‘I didn’t go to the GP because I couldn't afford it’: a health system in crisis

When Emma’s gastrointestinal and menstrual issues flared up, the Uni student couldn’t afford to see a GP. When she could eventually afford an appointment – then came the waitlist. How we can change the conversation on healthcare access.

Full-time university student Emma suffers from chronic gastrointestinal and menstrual issues. With limited finances, she says she recently stopped going to the doctor which has become too costly for her.  

“There were about four months at the back end of 2024 where I didn’t book in another specialist and I didn’t go to the general practitioner’s (GP) because I just couldn’t afford it,” says the19-year-old, who is only able to work casual shifts around her study commitments.  

Emma isn’t alone in dealing with her chronic illnesses. In 2022–23, 60 per cent of Australians (10.2 million) who visited a GP in the last 12 months had a long-term health condition according to data from the Australian Bureau of Statistics.

Emma says her doctor's appointments can be anywhere around the $100 mark, ultrasounds have cost her approximately $300 and specialist appointments can be up to $400 – and then there’s the cost of medication on top of that.  

Fortunately for Emma, her parents agreed to help cover some of these costs so she could get her health back on track – a decision she says she’s extremely grateful for.  

“If it wasn’t for their help, I would kind of just have to suck it up a bit because I have other things in my life that I need to be able to afford and I don’t have hundreds and hundreds of dollars to dish out on repeat doctor's appointments.”  

But it’s not just the cost that has been a barrier for Emma. She says the wait times to see a specialist, and even just a regular GP, are hindering her path to health.  

“It’s just hard when I’m trying to sort out issues now, but I have to wait months before I can even start to get the ball rolling.”  

A healthcare system under strain 

Australia's healthcare system is often praised by our leaders in the highest office, but it’s a system that across the nation is under increasing pressure. It’s struggling with an ageing population, a cost-of-living crisis making it more expensive and difficult to see a doctor, and chronic staff shortages.  

Thirty-one per cent of South Australians ranked access to quality healthcare and community care as one of their main concerns in the Flinders Wicked Problems Report. 

Long waitlists for medical procedures, limited access to adequate public healthcare, including emergency care and mental health services, access to rural and regional services, and access to aged care and social services are the most pressing issues.  

Data from the Australian Institute of Health and Welfare revealed that across Australia there were 65,000 public hospital beds available, on average, in 2022–23 – representing 2.5 beds per 1,000 population. 

New thinking in healthcare delivery models, whole-of-system approaches, and infrastructure improvements is critical in order to address a health system in crisis. Increased investment in health promotion, primary healthcare and preventive health is needed, especially for marginalised communities. Links between the health and social care systems need to be enhanced, and strengthening emergency services, addressing workforce challenges, and improving regional access is crucial. 

Technology easing the pressure on our healthcare systems  

To help find solutions to some of these issues, research from Flinders University is using new technology to improve healthcare systems and reduce the pressure on EDs.  

One major concern across the nation is the issue of ambulance ramping. In South Australia the time ambulances spend waiting has increased from 500 hours per month in 2017 to around 4,000 hours per month in 2024, according to data from the South Australian Government. There are multiple factors at play causing this issue such as bed shortages, staff shortages, and some people who are incorrectly presenting at the ED instead of their GP. 

One way to help ease the pressure on our struggling hospitals is by the use of virtual ED’s, which Flinders University is testing for effectiveness and best practice. These virtual ED’s allow patients to talk to a specialist emergency doctor from the comfort of home using a phone or video chat which can reduce the number of people going to the hospital. Flinders Professor, Jonathan Karnon is leading the research to see which methods work best and how they can be improved.  

“Virtual EDs have a potentially important role in managing demand for our public hospital system, however across South Australia, Western Australia, Victoria, New South Wales and Queensland where the various services have all been set up independently from each other, we see five separate systems with distinct differences in how they operate,” says Professor Karnon.  

“We want to look at each service available and learn from all of them, with the aim being to support the states to work out what is the best way to provide their particular virtual ED service and find improvements in their implementation and design for the betterment of patients.”  

Another way to ease the pressure on our healthcare systems is to make them more efficient via the development of an automated workflow system to reduce the administrative tasks for nurses and doctors. Flinders' Digital Health Research Lab, as part of the Flinders Health and Medical Research Institute, is creating personal assistant apps that help users manage their own health. These apps can make a big difference in managing conditions like diabetes, liver health, and mental health.  

By using these new technologies, Flinders University is helping to improve healthcare and make it more accessible for everyone.  

Helping teens on waitlists

Many Australian teenagers are waiting more than 100 days to receive specialist mental health treatment after being referred by their GP, according to research from Flinders University. 

“The wait time is a period of significant vulnerability because symptoms are acute, but treatment has not yet begun,” says Professor Bridianne O’Dea, Little Heroes Professor in Child and Adolescent Mental Health at the Flinders University Institute for Mental Health and Wellbeing. 

Now, a project from Flinders University, led by Professor O’Dea, ‘Left to their own devices’, is trying to help GPs give some psychological support to these teenagers, when they need it the most, but are stuck on waitlists.  

The project uses digital tools such as an online therapy session teens can do which aims to strengthen the brain’s capacity to cope with uncertainty, and there is an eight-week psychological program they can sign up for which delivers weekly SMS messages to build positive coping skills. 

This sort of help, which is offered instantly, is easy to access and doesn’t add more waiting time. 

The project is working with GPs from two Primary Health Networks, and researchers from the Black Dog Institute, University of New South Wales, University of Sydney, University of Melbourne, Orygen (youth mental health Australia), and Northwestern University (US).
 

At Flinders University, we are dedicated to finding solutions to complex challenges with research that matters. In a groundbreaking initiative, we asked 30,000 Australians from across the nation to voice the problems that matter to them the most in their local communities, resulting in The Flinders Wicked Problems Report. Read more here.