophthalmology services are generally well
geographically distributed, not all public hospitals provide ophthalmology services.
For some patients, especially those in rural Victoria, the only options to access
ophthalmology services include visiting a private provider, or travelling to Melbourne
or another rural area to access treatment at a public facility.
While the affordability of private services is a concern, some providers reported positive
experiences with private clinics collocated with public hospitals:
‘In public hospitals where the initial entry point is a collocated private clinic,
an appointment can be arranged over the phone and there is usually a written
response from the ophthalmologist once they have seen the patient. The
disadvantage is if the collocated private clinic does not bulk bill pensioners.
There do not seem to be any disadvantages in terms of surgical outcomes.
Further consideration of the public/private collaborations in public health
care may have some benefits.’
Some private ophthalmology clinics collocated with public hospitals have equipment
and infrastructure provided by the hospital, in return for treating public patients with
no out of pocket expenses.
A report by the Brotherhood of St Laurence, Seeing clearly: Access to affordable
eyecare for low income Victorians (Diviney & Lillywhite, 2004), found that where public
ophthalmology services were available, long waiting times for initial consultations were
considered a barrier to access. In areas such as Shepparton, with no public provision
of eye surgery, patients choose between paying for private surgery or travelling to
Melbourne or another rural hospital to access treatment at a public facility.
As well as the barriers to accessing public eye care services, there was considerable
criticism by consumers and consumer representatives about the cost of glasses and other
visual aids. Consumer representatives with experience of lower socioeconomic patients
were strongly critical of the costs associated with prescription glasses, claiming it acted
as a serious deterrent for many who needed corrective lenses. This was reinforced by
consumers who admitted deferring visits to the optometrist, even knowing their eye sight
was deteriorating, because they could not afford new glasses.
The VES provides eye tests and glasses at a nominal cost for Victorians who hold a
pensioner concession card (or have a health care card for at least six months) and their
dependants under the age of 18 years. The VES is funded by the department and is run
by the VCO. Rural patients can have their eyes tested and glasses prescribed through
a network of optometrists and ophthalmologists participating in the service. The RVEEH
and RCH also provide subsidised glasses to their patients.